Ben Click

IBD MD at University of Colorado. Clinician and researcher. Tweets my own. Retweet not endorsement.

[Ben Click @BenClickMD]

@IBDimmunology @Bealoquebea 🙏 @IBDimmunology They are likely localized CD as @JeanFredericCo1 referenced. IMO induced by microenvironment tissue trauma/ischemia. 🧐 that isolated anastomotic ulcers generally stay localized and less likely to progress than ileal. So it seems more “contained”

[Ben Click @BenClickMD]

‼️Important HBV reaction prevention in IBD pts. Note JAKi mod risk > aTNF in sAg(-), cAb(+) -> antiviral ppx. @GI_PharmD @JHashashMD @fudmanMD @Waseem_AhmedMD @IBDPharmD
https://t.co/HjLoTva1CK

[Ben Click @BenClickMD]

Crowdsourcing IBD journal club ideas. What are your biggest clinical impact recent articles? @fudmanMD @DCharabaty @IBDimmunology @Waseem_AhmedMD @EdwardLoftus2 @MLongMD @Bealoquebea

[Edward Loftus @EdwardLoftus2]

Maybe time to just get the C diff test?

[Ben Click @BenClickMD]

Makes sense and highlights 💊💉needs after ASUC 🏥, but still high (~50%) rate of “treatment failure” in IVCS responsive -> IFX + AZA. ? rapid steroid taper in IFX. ? No proactive TDM in high risk pop. Other thoughts? @Waseem_AhmedMD @berinsj @IBDimmunology

[Ben Click @BenClickMD]

@IBDimmunology @SophieBalzoraMD @Aetna Yeah that was an immediate “WTF” call. Turns out their system just messed up and they meant Remicade. Thanks for the unnecessary work CVS

[Ben Click @BenClickMD]

@IBDimmunology @Bealoquebea @LancetGastroHep No 💊💉 works better in SB than colon. Comparatively VDZ may not be as good as others. Postop is diff. Prevention after 🔪 induced remission may be “easier” than healing mod-sev ileal dz. So yes a bit of bad dogmatic rap

[Ben Click @BenClickMD]

@JamesLewisGIEpi @DrsMeena Most people get it in their arm, but you have always been a trailblazer!

[John Haydek, MD MS @JHaydek]

🚨AGA New Guideline Alert🚨
🔗https://t.co/Soq11pPrEc
▶️AGA Living Guideline: Pharmacological Management of Moderate-Severe Ulcerative Colitis
I’ll break down its 14 recommendations down over the next 7 tweets 🧵 👇
#AGA #GI #UC #IBD #MedTwitter

1/9

[Ben Click @BenClickMD]

First non aTNF to demonstrate efficacy in RCT to 🛑 endo recurrence. Good option and reassuring data to have.

[Harry Sokol @h_sokol]

Vedolizumab to prevent postoperative recurrence of Crohn's disease (REPREVIO): a multicentre, double-blind, randomised, placebo-controlled trial - The Lancet Gastroenterology & Hepatology https://t.co/6xZPtwsCIk

[Ben Click @BenClickMD]

@DuekerJeffrey @IBDimmunology @JHashashMD @FITWITMD @LoriPlung @ownyourcrohns Ditto, maybe even higher which is largely patient driven selection. Virtual care for IBD in Medicare in danger of pre-2020 coverage unless new legislation passed by 1/2025.

[IBDJournal & CC360 @IBDJournals]

More RWE that combo-AT effective in refractory IBD (n=79) @jensemineriomd
🟢Mean Mayo 3▶️1
🟢Mean SES-CD 12▶️4
🟢73% clin improvement
🔴47% AEs (URIs and derm issues mostly)

https://t.co/dSgN9tzQfS

[Ben Click @BenClickMD]

@GI_PharmD @CrohnsColitisFn Always several year lag behind new recommendation/intervention and routine clinical uptake. Need time to educate community providers. Hopefully will 📈 next few years.

[Sara Horst MD, MPH, FACG @HorstIBDDoc]

@ABennettMD did an amazing job at #ACG2024 presenting a multi-center study evaluating outcomes in transgender pts with IBD on gender affirming hormones!
@VUMCibd @VictorChedidMD @KiraNewmanMDPhD @JustinFieldMD @BenClickMD

[Ben Click @BenClickMD]

@IBDimmunology @DCharabaty @ibdgijami @MondayNightIBD @EliLillyandCo @JosephHabibi_MD @P_DeepakIBDMD @ibdnaik @joshsteinbergMD @Waseem_AhmedMD @JHashashMD @SchairerIBDMD @BattatMD4IBD @fudmanMD @IBD_Houston Not pertinent to case as still endo active dz, albeit better, but in absence of endo dz, no prospective data that treat to histo healing improves clin outcomes. So histo is 👍 if achieved but I do not (yet) treat to proactively. If histo nl in case, 🤔 sampling

[Ben Click @BenClickMD]

@IBD_FloMD @Tamara_alhobayb @catherinechoimd @LindsayClarkeMD @dunleavy_katie @GI_Jimmy15 @SGhoneimGI @AKohli_MD @SNaffouj @silverman_anna @JosephHabibi_MD @HSystromMD @SiriUrquhartMD @RussellYanofsky @GI_Zhou @MilestoneIBD @MRegueiroMD @tinahamd @DrsMeena Can someone please sit with @tinahamd ?

[Ben Click @BenClickMD]

@fudmanMD @AmelieT27 @JVG_GIMD @DCharabaty @MondayNightIBD @abbvie @JanssenUS @TakedaPharma @IBDJournals @DarrellPardi @john_damianosMD @IBD_JohnD @EugeneYenMD @JonathanMoses77 @KofiClarkeMD @DrRosenIBD @BenjaminLebwohl @RituVermaMD @CeliacResearch @BIDMC_GI @peter_bossuyt @BattatMD4IBD @BenClement_MD @AmJGastro @Khanna_S Coverage and copay is/was a pragmatic issue with MMX. Esp in older pop, fixed income, etc.

[Ben Click @BenClickMD]

@EdwardLoftus2 @JCC_IBD @amelia_kellar @pilarnos @guthealthmd @AndresYarur @maria_chs @JoanaTo62523004 @Y_ECCO_IBD Yup. SC is modeled for AUC. Similar findings to Roblin et al. May need higher “targets” for SC IFX to equate to IV

https://t.co/RCR9QdJxD3

[Ben Click @BenClickMD]

@ibddoctor @EdwardLoftus2 @IBDimmunology @GI_PharmD @MRegueiroMD @ibdgijami Agree, but in a few years we should have decent RWE since the confounding by indication will be rather limited. Would also allow larger sample sizes using multi center or claims data to reduce type II error.