Millie Long, MD: Highlights From ACG 2019

In an interview with MD Magazine®, Millie Long, MD, MPH, associate professor of medicine at the University of North Carolina, Chapel Hill, discusses some of the abstracts she is excited to learn about while at ACG 2019.

MD Magazine: In your opinion, what has been the highlight of ACG 2019?

Long: So, I think there are a number of really interesting abstracts being presented here. I'm actually quite excited for an abstract to be presented this afternoon that is looking at sequencing of biologics.

You know one of the things we really don't know is we see this blunted effect when someone is first initiated on anti TNF agent with inflammatory bowel disease. And if they don't respond, and they move on to a separate second biologic, what we found, regardless of the second biologic type is that there's a blunted response.

People previously exposed to anti-TNF agents, actually see do not do as well as patients who were naive to those agents when they're started on an anti-integrin therapy.

But interestingly, this afternoon, there will be an abstract presented that looks at the opposite. looks at one of alternate biologics first a medication like vedolizumab or ustekinumab, and then initiating a patient on an anti-TNF to try to understand do we still have that same blunted effect?

And while overall, we certainly need more and more data and more numbers, at least this abstract shows that we don't seem to see that blunted effect associated with an anti-TNF used second.

So that makes us think, is there something about the anti TNF agent, specifically the biology that somehow changes this response? I think a lot of further research is needed, but it's an intriguing abstract that hopefully will help us in regard to kind of positioning and sequencing some of our therapies.