Nathan Constantine-Cooke

PostDoc health data scientist in @charlie_lees' group @UoE_CGEM and @CataVallejosM's group @mrc_hgu. Modelling biomarkers in IBD.

[Nathan Constantine-Cooke @IBDNathan]

Today's PREdiCCt paper at a glance! Read the full paper here: https://t.co/mEbQfuz3IN

[Clara Ramos @clara_ramosb]

🚨I am excited to share our experience on dual targeted therapy using upadacitinib + risankizumab in refractory Crohn’s disease 💊📊

Recently published in JCC Plus: https://t.co/vJoSFn1ybI

🔥Adds real-world evidence to the emerging use of combination advanced therapies in IBD

[Charlie Lees @charlie_lees]

20 years ago we started asking IBD patients in Edinburgh for a scoop of poo.

Sounds simple.

It was.

But it changed everything.

New Atomic IBD on the FC story — from triage to trajectories to what comes next with SENTINEL.

https://t.co/XkV3ePV0yd

[The Bottom Line IBD @bottomlineibd]

* NEW PODCAST EPISODE *

What do the first PREdiCCt study results have to say about...

⭐️ Faecal calpro predicting future flares?
⭐️ How meat intake affects Crohn's vs UC patients?
⭐️ Women's reproductive hormones and #IBD symptoms?

🎧 Answers here! ➡️ https://t.co/DG19pI5Yzq

[Nathan Constantine-Cooke @IBDNathan]

I had the pleasure of chatting with the fantastic @bottomlineibd and @Crohnoid about the clinical and dietary results of the PREdiCCt study on their patient podcast.
You can find it on all the main podcast apps under Wresting the Octopus.

[The Bottom Line IBD @bottomlineibd]

Our latest #IBD podcast episode is now live!

Search "Wrestling the Octopus IBD" on your usual podcast platform.

[The Bottom Line IBD @bottomlineibd]

Our latest #IBD podcast episode is now live!

Search "Wrestling the Octopus IBD" on your usual podcast platform.

[The Bottom Line IBD @bottomlineibd]

What can studying 2,629 #IBD patients in remission over 10 years reveal about predicting flares in Crohn's and UC?

In tomorrow's podcast episode, we chat with @IBDNathan about the first PREdiCCT study results and what they mean for patients.

Search "Wrestling the Octopus IBD".

[Nathan Constantine-Cooke @IBDNathan]

The code for last week's PREdiCCt Study paper is now publicly available.
https://t.co/p4nnKGtUhi

[GI Nutrition Foundation @GI_NutritionFdn]

What can (and cannot) predict flares in people with #IBD in remission❓

💡New insights from the PREdiCCt Study from @IBDNathan, @Bealoquebea, @charlie_lees & colleagues after following 2,629 people 🇬🇧 in self-reported remission for 4 years:

✅ Feeling well is not the same as being at low inflammatory risk

✅ Baseline faecal calprotectin was the strongest predictor of future flare

👉Even when symptoms are quiet, your flare risk increases if fecal calprotectin is within the 50–250 µg/g "grey zone" (also called subclinical inflammation)

✅ In ulcerative colitis, higher baseline meat consumption (red and white) was associated with a double risk of flare

✅ No consistent associations between flare risk and:
🍔🍦ultra-processed foods
🥦🍎dietary fibre
🐟🍣polyunsaturated fatty acids
🍺🍷alcohol intake

💡Altogether, these findings show the importance of monitoring fecal calprotectin (not symptoms) in order to know disease activity and not overlook diet as a driver of flare susceptibility.

📚Read the full research article in @Gut_BMJ: https://t.co/2SGozS3B7c

🔍Learn more about the PREdiCCt study: https://t.co/f7PqKOTkMT

[The Bottom Line IBD @bottomlineibd]

We'll be shining a light on the PREdiCCt study in a forthcoming podcast episode!

@IBDNathan, one of the study authors (and an #IBD patient himself, to boot), will be joining Nigel and me later this week to discuss the results and what they mean for those of us with Crohn's & UC.

[Charlie Lees @charlie_lees]

A study of this scale only happens because of the people behind the numbers. As we share the first results from PREdiCCt in @Gut_BMJ, it is vital to acknowledge the immense human effort that made this possible over the last decade.

Lisa Derr has been the brilliant engine room of this project. As our trial manager, she led the study with precision, making sure everything stayed on track and on budget across 49 different sites.

