Clinical Decision Making in Inflammatory Bowel Disease Mimics: Practice Management from Inflammatory Bowel Disease LIVE.

Background

Since 2009, inflammatory bowel disease (IBD) specialists have utilized "IBD LIVE," a weekly live video conference with a global audience, to discuss the multidisciplinary management of their most challenging cases. While most cases presented were confirmed IBD, a substantial number were diseases that mimic IBD. We have categorized all IBD LIVE cases and identified "IBD-mimics" with consequent clinical management implications.

Methods

Cases have been recorded/archived since May 2018; we reviewed all 371 cases from May 2018-February 2023. IBD-mimics were analyzed/categorized according to their diagnostic and therapeutic workup.

Results

Confirmed IBD cases made up 82.5% (306/371; 193 Crohn's disease, 107 ulcerative colitis, and 6 IBD-unclassified). Sixty-five (17.5%) cases were found to be mimics, most commonly medication-induced (

Conclusions

The diverse presentation of IBD and IBD-mimics necessitates periodic consideration of the differential diagnosis, and reassessment of treatment in presumed IBD patients without appropriate clinical response. The substantial differences and often conflicting treatment approaches to IBD versus IBD-mimics directly impact the quality and cost of patient care.

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.

Déclaration de conflit d'intérêts

HWF: None to disclose. CW: None to disclose. SAS: Board of Trustees for the American College of Gastroenterology. SDH: Consultant for Takeda. Recipient of grants from the Crohn’s and Colitis Foundation and American Society of Colorectal Surgeons. BAB: Speaker fees from AbbVie, Takeda, Bristol-Myers Squibb, and Janssen Pharmaceuticals. Advisory Board for Bristol-Myers Squibb and Pfizer. ELB: Consultant for Target RWE. DB: Research Grants/ Investigator-Initiated Studies with Abbvie, Merck, Takeda. MB: Consultant for Abbvie, Prometheus, BMS, and Cristcot. MB: None to disclose. KC: Consultant for Takeda and AbbVie. Advisory Board for AbbVie and Janssen. Speakers bureau for Takeda, AbbVie, Janssen, and Pfizer. KC holds the position of Deputy Editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for this manuscript. LC: Consultant for Abbvie, Takeda, Target RWE. Speaker for Abbvie. Educational grant from Pfizer. RKC: Consulting Fee for Abbvie, Adiso, BMS, Fzata, Fresenius Kabi, IBD Education Group, Janssen, Magellan Health, Option Care, Pfizer, Samsung Bioepis, Sandoz, Sebela, and Takeda. Scientific Co-Director for CorEvitas Registry. Research Grant from Janssen. JD: None to disclose. ME: Speakers Bureau for Abbvie, Pfizer. Advisory Board for Bristol Myers Squibb. FAF: Consulting fee for Avalo Therapeutics, BMS, Braintree Labs, Fresenius Kabi, GI Reviewers, GSK, IBD Educational Group, Iterative Health, Janssen, Pharmacosmos, Pfizer, Sandoz Immunology and Viatris. DSMB for Lilly Pharmaceuticals. SF: Advisory Board for BMS, Janssen, Abbvie. Consultant for BMS, Abbvie. EF: Consultant for Abbvie, BMS, Janssen, Takeda. EF holds the position of Deputy Editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for this manuscript. JG: Consulting for MRM Health, Yiviva. Advisory Board for Pfizer, Takeda. Research Support from Bristol Myers Squibb. PG: Consultant and Speaker for Abbvie, Janssen, and Takeda. AG: None that is relevant to this topic. Spouse employed by and has equity in Rapt Therapeutics. JH: None to disclose. HH: Consulting fees for Alivio, AMAG, BMS, Boehringer, ExeGI Finch, Fresenius Kabi, Galapagos Gilead, Janssen, Lycera, Merck, Otsuka, Pfizer, PureTech, Seres, Ventyx. Research support from Allakos, Artizan Biosciences, Novo Nordisk, Pfizer. TH: None to disclose. CRK: None to disclose. ML: Advisory Board for Janssen. LCL: None to disclose. LCL holds the position of Deputy Editor for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for this manuscript. JM: Research funding from Pfizer. Fellowship funding from JNJ. Site PI for clinical trial for Seres Pharmaceutical. JP: Awaiting disclosures. TQ: Awaiting disclosures. CAS: Consultant and Advisory Board for Abbvie, BMS, Boomerang, Buhlmann, Janssen, Lilly, Napo Pharmaceuticals, Pfizer, Prometheus Biosciences, Prometheus Labs, Roivant, Takeda, Trellus Health. Speaker for CME Activities for Abbvie, Janssen, Pfizer, and Takeda. Grand Support from Abbvie, Janssen, Pfizer, and Takeda. AW: None to declare. SDW: Consulting fees for ARC/Corvus, Baxter, BD, GI Supply, Glaxo Smith Kline, ICON Clinical Research Limited, Intuitive Surgical, Leading BioSciences/PalisadeBio, Livsmed, Medtronic, Olympus, OstomyCure, Stryker, Takeda, Virtual Ports. Royalties for Inventor’s Income Intellectual Property for Intuitive Surgical, Karl Storz Endoscopy America Inc, Medtronic, Unique Surgical Innovations LLC. Inactive Consulting Agreements with CRH Medical, Intuitive Surgical, Pragme/GibLib, Renew Medical. EDW: Consultant and Speaker for Abbvie and Pfizer. MR: Advisory board and Consultant for Abbvie, Janssen, UCB, Takeda, Pfizer, BMS, Organon, Amgen, Genentech, Gilead, Salix, Prometheus, Lilly, Celgene, Boehringer Ingelheim Pharmaceuticals Inc (BIPI). MR holds the position of Editor-in-Chief for Crohn’s & Colitis 360 and has been recused from reviewing or making decisions for this manuscript.