Shrinivas Bishu @IBDimmunology profile

Shrinivas Bishu

@IBDimmunology

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Clinical Director of IBD and GI APD @UMichGIHep , #BillsMafia , minivan driving husband, dad of daughters. Looking for the glory I had in the mid-90s.

https://t.co/fhrCVg4qk6

Ann Arbor, MI

Joined September 2019

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Shrinivas Bishu

@IBDimmunology

2 months

Hearty and well deserved congrats to my friend @ebtapper on being named Academic Director of Hepatology @UMichGIHep @MichiganLiver Dedicated dad, and every bit as hard working, intellectual and witty as he appears. If you don't know him - get to meet him.

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Shrinivas Bishu

@IBDimmunology

2 years

@DrHarryThomas I’ve given up too much in life to give up white rice

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Shrinivas Bishu

@IBDimmunology

10 months

SQ VDZ approved for UC by @US_FDA Sept 27, 2023 Data in @AGA_Gastro (VISIBLE1 Trial) 👇🏾 1. IV wk 0, 2 --> SQ EOW maintenance 2. IV maint. = SQ maint. for endpoints. 3. Check the diagram below the title. Done.

Efficacy and Safety of Vedolizumab Subcutaneous Formulation in a Randomized Trial of Patients With...

Maintenance treatment with vedolizumab, a monoclonal antibody that inhibits the gut-selective α4β7 integrin, is administered intravenously. Some patients might prefer a subcutaneous formulation of...

www.gastrojournal.org

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Shrinivas Bishu

@IBDimmunology

1 year

Get a dog, they said. Good for the soul, they said. They didn’t mention cleaning up vomit and poo inside, or that your kids won’t help. He’s a rescue with anxiety and IBD. Karma for an child psychiatrist married to an IBD-ologists.

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Shrinivas Bishu

@IBDimmunology

2 months

Congrats to my friend @NDP1001 - the new Clinical Director of Hepatology @UMichGIHep @MichiganLiver The future looks bright @MichiganLiver !

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Shrinivas Bishu

@IBDimmunology

1 year

Congrats @DCharabaty , very nice to see this article in May’s @AmJGastro @AmCollegeGastro ⏺ @MondayNightIBD = hard work, done well. @MondayNightIBD Expanding Gastroenterology... : Official journal of the American College of Gastroenterology | ACG

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Shrinivas Bishu

@IBDimmunology

9 months

1/2: @FDA approved Mirikizumab (anti-IL23p19) for UC. ▶️IV induc. (0, 2, 4, 8) -> SQ q4 wks ▶️ LUCENT 1-3 trials ▶️ Primary Outcome = Clinical Remission 🟢deltas ~11% and 23% for induction, maintenance 🟠 full details not yet published 👇🏾see links in 2/2 for further details

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Shrinivas Bishu

@IBDimmunology

1 year

Aging in #IBD is starting to get the attention it deserves! 👇🏾 I am very pleased to present my friend @AdamFayeMD discuss where we’re going @UMichGIHep #GIGrandRounds When: Tuesday, May 16, 730-830 AM EST How:

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Shrinivas Bishu

@IBDimmunology

11 months

study by my talented colleague @ryanungaro in @AGA_CGH ✅UST > VDZ after aTNF in 2 seperate cohorts ( @MSHS_IBDCenter , @SPARCIBD ) I’m excited cause…This study used data from @SPARCIBD @CrohnsColitisFn Check @SPARCIBD for your next research!!

Second-Line Biologic Therapy Following Tumor Necrosis Factor Antagonist Failure: A Real-World...

In 2 independent real-world cohort settings, second-line therapy in CD with ustekinumab after TNF antagonist treatment failure was associated with a lower likelihood of treatment failure than...

pubmed.ncbi.nlm.nih.gov

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Shrinivas Bishu

@IBDimmunology

4 months

After losing response to first line agent, 2nd agents have ⬇️ efficacy in CD. Some think 1st agent changes biology. I don't. I think it selects refractory patients. @AGA_CGH supports that effective agents are effective 2nd. ▶️UPA works in CD. Done.

Upadacitinib Achieves Clinical and Endoscopic Outcomes in Crohn’s Disease Regardless of Prior...

Upadacitinib, an oral Janus kinase inhibitor, achieved significantly higher rates of clinical remission and endoscopic response vs placebo during induction (U-EXCEL [NCT03345849], U-EXCEED [NCT0334...

www.cghjournal.org

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Shrinivas Bishu

@IBDimmunology

1 year

I’m not at #DDW2023 (deadlines) - but I love this fun poster from @OnyiiUgonabo ▶️institutions + GI Twitter 🟢 @UMichGIHep tied with @MSHS_IBDCenter , trailing @MayoClinicGIHep ✅but @MayoClinicGIHep has 3 campuses!! I’m calling @berinsj @ariel_jordan22 @umfoodoc

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Shrinivas Bishu

@IBDimmunology

3 years

#Michigan is a very beautiful state Sunrise over Lake Michigan this morning 👇🏾 It’s the little things!

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Shrinivas Bishu

@IBDimmunology

2 years

This is allover #IBD Twitter with good reason👇🏾 Upa looking 🔥for CD —- at 12 wks!!! 👇🏾 And it’s a 💊 NOT IV or SQ! 😳🤯👇🏾 Will Upa be available globally?

