INWENDIGE ZIEKTEN

CENTRUM INWENDIGE ZIEKTEN/GASTRO-ENTEROLOGIE

ARTIKELS

ABSTRACT 1

Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti-TNF or conventional therapy: results of the European CONCEIVE study.

Moens A, Van der Woude C, Julsgaard M, Van Moerkercke W, et al. Alimentary Pharmacology & Therapeutics, 2020, 51(1), 129-138

INTRODUCTION Women with inflammatory bowel diseases (IBD) often receive biologicals during pregnancy to maintain disease remission. Data on outcome of vedolizumab-exposed pregnancies (VDZE) are sparse

OBJECTIVE To assess pregnancy and child outcomes of VDZE pregnancies and to compare these results to anti-TNF exposed (TNFE) or both immunomodulatory and biologic unexposed (CON IBD) pregnancies.

MATERIALS/METHODS A retrospective multicentre case-control observational study was performed.

RESULTS VDZE group included 79 pregnancies in 73 IBD women. The TNFE and CON IBD group included 186 pregnancies (162 live births) in 164 IBD women and 184 pregnancies (163 live births) in 155 IBD women, respectively. At conception, cases more often had active disease ([VDZE: 36% vs TNFE: 17%, P = .002] and [VDZE: 36% vs CON IBD: 24%, P = .063]). No significant difference in miscarriage rates were found between groups (VDZE and TNFE: 16% vs 13%, P = .567; VDZE and CON IBD: 16% vs 10%, P = .216). In liveborn infants, median gestational age and birthweight were similar between groups. Median Apgar score at birth was numerically equal. Prematurity was similar in the VDZE group compared to the control groups, even when correcting for disease activity during pregnancy. The frequency of congenital anomalies was comparable between groups as were the percentages of breastfed babies. During the first year of life, no malignancies were reported and infants' infection risk did not significantly differ between groups. CONCLUSION No new safety signal was detected in VDZE pregnancies although larger, prospective studies are required for confirmation.

ABSTRACT 2

Developing and evaluating a participatory arts programme for cancer patients and their caregivers.

Lefebvre T, Tack L, Meersman M, Vanneste H, Van Eygen K, Stellamans K, Derijcke S, Vergauwe P, Debruyne P, et al. Acta Clinica Belgica, 2020, DOI: 10.1080/17843286.2020.1773653

OBJECTIVE Cancer patients, survivors and caregivers often encounter severe distress, having significant consequences to wellbeing, functionality and physical health. This study developed and evaluated a participatory arts programme to determine if such could help to improve the wellbeing of cancer patients and their caregivers.

MATERIALS/METHODS To inform the development of a participatory arts programme, cancer patients and their caregivers at an Organisation of European Cancer Institute (OECI)designated cancer centre were asked which activities they would wish to engage in (anonymous survey one). A programme was then developed and trialled for 1 year. Following participation, we explored the satisfaction and any benefits of taking part (anonymous survey two).

RESULTS Survey one had a participation rate of 70%. In this survey, participants indicated they preferred group-based activities (61%) over an individual approachto take place on a monthly basis (46%). The developed programme ran from December 2018 to December 2019, with 435 patients and caregivers taking part. Two hundred and eighteen completed survey two and revealed a positive response to both the structure and content of the programme and its impact on the wellbeing of patients and caregivers. The majority indicated they felt (much) betterfrom participating in the participatory arts programme.

CONCLUSION This study points out the interest and potential value of a participatory arts programme to the perceived wellbeing. This suggests such programmes could be incorporated into

cancer care provision, to serve as psychosocial support. The latter is particularly relevant for improving the lives, wellbeing and health of cancer patients and those supporting them.

ABSTRACT 3

Endoscopic removal of an extraluminal, intrapancreatic dislocated common bile duct stone.

Billiet T, Holvoet A, Decock S, et al. Endoscopy, 2020, 52(2), DOI: 10.1055/a-0992-8832

Er is geen abstract beschikbaar.

ABSTRACT 4

Boerhaave's syndrome: successful conservative treatment in two patients.

Van Geluwe B, Vergauwe P, Van Moerkercke W, et al. Acta Gastroenterologica Belgica, 2020, 83(4), 654-656

ABSTRACT The Boerhaave syndrome is a spontaneous, post-emetic rupture of the esophagus and a rare but potentially fatal cause of upper gastrointestinal bleeding. There are currently no guidelines on the optimal treatment of these patients, although there is a strong tendency towards a surgical approach. We present 2 cases of male patients, 66- and 77-year old respectively, both admitted to the emergency department with hematemesis. Unexpectedly, these turned out to be caused by the Boerhaave syndrome. Based on the severity of presentation, either a conservative or endoscopic treatment was adopted, both with good outcome.

