August 5, 2022

What’s Ahead in Pediatric IBD Care? Cure-Based Therapies and Prevention-Based Interventions

Symposium highlights areas of hope and advancement within the field

22-CHP-3004617 CQD-Kurowski-Event Wrap Up – 1st Annual IBD

While treatment options for pediatric inflammatory bowel disease (IBD) have improved significantly over the last several decades, disease manifestations have also become more complex and with earlier onset in children than has been noted in previous eras.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Still, physicians say there is justified enthusiasm as targeted and personalized treatment, improved surgical techniques, and more informed epidemiological insights give way to a new paradigm in the delivery of pediatric IBD care.

These were central themes during the inaugural Kaplan Foundation Pediatric Inflammatory Bowel Disease Symposium hosted at Cleveland Clinic in May 2022. Jacob Kurowski, MD, a pediatric gastroenterologist who chaired the event, says when former colleague Barbara Kaplan, MD, who practiced at Cleveland Clinic for more than 20 years before retiring in 2021, shared her idea to create the symposium, he was eager to help bring the event to fruition.

“The words were barely out of her mouth and I burst open with 400 ideas about how we could do this,” laughs Dr. Kurowski. On their relationship, he says, “I worked with Dr. Kaplan very closely since joining Cleveland Clinic seven years ago, and even though we trained in different eras, we had a very similar passion and approach to patient care.”

Presentations at a glance

Together they designed a schedule of presentations that addressed three current topics in the pediatric IBD community: the role of regenerative medicine in the treatment of IBD, the use of artificial intelligence (AI) in predicting outcomes, and leveraging data to develop new epidemiological research models.

“It’s undeniable that technology—in therapeutics and data application—is changing the landscape in IBD care. These presentations provided a snapshot of some of that exciting work,” says Dr. Kurowski.

Leveraging artificial intelligence to better understand and treat IBD

Dr. Kurowski presented on current uses and future potential of AI in endoscopic, histologic and radiologic imaging, as well as machine learning applications of electronic medical records. He says applications can help predict responses to therapy, support disease monitoring, and inform the selection of therapy.

Advertisement

“AI includes machine learning, deep learning, supervised and unsupervised learning—each slightly different but all adept in removing inherent human-based bias and variability,” he says.

For his part, Dr. Kurowski and his team are currently involved in radiomics studies, which involve a pixel-by-pixel analysis of MRIs to develop a clearer picture of disease characteristics and use as a potential biomarker. He has also published several studies involving natural language processing, a machine learning tool that detects key terms in electronic health records and can help compare treatment outcomes and identify early response and failure.

He is hopeful AI can be used to inform precision medicine and help sharpen the delivery of care for patients with IBD.

“If we know that 600 patients we’ve previously taken care of with a certain set of characteristics have all responded to this therapy versus that therapy, that can help inform a treatment plan and support clinical decision-making with patients and families.”

A closer look at the global epidemiology of IBD

Eric Benchimol, MD, PhD, a pediatric gastroenterologist at the Hospital for Sick Children in Toronto, delivered the keynote address at the symposium. His presentation examined the global epidemiology of IBD, including literature that shows the growing incidence of IBD in newly industrialized and developing countries.

He stressed that access to health data has enabled investigations linking IBD to certain exposures, particularly early antibiotic use and environmental risk factors such as air pollution, water quality, neighborhood walkability, and other variables. He also explored associations related to race and ethnicity, patterns of human migration, and their subsequent effect on the human microbiome, relating to the incidence of IBD.

Advertisement

The new way forward, he argues, is continuing bench research to improve bedside care, but also an increased focus on extrapolating patient data to better understand IBD causes and manifestations at the population level, and then delivering broader interventions that may also inform personalized care.

Dr. Benchimol is hopeful this new model is achievable by leveraging reliable data mining methodology and fostering collaboration among clinicians, basic and translational scientists, epidemiologists, computer and data scientists, engineers, policymakers, and patients and families.

The takeaway message

Dr. Kurowski says the presentations address themes that loom large within the field.

“There is a lot of hope and advancement in this field as we move toward cure-based therapies and prevention-based interventions. We have identified several environmental risk factors, some more modifiable than others, and that work will continue to be important. These presentations represent the evolution of the field and how it continues to move forward, not just in the coming years but in the coming decades.”

Related Articles

Doctor talking with patient
February 21, 2024
Consider Risk Factors When Deciding Care Path for Postoperative Crohn’s Disease

Strong patient communication can help clinicians choose the best treatment option

Federico Aucejo, MD
February 7, 2024
New Research Indicates Liver Transplant, Resection as an Option for Patients with CRLM

ctDNA should be incorporated into care to help stratify risk pre-operatively and for post-operative surveillance

Impostor phenomenon
February 6, 2024
Recognizing the Impact of Impostor Phenomenon and Microaggressions in Gastroenterology

The importance of raising awareness and taking steps to mitigate these occurrences

Koji Hashimoto, MD, and team
February 2, 2024
Combined Cardiac Surgery and Liver Transplant Is a New Option for Highly Selected Patients

New research indicates feasibility and helps identify which patients could benefit

Ajita Prabhu, MD
January 29, 2024
Case Study: Repair Surgery for Patient with Hernia and Abdominal Damage

Treating a patient after a complicated hernia repair led to surgical complications and chronic pain

liver
December 8, 2023
MILU Improves Outcomes Among Critically Ill Patients with Advanced Liver Disease

Standardized and collaborative care improves liver transplantations

CQD-4306360-robotic-1
December 4, 2023
First Robotic Sleeve Gastrectomy Using Magnets in the US Performed at Cleveland Clinic

Fewer incisions and more control for surgeons

alcohol
November 17, 2023
Younger Patients with Alcohol-Associated Hepatitis Present to the ED More Often, Research Shows

Caregiver collaboration and patient education remain critical

Ad