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Shrinivas Bishu

@IBDimmunology

1 year

What defines ‘severe’ #IBD ? It’s critical to distinguish ‘severe’ presentation from longitudinally ‘severe’ dz ‘Severe’ #IBD = hard to define. this @LancetGastroHep is a great start 👇🏾 ✅it, and let me know what you 💭 🟢it’s short, to look at it

Difficult-to-treat inflammatory bowel disease: results from an international consensus meeting

Many patients with inflammatory bowel disease (IBD) have persistent symptoms and disease activity despite the best available medical or surgical treatments. These patients are commonly referred to as...

www.thelancet.com

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Shrinivas Bishu

@IBDimmunology

5 months

If you are a GI fellow, or anyone interested in #IBD The by @Bealoquebea is a must. Encyclopedic catalogue of IBD medication trials…..by year…..with links!

Beatriz Gros

@Bealoquebea

5 months

@JamesLewisGIEpi @fgomollon @DCharabaty @AshkanRA @ibdseb @IBDimmunology @ign76 @Y_ECCO_IBD @Jonathansegal85 @geteccu @sepdigestiva If you do not want to miss any of the updates of the you can subscribe ⭐️It is just one email per month, nothing else. And if you do not enjoy it you can unsubscribe, we will miss you but this will allow others to join 🙏🏻

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Shrinivas Bishu

@IBDimmunology

2 years

It is our honor to host Dr. Micheal Camilleri for @UMichGIHep #GIGrandrounds in honor of our former chief - Dr. Chung Owyang! Please consider joining us and @JBrandlerMD ! When: 5/10, 730 AM EST Who: Everyone How:

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Shrinivas Bishu

@IBDimmunology

2 years

🦃 a coming in 🇺🇸, and @UMichGIHep #GIGrandRounds keeps a rollin' Join us 11/22/22 as @berinsj host @charlie_lees of @EdinburghUni discuss 'Unmet needs in #IBD '! When: Tuesday, 11/22/22, 730 AM EST Who: Anyone who interested in learning! How:

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Shrinivas Bishu

@IBDimmunology

2 years

▶️Patient was doing great on IFX for #Crohns ▶️Insurance ⬆️ co-pay to 20% of the cost!!!! ▶️Patient can’t afford - now with multiple strictures through budesonide/MTX 👉🏾insurance is supposed spread risk to cover ill pts - not leave them stranded!!! 👉🏾forkin ridiculous! 🤬🤬

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Shrinivas Bishu

@IBDimmunology

11 months

Following up on post-op Crohns, excellent review in @AGA_CGH 👇🏾 ▶️new ✂️ ▶️peeps like @GKochharMD @SchairerIBDMD doing EST 🟢where exactly does the neo-TI start? ✅my colleagues @P_DeepakIBDMD @Marylandibddoc considered this for @SPARCIBD

Postoperative Crohn's Disease Recurrence: Time to Adapt Endoscopic Recurrence Scores to the Leading...

After ileocolic resection with ileocolic anastomosis for Crohn's disease, most patients experience early endoscopic recurrence of which the severity predicts the risk of subsequent clinical and...

www.cghjournal.org

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Shrinivas Bishu

@IBDimmunology

2 years

Very, very, very happy to see my friend @ibdgijami at #ACG2022

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Shrinivas Bishu

@IBDimmunology

4 years

Covid-19 + fecal shedding-fresh DATA in Lancet GI - 74 p with respiratory + fecal sampling Take home: ▶️55% with fecal shedding ▶️shedding mean = 28 d >>> 16 d respiratory shedding (+) ➡️fecal shedding through convalescence ➡️ use caution GI friends!

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Shrinivas Bishu

@IBDimmunology

9 months

1/2: @FDA approved Etrasimod (ET) today for UC. ▶️ ET = S1P1,4,5 = diff. sel. c/w Ozanimod ▶️ 2 mg/d PO. ▶️ Fig 3. ELEVATE Trial 👇🏾 @TheLancet ✅ delta for 🔦 remission = 18%. 🔴AEs/SAEs in Table 2

Etrasimod as induction and maintenance therapy for ulcerative colitis (ELEVATE): two randomised,...

Etrasimod was effective and well tolerated as an induction and maintenance therapy in patients with moderately to severely active ulcerative colitis. Etrasimod is a treatment option with a unique...

www.thelancet.com

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Shrinivas Bishu

@IBDimmunology

1 year

#IBD patients, rightfully, are concerned that biologics ⬆️ risk of cancer. This study in @AmJGastro indicates the opposite. ⏺nationwide, Japan, retro, caveats - yes 🟢biologics + regular endo = ⬇️advanced cancers Suggests 💊—> ⬇️🔥—> ⬇️cancer Good.

Effect of Biologics on the Risk of Advanced-Stage... : Official journal of the American College of...

colitis (UC) diagnosed with IBD-associated intestinal neoplasia (dysplasia or cancer) from 1983 to 2020 were included in this study. Therapeutic agents were classified into 3 types: biologics,...

journals.lww.com

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Shrinivas Bishu

@IBDimmunology

1 year

I’m having dinner with my 10 y/o daughter and two of her friends. They are all making fun of me. And I’m paying for the meal.

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Shrinivas Bishu

@IBDimmunology

9 months

Interesting studies on pre-clinical diagnosis of IBD. @PREDICTIBD with this in @CellRepMed ▶️ drawn from a geographic area = ⬇️ bias ▶️ typical labs in future IBD > Cntl. 👇🏾 🟡 The 'catch'.......labs are in normal range.....but look at the trends.

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Shrinivas Bishu

@IBDimmunology

1 year

How does the environment drive the risk of #IBD ? This is a critical question in #IBD . Join at @berinsj host @ManasiAgrawalMD discussing Environmental- #IBD interactions @UMichGIHep #GIGrandrounds . Tuesday, March 28th, 730-830 AM EST How:

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Shrinivas Bishu

@IBDimmunology

2 years

Congrats to @UMichGIHep graduates today It’s a honor and a pleasure to have worked with you all @JBrandlerMD @Kevin_D_Platt , Anand, Bharat, Megan, Edward and Sameer I look forward to calling you all colleagues! CONGRATS 🎉🎊🍾!

