Gastroenterology Month in Review: August 2024

As the summer months draw to a close and with fall on the horizon, the field of gastroenterology prepares to enter a busy conference season sure to offer a plethora of novel research and new pipeline developments. A fitting segue into a busy autumn, HCPLive’s gastroenterology coverage in August was characterized by notable expansions in gastrointestinal treatment and screening access as well as the release of the latest installment of Qazi Corner, all of which we spotlight in this month in review.

Expanding Treatment, Testing Access in GI

Humira Biosimilar Added to Costco Member Prescription Program

Adalimumab-aaty, which was FDA approved on May 23, 2023, and became commercially available in the US on July 2, 2023, was added to the Costco member prescription program in August, allowing eligible members and their dependents to obtain the drug at a substantial discount. The high-concentration, citrate-free Humira biosimilar is approved for the same indications as reference adalimumab: rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurativa, and uveitis, although for pediatric patients, adalimumab-aaty is only approved for treating juvenile idiopathic arthritis and Crohn disease.

"We are pleased to partner with Costco, the largest warehouse club and third-largest retailer in America," Francine Galante, Vice President, Market Access, Celltrion USA, said in a statement. "We are committed to increasing patient choice through access to biosimilars. The inclusion of adalimumab-aaty to the Costco Member Prescription Program will expand patients' treatment options and help reduce healthcare costs."

William Grady, MD: Improving Colorectal Cancer Screening Compliance with Patient Choice

Following the FDA approval of Guardant Health’s Shield blood test, the first FDA-approved blood-based primary screening option for adults 45 years of age and older at average risk for colorectal cancer, the editorial team of HCPLive Gastroenterology spoke with William Grady, MD, medical director of the Gastrointestinal Cancer Prevention Program at Fred Hutchinson Cancer Center, for additional insight into the decision and its impact on patient choice.

Although colonoscopy is widely considered to be the “gold standard” for colorectal cancer screening, many patients avoid getting one due to the invasive nature of the procedure and potentially inconvenient aspects of a colonoscopy. Thus, noninvasive alternatives may offer a more appealing, convenient alternative to help improve screening rates. Stool tests have long been the only non-invasive alternative, until the FDA approval of the first blood-based test with Guadant’s Shield.

“The tragedy is we have a test already, colonoscopy, that's very accurate for detecting colorectal cancer and detecting advanced polyps, but if it's not used, it doesn't work at all,” Grady said. “For those people who are opting not to colonoscopy and not to do the stool-based testing, we’re hoping they will now do colon cancer screening with a blood test.”

New Installment of Qazi Corner

To conclude the month of August, HCPLive and Taha Qazi, MD, a gastroenterologist at Cleveland Clinic, released the seventh issue of Qazi Corner, a collaborative quarterly newsletter on gastroenterology research, news, and trends between HCPLive and editor-in-chief Qazi.

The latest installment features a trio of articles from Cleveland Clinic experts about the timing of endoscopic retrograde cholangiopancreatography (ERCP) in liver transplant recipients, important considerations for pre-procedure planning in patients on GLP-1 receptor agonists getting an endoscopy, and the differential diagnosis of seronegative villous atrophy.

Safety, Outcomes of Early Versus Late ERCP in Liver Transplant Recipients

Biliary complications are a common cause of morbidity following liver transplantation, with the most common being strictures and leaks. Findings from this article suggest similar technical success, late postprocedural bleeding, post-ERCP pancreatitis, stent deployment, dislodgment, and cardiopulmonary complications in patients receiving early versus late ERCP. However, greater rates of early post-procedure bleeding were observed in patients who underwent ERCP ≤ 30 days after liver transplant as compared to ERCP > 30 days.

GLP-1 Receptor Agonists and Pre-Procedure Planning for Endoscopy

In light of the growing popularity of GLP-1 RAs, an obscure side effect has led to significant clinical considerations in the peri-endoscopy arena. Specifically, GLP-1 RAs have been shown to slow gastric emptying and reduce bowel motility due to inhibition of peristalsis at the level of the GLP-1 receptors localized to myenteric neurons. The exploration and validation of potential adverse events during endoscopy have prompted further consideration of the peri-endoscopic management of GLP-1 RA use.

The Clinical Challenge of Seronegative Villous Atrophy: A Preview

Findings from this article demonstrate the heterogeneous makeup of seronegative enteropathies, with just 26% of included patients able to be classified using current Paris consensus definitions. This highlights the need for systematic evaluation and clinical follow-up for patients with villous atrophy and negative celiac serologic testing to ensure adequate diagnosis.