Shrinivas Bishu
@IBDimmunology
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IBD Clinical Director & GI APD @UMichGIHep, #BillsMafia, suburu driving husband of @jquigleymd, embarrassing dad of daughters. I peaked in 1996.
Ann Arbor, MI
Joined September 2019
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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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.
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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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Congrats to my friend @NDP1001 - the new . Clinical Director of Hepatology @UMichGIHep @MichiganLiver . The future looks bright @MichiganLiver!
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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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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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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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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!!.
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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.
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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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#Michigan is a very beautiful state. Sunrise over Lake Michigan this morning 👇🏾. It’s the little things!
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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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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.
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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!.
@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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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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🦃 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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▶️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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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 .
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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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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.
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#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.
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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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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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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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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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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?.
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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 👇🏾.
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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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 👇.
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#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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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?.
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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).
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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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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▶️ @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 .
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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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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?.
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🔥 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 👇.
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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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@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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#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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Excellent + succinct piece in @AGA_CGH on updating Rutgeerts scoring + modern surgical anastomosis. It’s worth your 5 min for the references alone!.
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IM residents! - consider @UMichGIHep for your fellowship!!. ✅incredible faculty.✅great research.✅supportive fellows and program directors! . ▶️I’m an APD - so caveat!!!.
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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.
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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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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.
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#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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Grants submitted. Older kids at sleep-away camp. I'm ready to tweet again.
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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!!.
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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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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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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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#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?.
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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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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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@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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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.
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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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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!.
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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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.
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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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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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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@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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You know you hit peak #MedTwitter when a crypto bot is on your chain. #dropthemic. #topthat @ebtapper and @ibdgijami @DrHarryThomas . #killedit.
@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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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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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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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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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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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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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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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!.
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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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#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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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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🧢 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 .
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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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What a beautiful place! . Sunrise over Lake Michigan. Sutton’s Bay, MI. Happy Friday!
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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!.
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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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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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!.
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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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?.
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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.
🎉 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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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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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?.
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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.
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Day 4 of no power in Ann Arbor. It’s cold and our table looks like this.
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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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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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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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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!.
@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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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?.
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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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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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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?.
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I was happy to write this commentary in @jclinicalinvest . I strongly encourage to read this paper in @jclinicalinvest by @AmerGastroAssn CDA winner @alhecht.
#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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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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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!!.
@IBDimmunology innovating in the treatment of immune checkpoint-inhibitor colitis. Effectiveness of JAK inhibitors
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