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Shrinivas Bishu

@IBDimmunology

2 months

Guidance on diet in IBD in @AGA_Gastro @AmerGastroAssn by my friend @JHashashMD 👇🏾 4 points ▶️Mediterranean diet = winner ⏺️we have such little data on diet and IBD ⏺️we have even less data on adherence to diet! ✅What’s your advice to patients?

AGA Clinical Practice Update on Diet and Nutritional Therapies in Patients With Inflammatory Bowel...

This expert review was commissioned and approved by the AGA Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the...

pubmed.ncbi.nlm.nih.gov

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Shrinivas Bishu

@IBDimmunology

11 months

Absolutely love this thread on Curcumin for arthritis Long story - study failed, but to me, the lesson is the disconnect between hope that some ‘natural’ things work, and reality that most don’t. Check it for your self 👇🏾

TheLiverDoc

@theliverdr

11 months

Ok listen to this. It's about a new study on curcumin. This is the largest clinical study that looked at benefits of curcumin (bioactive compound in turmeric) for persons with rheumatoid arthritis. This was not a run-of-the-mill study. This was well-designed, beautifully

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Shrinivas Bishu

@IBDimmunology

2 months

1/3 @eamonnquigleymd this study is awesome. ⏺️Some genes = ⬆️ risk for IBD ⏺️ key risk gene = ⬆️ ETS2 ⏺️ETS2 = KEY inflammation gene ▶️ETS2 = ⬆️ inflammatory IBD genes in macs 🟢ETS2 can be blocked = New tx? = WOW Full paper in @nature in 2/3 👇

Bowel disease breakthrough as researchers make ‘holy grail’ discovery

Scientists pinpoint driver of IBD and other disorders with work under way to adapt existing drugs to treat patients

www.theguardian.com

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Shrinivas Bishu

@IBDimmunology

1 year

#NAFLD is a BIG problem. Why do some people get it, while others don’t? Is it in the 🧬? @UMichGIHep #GIGrandRounds and @BloomPringle present our own #VincentChen - who has an @NIDDKgov K23 - bring insights. When: 5/23/22, 730-830 AM EST How:

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Shrinivas Bishu

@IBDimmunology

1 year

UPA for CD, TONS of data @NEJM ▶️ 12 + 52 wk; 15 or 30 mg for maint. ▶️SES-CD across trials to start ~14, no strictures 🟢12 wk 🔦 Res diff ~30%! 🟢52 wk 🔦 Rem diff ~14 or 24%!! 🔴dose depen. 'hepatic d/o', ⬆️VZV, CK + ⬇️ CBC 💭 positioning?

Upadacitinib Induction and Maintenance Therapy for Crohn’s Disease | NEJM

Upadacitinib, an oral selective Janus kinase (JAK) inhibitor, is under investigation for the treatment of Crohn’s disease. In two phase 3 induction trials (U-EXCEL and U-EXCEED), we randomly assign...

www.nejm.org

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Shrinivas Bishu

@IBDimmunology

11 months

1/2 Lots JAKis coming. See #2 for quic primer on JAKs Latest in @AGA_CGH 👇🏾 ▶️P2b, 2 drugs: JAK3i and JAK1/TYK2i 🟢⬇️Mayo at wk 8 = -4.6 with the most interesting agent - ritlecitinib 🟢skip to Fig 2 👇🏾

Oral Ritlecitinib and Brepocitinib for Moderate-to-Severe Ulcerative Colitis: Results From a...

The efficacy and safety of ritlecitinib (oral JAK3/TEC family kinase inhibitor) and brepocitinib (oral TYK2/JAK1 inhibitor) as induction therapy were assessed in patients with active, moderate-to-s...

www.cghjournal.org

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Shrinivas Bishu

@IBDimmunology

1 year

Hats off to @EdwardLoftus2 on helping patients with #IBD maintain their disease👇🏾 ▶️complex story - on dual therapy, and pushing boundaries to maintain remission ▶️insurance practices for deciding approval are shady, and compromise unbiased assessments (and I’m being nice)

ProPublica

@propublica

1 year

New: After a college student finally found a treatment that worked, the insurance giant decided it wouldn’t pay for the costly drugs. His fight to get coverage exposed the insurer’s hidden procedures for rejecting claims.

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Shrinivas Bishu

@IBDimmunology

2 years

Honored to host @FlorianReider of @ClevelandClinic for GI GR @UMichGIHep - please joins us! 👇🏾 What’s next in #IBD therapies? 🎯 #Fibrosis 👇🏾 When: Tuesday Feb 22, 730 AM EST Who: everyone How:

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Shrinivas Bishu

@IBDimmunology

1 year

▶️ @ImmunityCP @broadinstitute 👇🏾 #crohns = ⬆️ immune cells + reprogrammed epi. + stromal cells 🟠data increasingly links Epi cell reprogramming with #IBD 🟢can we develop new tx? Love discussing this with @ign76 @Bealoquebea @AshkanRA @JGubatanMD

The landscape of immune dysregulation in Crohn’s disease revealed through single-cell transcripto...

Crohn’s disease (CD) is a heterogeneous condition impacting the ileum and colon in unique ways. Here, Kong et al. define the unique epithelial, stromal, and immune characteristics of CD by generating...

www.cell.com

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Shrinivas Bishu

@IBDimmunology

1 year

On IBD inpatient this week, conundrum arose. ⏺19 y/o, pregnant, ASUC ▶️poorly controlled before pregnancy ▶️preg unexpected —> severe flare, CRP ⬆️with IV steroids ⏺next step? IFX? Cyclo? UPA? Thoughts? + what do you tell her about risk for ✂️?