I want to extend my deepest thanks to every local Principal Investigator, every dedicated research nurse, and the administrative teams who worked tirelessly on the ground.

Most of all, we thank the 2,629 participants. Lisa and her team were in direct contact with many of you, sending out monthly questionnaires and answering your calls. Your commitment to this research is what will ultimately help us improve outcomes for everyone living with inflammatory bowel disease.

In this video, Lisa shares her perspective on what it takes to manage a national study and the highlights of working with such an incredible community.

@EdinUni_IGC

[Charlie Lees @charlie_lees]

https://t.co/dw7XsAalkX

[Charlie Lees @charlie_lees]

What really defines an IBD flare?

In the PREdiCCt study - published today in Gut - we explored the crucial disconnect between how a patient feels and what their biology says.

Nik Plevris, consultant gastroenterologist at the Edinburgh IBD unit, dives into our findings on patient-reported flares compared to objective flares.

We followed over 2,500 people for up to four years. The signal from baseline faecal calprotectin was undeniable across both Crohn's disease and UC. Even at levels currently considered a safe target, the risk of a future objective flare was significantly higher.

This data suggests we need to be more stringent with our monitoring targets to truly keep people in deep remission.

Watch the video to see how these different flare definitions impact our understanding of the disease.

[Charlie Lees @charlie_lees]

One of the most common questions in any IBD clinic is: What should I eat?

Beatriz Gros, consultant gastroenterologist and researcher, shares the landmark dietary results from the PREdiCCt study, now published in Gut.

We studied the habitual diets of over 1,000 patients in remission for up to four years to find clear answers. While we found no consistent signals from fiber or ultra-processed foods, we identified a significant association between meat intake and flare risk in ulcerative colitis.

This research provides a much-needed evidence base to help clinicians and patients make informed choices about diet and long-term disease management.

Watch the video to learn more about how diet influences IBD flare risk.

[Nathan Constantine-Cooke @IBDNathan]

The first PREdiCCt study paper is published tomorrow in #Gut! Watch our video on the study design with videos also forthcoming from Nikolas Plevris and Beatriz Gros describing key results.

[Charlie Lees @charlie_lees]

Why do people with Crohn's and Colitis flare?

This is the fundamental question we set out to answer when we started the PREdiCCt study in 2016.

On Tuesday, the first major results will be published in @Gut_BMJ

We wanted to look beyond just the clinical data. We focused on the environment: diet, lifestyle, exercise, sleep, and stress. By combining these factors with the microbiome and genetics, we aimed to understand the true drivers of disease activity over time.

This has been a decade in the making.

We recruited 2,629 patients across 49 adult and pediatric sites before the pandemic halted recruitment in March 2020. Since then, our team has been busy assimilating years of follow up data. Most participants have now been followed for over four years.

In this video, I talk through the background and design of the study. It represents a massive collective effort from clinical trials units, statisticians, and project managers.

Most importantly, it represents the dedication of the people living with IBD who gave their time to this research. Our goal is to provide the evidence needed to help patients stay in deep remission and to help clinical teams provide better, more personalized care.

I look forward to sharing the findings with you this week.

@EdinUni_IGC @EdinburghUni @NHS_Lothian @IBDNathan @predicct @Bealoquebea @PlevrisN @UKRI_News

[Charlie Lees @charlie_lees]

Why do people with Crohn's and Colitis flare?

This is the fundamental question we set out to answer when we started the PREdiCCt study in 2016.

On Tuesday, the first major results will be published in @Gut_BMJ

We wanted to look beyond just the clinical data. We focused on the environment: diet, lifestyle, exercise, sleep, and stress. By combining these factors with the microbiome and genetics, we aimed to understand the true drivers of disease activity over time.

This has been a decade in the making.

We recruited 2,629 patients across 49 adult and pediatric sites before the pandemic halted recruitment in March 2020. Since then, our team has been busy assimilating years of follow up data. Most participants have now been followed for over four years.

In this video, I talk through the background and design of the study. It represents a massive collective effort from clinical trials units, statisticians, and project managers.

Most importantly, it represents the dedication of the people living with IBD who gave their time to this research. Our goal is to provide the evidence needed to help patients stay in deep remission and to help clinical teams provide better, more personalized care.

I look forward to sharing the findings with you this week.