ABSTRACT 5

Capsule endoscopy: diagnosis of intestinal localisation of systemic follicular B-cell non-Hodgkin lymphoma.

Demeester J, Dewint P, Van Moerkercke W, et al. Acta Gastroenterologica Belgica, 2020, 83(1), 73-75

ABSTRACT We report the case of a 58 year old man with occult obscure gastro-intestinal bleeding (OGIB) without other significant symptoms, in which systemic localisation of follicular B-cell non-Hodgkin lymphoma was discovered trough capsule endoscopy. This case reflects the clinical significance of performing capsule endoscopy in patients with OGIB.

ABSTRACT 6

Effectiveness and persistence of Vedolizumab in patients with inflammatory bowel disease: results from the Belgian REal-LIfe study with VEdolizumab (Be-RELIVE).

Reenaers C, Cremer A, Dewit O, Van Moerkercke W, et al. Acta Gastroenterologica Belgica, 2020, 83(1), 15-23

INTRODUCTION Vedolizumab (VDZ) is a gutselective integrin inhibitor used to treat Crohn's disease (CD) and ulcerative colitis (UC). This retrospective study assessed effectiveness and treatment persistence of VDZ in a Belgian reallife cohort of CD and UC patients.

MATERIALS/METHODS CD and UC patients from 15 Belgian centers, who started VDZ between 01/09/2015 and 31/06/2016 and attended ≥1 visit after the first VDZ infusion, were included. Data were collected before first infusion, at week (W)10, W14 (CD patients only), month (M)6 and last follow-up. Treatment response and remission rates (changes in disease activity scores) and treatment persistence (Kaplan-Meier analysis) were assessed.

RESULTS Of the 348 patients receiving at least one dose of VDZ, 325 (202 CD, 45 biologic-naïve; and 123 UC, 42 biologic-naïve) patients were included in data analyses. At M6, 87.6% (176/201) of CD and 86.1% (105/122) of UC patients were still on VDZ treatment, 75.6% (34/45) and 83.9% (26/31) achieved clinical response, and 66.7% (44/66) and 42.9% (15/35) were in remission. At M6 remission rates was significantly higher while response rates tended to be higher among biologic-naïve versus biologic-failure CD patients.

CONCLUSION VDZ offers an effective treatment option in real-life settings and treatment effectiveness appears higher in bio logic-naïve versus biologic-failure CD patients.

ABSTRACT 7

Underrepresentation of vulnerable older patients with cancer in phase II and III oncology registration trials: a case-control study.

Tack L, Ketelaars L, Martens E, Stellamans K, Van Eygen K, Werbrouck P, Vergauwe P, Debruyne P, et al. Journal of Geriatric Oncology, 2020, 11(2), 320-326

OBJECTIVE We aimed to determine the proportion of “fit” versus “vulnerable” older patients with cancer included in phase II and III oncology registration trials, as compared to the proportions in a real life oncology setting.

MATERIALS/METHODS Trial and patient characteristics of older (≥70 years) patients treated at the OECI-designated clinical cancer centre in Kortrijk and included in a phase II or III oncology registration trial were collected retrospectively. These patients were matched individually with randomly-selected patients from the general oncology setting, based on gender, age, tumour type, tumour stage, and treatment intent. Patients' fitness, based on routine Geriatric-8 (G8) screening, was retrieved from prospectively constructed databases.

RESULTS Between November 2012 and October 2018, 218 older patients with cancer were included in a phase II or III oncology registration trial. Of those, 41 cases with a mean age of 76.0 years were included in the analyses. A Fisher's Exact Test revealed a statistical significant difference between cases and matched controls, with a higher proportion of “fit” patients included in phase II or III oncology registration trials compared to the proportion in the matched control group (respectively 70.7% and 41.5%, p < .010).

CONCLUSION We provide evidence for the hypothesis that older patients included in phase II or III oncology trials are significantly fitter than the real life oncology population. Some form of geriatric evaluation should be integrated in future cancer clinical trials to enable stratification according to this parameter and allow subgroup analysis. This will broaden the application and interpretation of trial results.