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Shrinivas Bishu

@IBDimmunology

2 years

@DrHarryThomas I’m a terrible Indian. Can’t spell, didn’t play tennis.

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Shrinivas Bishu

@IBDimmunology

1 year

Perianal fistulas in #CD = bad news. ✅this it👇🏾in ⁦⁦⁦⁦ @eClinicalMed ⁩ ⁦ @LancetGastroHep ⁩ ⏺typical approach = setons + aTNFs ▶️setons/aTNF + ✂️ > no ✂️ 🟢 42% healing vs 18%!!!! ✅maybe ✂️ closure should be used more often?

Short-term anti-TNF therapy with surgical closure versus anti-TNF therapy alone for Crohn's...

This study confirmed that surgical closure should be considered in amenable patients with perianal fistulas and Crohn's disease as long-term outcomes were favourable, and that radiological healing...

www.thelancet.com

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Shrinivas Bishu

@IBDimmunology

2 years

🔥 of the 📰 - #Upacitinib now approved for UC ▶️ 2G JAKi, JAK1 selec. (TOF is 1G, non-selec. JAK1/3) ▶️Data looking 💪 👇 ➡️U-ACHIEVE @ibddoctor 👉wk 8 remission/response = 20% and 36% (PBO < 2%) Fig 2 ➡️U-ACCOMPLISH = same 👇

OP23 Efficacy and safety of upadacitinib as induction therapy in patients with Moderately to...

Upadacitinib (UPA) is a selective and reversible Janus kinase inhibitor.U-ACCOMPLISH is one of two phase 3 induction trials that evaluated the safety and efficacy of UPA 45 mg once daily (QD) in...

www.ncbi.nlm.nih.gov

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Shrinivas Bishu

@IBDimmunology

2 years

Precision medicine in #IBD is 🔥 But where at we at? Find out as @berinsj hosts @AshwinMDIBD of @MGHMedicine for @UMichGIHep #GIGrandRounds When: Dec 13, 730-830 AM EST Who: Everyone! How:

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Shrinivas Bishu

@IBDimmunology

1 year

@berinsj pitched JAKi for ASUC at #CCCongress23 @AGA @CrohnsColitisFn Now hear how he puts this in action with a SMART adaptive trial - that got him a K23 @NIDDKgov ! When: @UMichGIHep #GIGrandRounds , 1/24/23, 730-830 AM EST How:

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Shrinivas Bishu

@IBDimmunology

2 years

#GIfellows #GItwitter , you know the IR approaches for portal HTN and #cirrhosis ? Don’t wait till your on call! join @BloomPringle host Mamadou Sanogo for #GIGrandrounds @umichmedicine When: Oct 4, 2022, 730-830 AM EST Who: everyone How:

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Shrinivas Bishu

@IBDimmunology

2 years

Excellent + succinct piece in @AGA_CGH on updating Rutgeerts scoring + modern surgical anastomosis. It’s worth your 5 min for the references alone!

Postoperative Crohn's Disease Recurrence: Time to Adapt Endoscopic Recurrence Scores to the Leading...

After ileocolic resection with ileocolic anastomosis for Crohn's disease, most patients experience early endoscopic recurrence of which the severity predicts the risk of subsequent clinical and...

www.cghjournal.org

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Shrinivas Bishu

@IBDimmunology

1 year

IM residents! - consider @UMichGIHep for your fellowship!! ✅incredible faculty ✅great research ✅supportive fellows and program directors! ▶️I’m an APD - so caveat!!!

Meghan Barrett-Englert, MD, MS

@MB_Englert_MD

1 year

@UMichGIHep @JessSheehanMD @SarahUttal @JeffGibbsMD @umfoodoc @JoyceKimMD @DrDrAbhishekS

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Shrinivas Bishu

@IBDimmunology

1 year

Neat result on metabolome in #IBD in @Gut_BMJ by @WeersmaLab Metabolome = stuff made by the gut 🦠 + 👨🏾 in the intestine ▶️ Coffee = BIG determinant of the gut metabolome Cool, but who would have thought? ▶️ CD resections -- also major league impact.

Faecal metabolome and its determinants in inflammatory bowel disease

Objective Inflammatory bowel disease (IBD) is a multifactorial immune-mediated inflammatory disease of the intestine, comprising Crohn’s disease and ulcerative colitis. By characterising metabolites...

gut.bmj.com

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Shrinivas Bishu

@IBDimmunology

3 years

Culture and race are hugely important in IBD. I'm super-excited to moderate @ownyourcrohns @thisimmunelife and @thechristianjl as their perspectives as #Indian , #Egyptian and #AfricanAmerican with IBD Join us! 👇

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Shrinivas Bishu

@IBDimmunology

6 months

What can AI do for IBD endoscopy? Check it in @AGA_Gastro 👇🏾 ⏺️MES = doesn’t account for spatial distribution 🟢 @CrohnsDoc has AI that accounts for MES + spatial extent 🟢The impact? ⬆️ability to detect = ⬇️⬇️ sample size for trials. ✅Fig 6

Using Computer Vision to Improve Endoscopic Disease Quantification in Therapeutic Clinical Trials...

Computer vision measures of endoscopic activity are more granular and sensitive to ulcerative colitis disease severity than the Mayo Endoscopic Score and may help personalize disease and therapeutic...

www.gastrojournal.org

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Shrinivas Bishu

@IBDimmunology

2 years

#Upacitinib for UC -- I've several patients on it now. Got FCP for a patient just now Failed EVERYTHING - including TOF Now on wk 6 of UPA ▶️ BMs ⬇️ 15 --> 2/d ▶️ bleeding resolved ▶️ FCP down from 1,200 --> 28!!! WHAT WHAT! I am very pleased for my patient!