@EdinUni_IGC @EdinburghUni @NHS_Lothian @IBDNathan @predicct @Bealoquebea @PlevrisN @UKRI_News

[Nathan Constantine-Cooke @IBDNathan]

🚨We’ve been on a roll with papers📄! Read about our pan-UK RWE study of risa in CD (across 25 health boards!). Huge thanks to the HCPs and 763 people living with IBD that contributed to this study.

[Frontline Gastro @FrontGastro_BMJ]

⚠️ ❗ Real-world effectiveness of risankizumab in Crohn’s disease: a pan UK retrospective cohort study 🚨 🚨

👫 763 participants with CD
💉 Treatment persistence at 6 and 12 months was 95.4% and 89.2%, respectively
✅ Rates of clinical, CRP and FCAL remission were 52% (123/236), 53% (169/319) and 44% (69/156) at 6 months
😃 Rates of clinical remission for ustekinumab naive versus exposed were 57% (29/51) vs 51% (94/185) (p=0.54) 6 months

Conclusion: Risankizumab was effective in a large, real-world, medically refractory CD cohort with excellent persistence and good clinical and biochemical remission rates.

Read it here! ▶️ ▶️ ▶️ https://t.co/BJvhBi1Roo

With thanks to Alex Elford @alexelford3 and co-authors for this fantastic piece of work. @charlie_lees @PlevrisN

@RichardPollok @ibdseb @ChristianSelin3 @jklimdi @SamaanMark @UKgastrodoctor @DisneyBen @jennie_clough @Krishna___S @LoveshDyall

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

#IBD #InflammatoryBowelDisease #CrohnsDisease #UlcerativeColitis #IBDResearch #IBDScience #Biologics #AdvancedTherapies #IL23 #IL23Inhibition #Risankizumab #Skyrizi #Gastroenterology #GI #MedTwitter #AcademicMedicine #ClinicalResearch

[Charlie Lees @charlie_lees]

@FrontGastro_BMJ Delighted to see this out.
Many thanks to @AlexElford3 and @PlevrisN for driving this project, and for all contributing sites across the UK.
It is a big cohort (n=763 patients treated with risa).

[Frontline Gastro @FrontGastro_BMJ]

⚠️ ❗ Real-world effectiveness of risankizumab in Crohn’s disease: a pan UK retrospective cohort study 🚨 🚨

👫 763 participants with CD
💉 Treatment persistence at 6 and 12 months was 95.4% and 89.2%, respectively
✅ Rates of clinical, CRP and FCAL remission were 52% (123/236), 53% (169/319) and 44% (69/156) at 6 months
😃 Rates of clinical remission for ustekinumab naive versus exposed were 57% (29/51) vs 51% (94/185) (p=0.54) 6 months

Conclusion: Risankizumab was effective in a large, real-world, medically refractory CD cohort with excellent persistence and good clinical and biochemical remission rates.

Read it here! ▶️ ▶️ ▶️ https://t.co/BJvhBi1Roo

With thanks to Alex Elford @alexelford3 and co-authors for this fantastic piece of work. @charlie_lees @PlevrisN

@RichardPollok @ibdseb @ChristianSelin3 @jklimdi @SamaanMark @UKgastrodoctor @DisneyBen @jennie_clough @Krishna___S @LoveshDyall

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

#IBD #InflammatoryBowelDisease #CrohnsDisease #UlcerativeColitis #IBDResearch #IBDScience #Biologics #AdvancedTherapies #IL23 #IL23Inhibition #Risankizumab #Skyrizi #Gastroenterology #GI #MedTwitter #AcademicMedicine #ClinicalResearch

[Charlie Lees @charlie_lees]

⏰ Final call — applications close Sunday

Advanced Clinical Fellow (IBD Gastroenterology) — Edinburgh

If you're an advanced gastroenterology trainee thinking about your next move, this IBD-focused fellowship at the Western General Hospital might be exactly what you're looking for.

One year. Career-defining opportunities in:
• Advanced clinical IBD management
• High-impact clinical research & trials
• Real-world data / epidemiology
• Data science projects (for those inclined)

You'd be joining Edinburgh's translational IBD ecosystem, with the chance to work within my "Transformative IBD Medicine" programme, integrating biomarkers, EHR data, multi-omics, and machine learning to build the next generation of clinical tools.

Alumni include Nik Plevris, Beatriz Gros, Alex Elford, and Clara Ramos. All now doing exceptional things.

📌 Deadline: 05 Jan 2025 Apply here:
https://t.co/QIjnlPAJ9e