Miller School In Full Force at Digestive Disease Week 2024
Article Summary
- Incoming American Gastroenterological Association President Dr. Maria Abreu addressed gender equity and took part in inflammatory bowel disease (IBD) and colitis-associated cancer research forums.
- Dr. Oriana Damas discussed diet and ulcerative colitis during her DDW presentation.
- Dr. Cynthia Levy participated in a panel presentation on clinical trial evolution and innovation, focusing on enrollment strategies for diverse populations.
University of Miami Miller School of Medicine researchers participated in 43 plenary sessions, oral presentations, clinical symposiums, panel discussions, poster sessions and more at Digestive Disease Week (DDW), May 18-21 in Washington, D.C.
DDW is the premier global meeting for clinicians and researchers in gastroenterology, hepatology, gastrointestinal endoscopy, gastrointestinal surgery and related fields.
“Our presentations and involvement in a variety of other activities at DDW, including chairing oral sessions, reflects our productivity and national prominence,” said Paul Martin, M.D., chief of the Division of Digestive Health and Liver Diseases and Sol Mandel Endowed Professor of Medicine at the University of Miami Miller School of Medicine. “Our faculty and trainees presented on a variety of topics at Digestive Diseases Week, reflecting our expertise in areas including advanced endoscopy, inflammatory bowel disease and the management of chronic liver disease.”
Miller School faculty, fellows, residents and students were in full force at DDW, sharing research, networking and learning, according to Maria T. Abreu, M.D., director of the Crohn’s and Colitis Center in the Miller School’s Division of Digestive Health and Liver Diseases.
“DDW is always a special time. And to be at the meeting as part of a division that is actively pushing the field forward on so many fronts is a privilege,” said Dr. Abreu, who at the end of May will become president of the American Gastroenterological Association (AGA), the principal society at DDW. Dr. Abreu will be the fifth woman and first Latina to lead the global organization of more than 16,000 members. “We strive in academics to create new knowledge and to embrace new knowledge, and all of those things were on full display with our University of Miami group at DDW. I couldn’t be prouder to work with such an exemplary group of people.”
Dr. Abreu took part in panel discussions, including one about the AGA Gender Equity Project, and inflammatory bowel disease (IBD) and colitis-associated cancer research forums. She also participated in professional development and leadership clinical symposia. Her lab’s research was featured in DDW oral and poster sessions.
“We presented our work on a multitude of topics, including fundamental research, such as some of the work that we are doing to define how gut bacteria activate pathways that result in colon cancer, especially in people with inflammatory bowel disease,” Dr. Abreu said. “DDW featured our group’s research to understand the genetics of Crohn’s and colitis in Hispanic patients.”
Diet and Ulcerative Colitis
Oriana M. Damas, M.D., associate professor of medicine and director of translational studies for the Crohn’s and Colitis Center at the Miller School, presented on the timely topic of diet and ulcerative colitis.
“There are no studies that examine diet in very active ulcerative colitis. Few studies have looked at the role of diet in enhancing response to medication. We also lack data on dose-response relationships between diet and the threshold of what’s effective in terms of achieving anti-inflammatory properties,” Dr. Damas said. “With that in mind, I created a clinical trial looking at how using intervals of a diet, which has the premise of a low-calorie, plant-based, high-fiber diet, can improve clinical response to medications in patients with active ulcerative colitis. Our secondary endpoint was to examine the impact on variables that look at inflammation, like fecal calprotectin and serum amyloid A protein.”
In the study, 32 ulcerative colitis patients initiating JAK inhibitor treatment (either upadacitinib or tofacitinib) were randomized to either the invention diet or a control group. The members of the control group ate what they wanted but received counseling to avoid foods they could not tolerate. Nine patients in the intervention and 12 control group participants completed an eight-week study.
“We found that by week eight, two five-day cycles of the lower-calorie, plant-based, high-fiber diet improved clinical response in patients with moderate to severely active ulcerative colitis who were initiating JAK inhibitor therapy,” Dr. Damas said.
DDW was an ideal platform for this novel research, according to Dr. Damas.
“DDW highlighted this important work, an area that is advancing in our field. Presenting at the meeting inspired others to look at diet as a form of therapy for ulcerative colitis and offered an opportunity for collaboration with other institutions to do work like this in a multicenter study,” she said.
Plans are underway at the Miller School for a larger, multicenter study looking at diet and ulcerative colitis.
Early Onset Colorectal Cancer
With recent headlines about cancer striking adults at earlier ages, Shria Kumar, M.D., assistant professor in the Division of Digestive Health and Liver Diseases at the Miller School, presented on risk factors associated with colorectal cancer in adults younger than 50 years.
“The rise of early onset colorectal cancer (EOCRC) or CRC in persons under age 50 is concerning, enough so that national societies have recently expanded screening recommendations,” Dr. Kumar said. “But we still don’t understand enough about the problem.”
What we do know, according to Dr. Kumar, is that colorectal adenomas are the precursor lesion to EOCRC and can be resected to prevent cancer.
“Identifying which persons are most likely to have colorectal adenomas can lead to targeted screening strategies, which is the ideal approach,” she said.
Dr. Kumar and Miller School colleagues identified the prevalence of colorectal adenomas and associated risk factors in average-risk individuals younger than 50 undergoing colonoscopy. The researchers found higher body mass index (BMI), increasing age and male sex were associated with colorectal adenomas in adults younger than 50.
“Surprisingly, we found strikingly protective associations in those who are U.S. born and use aspirin,” Dr. Kumar said. “This is an important jump-off point. Larger studies should investigate whether there are increased rates of EOCRC and colorectal adenomas in immigrants residing in the U.S. and continue to granularly define at-risk populations to target screening.”
This important data highlights the Miller School’s commitment to studying pressing issues in patient populations with a varied demographic profile.
“While other centers can conduct this work, our ability to conduct this work in a diverse population with access to country of birth/country of origin is unique,” Dr. Kumar said.
Leading the Conversation on Liver Disease
Cynthia Levy, M.D., professor in the Division of Digestive Health and Liver Diseases and associate director of the Schiff Center for Liver Diseases at the Miller School, started the American Association for the Study of Liver Diseases (AASLD) plenary session with her presentation, “Efficacy and Safety of Seladelpar in Patients with Primary Biliary Cholangitis in the ASSURE Study: Interim Results.”
Results were encouraging and confirmed findings from the pivotal, phase 3 trial.
Dr. Levy, who is vice chair of the AASLD Practice Guidelines Committee, moderated its practice guidelines clinical symposium at DDW. She participated in a panel presentation during DDW’s Liver Leaders Council Summit on clinical trial evolution and innovation, focusing on enrollment strategies for diverse populations in early- and late-phase clinical trials, moderated the topic forum “Human and Experimental Cholestasis and Autoimmune Liver Diseases” and shared research reflecting seven years of experience on hepatic events in in primary biliary cholangitis patients treated with obeticholic acid.
“At the Miller School, our digestive health and liver diseases faculty are not only conducting pioneering research, but we’re also leading the field on how to directly bring those changes to clinical practice and improve patient care,” Dr. Levy said.
Tags: Digestive Disease Week, Division of Digestive Health and Liver Diseases, Dr. Cynthia Levy, Dr. Maria Abreu, Dr. Oriana Damas, Dr. Paul Martin, Dr. Shria Kumar, liver diseases