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Shrinivas Bishu

@IBDimmunology

1 year

Grants submitted. Older kids at sleep-away camp. I'm ready to tweet again.

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Shrinivas Bishu

@IBDimmunology

8 months

Lots of new meds, finally got to Guselkumab in @AGA_Gastro ▶️anti-p19 abs, p2b, induction in UC ▶️prior anti-IL-23 use -> 🚫 ▶️> 65% with MES = 3 🟢endo improvement c/w placebo = 18% delta ✅Fig 2. the number of anti-IL-23s is getting🥜's!!

Guselkumab in Patients With Moderately to Severely Active Ulcerative Colitis: QUASAR Phase 2b...

Improvement at 12 weeks was greater with intravenous guselkumab vs placebo. Guselkumab-treated patients without a clinical response at 12 weeks benefited from additional guselkumab administered...

www.gastrojournal.org

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Shrinivas Bishu

@IBDimmunology

2 years

IMPORTANT news for #IBD patients on prednisone or biologics. Heard of Euvasheld? It’s an antibody that may prevent #Covid infections. 👇🏾👇🏾 Talk to your doctor - you may be able to get this. @umichmedicine has a supply right now and are able to give it!! 📞🤳☎️ us!

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Shrinivas Bishu

@IBDimmunology

2 years

1/4 GI fellows - properly interpreting trials (CTs) in #IBD is critical. - Let’s talk 🔑 aspects, namely ‘end-points’ ✅2 concepts: ▶️Precision = finding the same value on repeated measures ▶️Accuracy = finding the ‘right’ value

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Shrinivas Bishu

@IBDimmunology

2 years

What is up with EoE?!?! IDK - but Dr. Lynch knows! 👇🏾 @joanwchen of @UMichGIHep is excited to host @KristleLynchMD of @penngihep for #GIGrandrounds - join us! When: 4/5/20, 730-830 EST How: Who: Everyone!

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Shrinivas Bishu

@IBDimmunology

1 year

#ASUC is at the cusp of refinement @BenClickMD discussed this, now in @Gut_BMJ 👇🏾 ☑️low n’s for validation ✅ADMIT CRP, Alb, UCEIS predict CS failure ✅future seems towards biologics earlier 🟢 read for yourself 👇🏾 What’s the 🏴󠁧󠁢󠁥󠁮󠁧󠁿 take @ibdseb ?

Early management of acute severe UC in the biologics era: development and international validation...

Objectives We aimed to determine whether changes in acute severe colitis (ASC) management have translated to improved outcomes and to develop a simple model predicting steroid non-response on...

gut.bmj.com

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Shrinivas Bishu

@IBDimmunology

2 years

Ever retry IFX after LOR? Read REGAIN @AmJGastro 👇🏾 ▶️IFX restart after LOR ▶️endpoint = wk 26 CDAI < 150 🟠likely ⬇️power ✅35% response 🟢In restarts - Hcort as pre-med 🔴Do you use Hcort with IFX retrial? 🔴I don’t, should I, or is SFR a goal?

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Shrinivas Bishu

@IBDimmunology

2 years

About to leave @DTWeetin with the @UMichGIHep team of @berinsj and #RyanStidham ✅heading to #CCCongress23 @AmerGastroAssn @CrohnsColitisFn Fine print - none of us look like this.

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Shrinivas Bishu

@IBDimmunology

2 years

@berinsj selling JAKi up front for ASUC at #CCCongress23 @CrohnsColitisFn @AmerGastroAssn That’s what we’re thinking @UMichGIHep Wonder what the shark tank thinks!

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Shrinivas Bishu

@IBDimmunology

10 months

The SEQUENCE trial (Risa vs Ust) press-release = good place to talk about non-inferiority (NFI) trials. They are complex, check 👇🏾 @NEJM . NFI = show NO difference, pay attention to: ▶️ margin of NFI ▶️ biases in ITT in arms ▶️ power analy/sample size

Challenges in the Design and Interpretation of Noninferiority Trials | NEJM

In this review, the authors consider the characteristics and challenges of noninferiority trial designs, including seven essential features of noninferiority trials.

www.nejm.org

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Shrinivas Bishu

@IBDimmunology

1 year

Hearty congrats to my friends and colleagues @AdamFayeMD @nyulangone and @KiraNewmanMDPhD @UMichGIHep on their @ACG junior faculty awards! Next step - @NIH !!

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Shrinivas Bishu

@IBDimmunology

3 years

Very honored to be a part of this collaboration @P_DeepakIBDMD @MadhoorRamdeen @drvishal82 @drsumitbhatia @ownyourcrohns @vipuljairath @ibdseb @nehagastrord Global #IBD group patients + providers spanning 5 nations. Focused on patient needs, provider development, and research!

South Asian IBD Alliance (SAIA)

@southasianIBD

3 years

Thrilled to introduce #GITwitter to South Asian IBD Alliance (SAIA, @SouthAsianIBD ), the first patient-clinician led collaborative in #IBD spearheaded by @ibdesis & a team of #SouthAsian clinicians. Looking forward to working together to minimize disparities! #SouthAsianIBD

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Shrinivas Bishu

@IBDimmunology

3 years

Super-honored to be a part of this patient-provider collab ⬇️ ▶️ #IBD is a 🌍 problem. ▶️let’s change the game. @ownyourcrohns @P_DeepakIBDMD @drvishal82 @ibdseb @DCharabaty @LancetGH @LancetGastroHep

South Asian IBD Alliance (SAIA)

@southasianIBD

3 years

Thank you to @LancetGastroHep for spotlighting @southasianIBD to amplify the #healthdisparities the global #SouthAsianIBD community is facing. SAIA is the 1st multinational patient-clinician led alliance in the #IBD space here to create positive change:

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Shrinivas Bishu

@IBDimmunology

7 months

Interested in #IBD peds to adult transitions of care? Wanna build a program? ✅want a unique chance to develop a program, consider joining @ibddoctor @JeremyAdlerMD and me @UMichGIHep 🟢graduating fellows welcome! ✅LMK - DM me for dets. 🟢TB12 went here, look at him now!

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Shrinivas Bishu

@IBDimmunology

2 years

We’re heading back to the RUQ as @BloomPringle hosts @HepatoEpi for @UMichGIHep @MichiganLiver #GIGrandRounds ! 👇🏾 When: 11/15/23, 730 AM EST Who: Everyone!! How:

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Shrinivas Bishu

@IBDimmunology

2 years

@ibdgijami @DrReddyGI @ClevelandClinic @ibddoctor @umfoodoc complicated ethics, pt access + 🏥economics. ▶️pts frustrated w/o access to their provider, but we are often booked out - so no room ▶️my panel ~1,700, I’m booked to 10/2023 ▶️🏥 want more pts ✅providers stuck in the middle ✅we need a better model for chronic care

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Shrinivas Bishu

@IBDimmunology

2 years

You know you hit peak #MedTwitter when a crypto bot is on your chain. #dropthemic . #topthat @ebtapper and @ibdgijami @DrHarryThomas #killedit

Abdullah Olğan

@AbdullahOlgan

2 years

@ownyourcrohns @southasianIBD @ibdesis @P_DeepakIBDMD @nehagastrord @IBDimmunology @FITWITMD @ibddoctor @bkocharmd @drvishal82 @vipuljairath @drsumitbhatia @DCharabaty crc crypto classic total 100 million supply 45 million locked roadmap binance okex kucoin gate io I recommend you to review

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Shrinivas Bishu

@IBDimmunology

1 year

Ok, I have a patient with TB reactivation on UPA Didn’t get it on aTNF He’s from SE Asia - so he likely had latent TB Anyone else seeing this in JAKis?

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Shrinivas Bishu

@IBDimmunology

1 year

Know what a poly-loop is? General GIs shy away from it. @APrabhuMD taught me. great tool for large polyps. I used it today👇🏾 I’m an average endoscopist @UMichGIHep fellows will tell, so if I can do it - you can to.

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Shrinivas Bishu

@IBDimmunology

5 months

Great fun to come back to @PittGILiverNutr , meet old mentors #MarcSchwartz @rockscho Make new friends #AmirGhafarri , and @JosephHabibi_MD and see @LoriPlung Honored @DuekerJeffrey invited me for @CrohnsColitisFn IBD UNITE.

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Shrinivas Bishu

@IBDimmunology

1 year

I practice #IBD in a city, but thats not where most patients are. ▶️How do you deliver #IBD care to rural regions? 🟢join @UMichGIHep #GIGrandrounds present @DrCoreySiegel present solutions!! ⏺Tues 21, 2023 ⏺730-830 AM EST ⏺

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Shrinivas Bishu

@IBDimmunology

3 years

Why are patient reported outcomes ( #PROs ) important in #IBD ? 1) Thats the patient QoL 2) #FDA will require these for trials - no good PROs for peri-anal fistulas in #CD - ✅ out a good start in @Gut_BMJ 👇🏾 - 28 Qs, refined, usable in trials

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Shrinivas Bishu

@IBDimmunology

2 years

Last hurrah from @UMichGIHep , La Jolla @DDWMeeting with @Abhi2Shenoy @berinsj , we missed @ebtapper and @Guts_and_Butts Rolling to #ACG2022 , #CCCongress23 , even #ECCO2023 ? work + play hard. We’re planning on tracksuits for ‘Royal Tannenbaum’ vibes Hope to see everyone soon!

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Shrinivas Bishu

@IBDimmunology

2 years

Hungry for more data now that #UEGWeek22 is over? - we’re keeping #IBD data going! Join us for #GIGrandRounds @UMichGIHep as our own @ibddoctor breaks down: ▶️QI in inpatient #ASUC When: Tuesday 18, 2022; 730-830 AM EST Who: everyone! How:

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Shrinivas Bishu

@IBDimmunology

2 years

Work under a ‘non-compete’ - I bet you do! I love working @UMich @UMichGIHep but IMO - non competes - especially for large health care employers is unfair. Check this 2 min story on @Marketplace on @NPR the @FTC proposal to nullify them!

Noncompete clauses could be on their way out - Marketplace

The Federal Trade Commission announced a proposal this week to ban the use of noncompete clauses in employee contracts, which restrict the ability of workers to switch to competitors in the same...

www.marketplace.org

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Shrinivas Bishu

@IBDimmunology

2 years

Lol - went to 🇮🇪 to visit the in-laws Left my phone 😳, 400+ text messages!! It was Liberating to not have it!

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Shrinivas Bishu

@IBDimmunology

3 years

#CCCongress22 is going on - still hungry after that? @UMichGIHep is honored to host @DrJordanAxelrad of @NYUlangone deliver #GIGrandRounds on #Infections and 🦠 in #IBD When: Tuesday 1/25 Who: everyone Where: zoom ⬇️

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Shrinivas Bishu

@IBDimmunology

2 months

My only ⁦ @DDWMeeting ⁩ post My friend ⁦ @P_DeepakIBDMD ⁩ presenting his work from ⁦ @SPARCIBD ⁩ ⁦ @CrohnsColitisFn ⁩ If you don’t know about ⁦ @CrohnsColitisFn ⁩ PLEXUS - find out Great resource for multifaceted research!

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Shrinivas Bishu

@IBDimmunology

2 years

🧢 off @Calen_Steiner + @AGA_CGH on work in Fibrosis #IBD ☑️Fibrosis = big problem in #IBD ☑️Anti-Fibrotic’s for #IBD coming soon!! ☑️ @IBD_FloMD leading a program to develop rigorous endpoints ✅biomarkers badly needed 👇🏾 @ibddoctor @berinsj

Biomarkers for the Prediction and Diagnosis of Fibrostenosing Crohn’s Disease: A Systematic Review

Intestinal strictures are a common complication of Crohn’s disease (CD). Biomarkers of intestinal strictures would assist in their prediction, diagnosis, and monitoring. Herein we provide a compreh...

www.cghjournal.org

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Shrinivas Bishu

@IBDimmunology

6 months

Want to build an IBD center? 🟢 @ibdtweets @jensemineriomd @DavidHudesmanMD built IBD centers laces up. 🟢They know a lot about a lot. #IBDREACH #CCCongress24 @CrohnsColitisFn @AmerGastroAssn Register:

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Shrinivas Bishu

@IBDimmunology

2 years

What a beautiful place! Sunrise over Lake Michigan Sutton’s Bay, MI Happy Friday!

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Shrinivas Bishu

@IBDimmunology

2 years

Give a minute to shout out @allie_schulman for her latest @ASGEendoscopy @ABEbariatric achievements! I am honored to call her my colleague @UMichGIHep New mom + hard working + great sense of humor + civility + humility = @allie_schulman !

Allison Schulman MD, MPH

@allie_schulman

2 years

I am incredibly honored to have been selected as the next Chair for the Association of Bariatric Endoscopy @ABEbariatric @ASGEendoscopy 🙏 So excited to continue working w our surgical colleagues to move the field of #obesity & #endoscopy forward #WomenInEndo

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Shrinivas Bishu

@IBDimmunology

4 years

Given @MondayNightIBD convo on vaccines + Vedo ▶️ will you recommend #IBD patients on biologics get #COVID19 vaccines? ▶️mRNA vac = Protective IgG 👉🏾I will @DanSharpIBD @bottomlineibd @ownyourcrohns @CrohnieBologna @dr_fcalderaibd @DCharabaty @DuekerJeffrey @ibdgijami

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Shrinivas Bishu

@IBDimmunology

2 years

Shout out!!! 👇🏾👇🏾 ✅ @ownyourcrohns + @rebelliousgut for outstanding moderating + ⬆️ #IBD awareness in SA! ✅ @AmCollegeGastro + @CCF_IN for collab! ✅ @southasianIBD , @FITWITMD @nehagastrord @GI_PharmD @P_DeepakIBDMD - expertise! ✅ @IBDMD and @ibddoctor - for Twitter support!

Tina Aswani-Omprakash, MPH

@ownyourcrohns

2 years

Special shout-out to our patient advocates from team @ibdesis under the umbrella org @southasianIBD ! You all did fantastic work today! 🌟 Special thanks to two of our #IBD patients who fought through #Covid & #typhoid to speak at this conference. 🙏🏽 #SouthAsianIBD

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Shrinivas Bishu

@IBDimmunology

3 months

Sometimes I get asked about stem-cell transplantation (SCT) for IBD ☑️ @LancetGastroHep 👇🏾 🟢bold idea + brave pts + investigators. 🔴 risk of SCT >>>> risk of IBD 🔴SCT not better than standard tx 🔴don’t trade morbidity for mortality?

Haematopoietic stem-cell transplantation for patients with Crohn's disease: primum non nocere

Crohn's disease is a lifelong and disabling condition characterised by progressive inflammatory damage of the gut wall.1 The multifactorial pathogenesis of Crohn's disease means that recognising the...

www.thelancet.com

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Shrinivas Bishu

@IBDimmunology

1 year

Highlighting this by @AdamFayeMD + team in @AmCollegeGastro @AmJGastro ▶️We have little guidance on✂️risk in older #IBD pts. This paper 👇🏾finds: 🟠⬆️age = ⬆️risk of complications 🟠pre-op risk factors are the same ✅many older patients with #IBD are safe for surgery

Adam Faye MD MS

@AdamFayeMD

1 year

🎉 Excited to present our work on risk factors for adverse #postop events in #IBD @AmJGastro @AmCollegeGastro 🚨 Similar factors/odds seen for older & younger adults with IBD. Need to include these factors re: op risk for older adults (not age alone)

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Shrinivas Bishu

@IBDimmunology

1 year

Hot off the press! @umichmedicine , and therefore @UMichGIHep is no longer submitting to @usnews rankings. THANK YOU - for all that is decent. @DrDrAbhishekS your voice has been heard.

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Shrinivas Bishu

@IBDimmunology

4 months

POR in CD is biologically interesting. Endo and surgical POR @IBDBen @BenClickMD study @AGA_CGH ▶️biologics ⬇️🔦recurrence (across risk) ▶️biologics did not ⬇️✂️in low risk for POR 🟢total n good, so why? are we bad at risk stratifying POR?

Real-World Surgical and Endoscopic Recurrence Based on Risk Profiles and Prophylaxis Utilization in...

Preoperative risk stratification may help guide prophylactic biologic utilization for the prevention of postoperative Crohn's disease (CD) recurrence; however, there are limited data exploring and...

www.cghjournal.org

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Shrinivas Bishu

@IBDimmunology

9 months

Flare with JAKi dose reduction? Does re-esclation work? I like what this study by @UmaMahadevanIBD @AGA_CGH implies ▶️ 27% re-esclated TOF (5 --> 10 BID) ✅63% re-captured resp. 🟡Didn't recapture = severe disease 🟠n = small; biases, sure. But still.

Real-World Experience With Tofacitinib Dose De-Escalation in Patients With Moderate and Severe...

Tofacitinib is associated with sustained steroid-free remission in patients with ulcerative colitis (UC), with the lowest effective dose recommended for maintenance therapy. However, there are...

www.cghjournal.org

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Shrinivas Bishu

@IBDimmunology

1 year

Day 4 of no power in Ann Arbor. It’s cold and our table looks like this.

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Shrinivas Bishu

@IBDimmunology

2 years

Please give a well earned 🥂to our hard working @UMichGIHep @umichmedicine faculty @DDWMeeting #JohnCarethers incoming @AmerGastroAssn president! #ChungOwyang - Beaumont Prize #AnnaLok - Distinguished Mentor @ibddoctor - Distinguished Clinician HEARTY Congrats!!! 🥳🎉🙌🎇🎆

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Shrinivas Bishu

@IBDimmunology

4 years

Who in #MedTwitter feels better after a good run🏃🏾‍♂️? - may not be in your 🧠 - or is it? Check this @ScienceMagazine ▶️ plasma from exercising 🐁 —> old 🐁 ⬆️cognition + learning ▶️2/t liver derived protein 👉🏾 #liver #brain axis- amazing!! 🤓

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Shrinivas Bishu

@IBDimmunology

10 months

Game-ball to my bud @CrohnsDoc , honored by @CrohnsColitisFn MI. In a world of smart people, he’s at the top. ⏺️developed game changing AI in #IBD ✅kind soul ✅humble He’d kill me if he knew I posted this - but give him a shout if you see him! 👏 👏

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Shrinivas Bishu

@IBDimmunology

3 years

Highly honored to have given #IBD grand rounds @nyulangone courtesy of @DrJordanAxelrad @SBhattacharya27 We @UMichGIHep are excited to host @SophieBalzoraMD @DrJordanAxelrad and @MarkPochapin for our Grand Rounds!

Jordan Axelrad, MD, MPH

@DrJordanAxelrad

3 years

@IBDimmunology on the global burden of #IBD @nyulangone #IBD grand rounds! @shannonchangmd @DavidHudesmanMD @SBhattacharya27 @SimonHongMD @AdamFayeMD @HolmerMd @MelissaRosenMD @SophieBalzoraMD @joannkwah @nyugrossman

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Shrinivas Bishu

@IBDimmunology

4 months

EIMs in IBD = strong interest. Defining an EIM = hard + imprecise. Ask @KatieFalloonMD . @doc_ibd put this in @AGA_Gastro . ▶️HLA genes = strong link --> maybe EIMs driven by mimicary of self antigens to gut microbiota?

Comprehensive Association Analyses of Extraintestinal Manifestations in Inflammatory Bowel Disease

We present the largest multicenter study investigating clinical, serologic, and genetic variables with inflammatory bowel disease extraintestinal manifestations, identifying critical associations...

www.gastrojournal.org

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Shrinivas Bishu

@IBDimmunology

2 years

IMMs/TNF management is evolving. Check it in @AGA_CGH 👇🏾👇🏾 ▶️IMM withdrawal (WD) = ⬆️TNF ADA ▶️but 🚫⬆️ in LOR ▶️risk of ADA ⬆️ in yr 1 of IMM WD ✅complex stats😐😵‍💫😬 🔶what’s your practice? 🔶Increasingly, I stop even w/IFX but do I have it wrong?

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Shrinivas Bishu

@IBDimmunology

2 years

Autoimmune liver dz are interesting. More importantly, we need better treatments. Join @BloomPringle host @DrCynthiaLevy at the next @UMichGIHep #GIGrandRounds When: Tuesday, Dec 6th, 730-830 AM EST Who: All How:

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Shrinivas Bishu

@IBDimmunology

3 months

Interesting MA of RCTs of DCE v HD-WL for dysplasia in IBD @DrSamirAShah1 @AmJGastro ☑️DCE > HDWL for fraction of pts with at least one dysplasia (19% v 9%) ⏺️low heterogeneity. ⏺️ implies targeted (DCE) > Rand. bx? ✅ I use NBI - what do you use?

Dye Chromoendoscopy Outperforms High-Definition White Light ... : Official journal of the American...

y bowel disease (IBD) undergoing surveillance colonoscopy. METHODS: A comprehensive search was performed for randomized controlled trials (RCT) comparing HD-WLE and DCE in patients with IBD. The...

journals.lww.com

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Shrinivas Bishu

@IBDimmunology

2 months

I was happy to write this commentary in @jclinicalinvest I strongly encourage to read this paper in @jclinicalinvest by @AmerGastroAssn CDA winner @alhecht

Journal of Clinical Investigation

@jclinicalinvest

2 months

#Commentary : A step closer to understanding how a diet high in simple carbohydrates may cause dysbiosis: @HpyloriDoc @IBDimmunology @umichmedicine Related article:

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Shrinivas Bishu

@IBDimmunology

2 years

Got stones? EUS or MRCP? Amazing - few studies comparing them @UMichGIHep Check it in @Gut_BMJ 👇🏾 ▶️intermediate probability for cholidocolithiasis, then MRCP = EUS for detecting stones. ▶️Done. If you don’t know, @AIGHospitals are pros.

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Shrinivas Bishu

@IBDimmunology

3 years

Love the collab between @UMichGIHep @UMRogelCancer @ibddoctor @JoannaMeliaMD @IBDHopkins with input from @MGH_GI and @DanaFarber faculty that made our small study 👇🏾possible !! - hopefully it’s useful in treating Check-point colitis!!

Peter Higgins

@ibddoctor

3 years

@IBDimmunology innovating in the treatment of immune checkpoint-inhibitor colitis. Effectiveness of JAK inhibitors

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