Several therapeutic innovations in the management of Clostridioides difficile infection recurrence, current evidence on the efficacy of weight loss procedures in reversing nonalcoholic fatty liver disease, and an interview the use of artificial intelligence were spotlighted at Digestive Disease Week (DDW) 2022.
Digestive Disease Week (DDW) 2022, held virtually and in San Diego, California, from May 21 to 24, spotlighted several therapeutic innovations in the management of Clostridioides difficile infection (CDI) recurrence, current evidence on the efficacy of weight loss procedures in reversing nonalcoholic fatty liver disease (NAFLD), and an interview with a gastroenterologist on how artificial intelligence (AI) is used in her specialty and what challenges it may pose for clinicians.
Here are the conference highlights from DDW 2022.
RBX2660, a microbiota-based live biotherapeutic, was shown in a pair of posters presented at DDW 2022 to be effective in preventing CDI recurrence and restoring the microbiome. Paul Feuerstadt, MD, of Yale University School of Medicine and PACT Gastroenterology Center, and an author of one of the posters, said in an interview with The American Journal of Managed Care® (AJMC®) that “it’s truly an exciting time in this space,” considering that clinicians across disciplines have struggled to manage CDI for decades.
Following these findings, RBX2660 would be renamed Rebyota (fecal microbiota, live-jslm) and become the first fecal transplant therapy approved by the FDA for the prevention of CDI recurrence in individuals 18 years and older, following antibiotic treatment for recurrent CDI.
A panel discussion at DDW 2022 covered current evidence on weight loss achieved through bariatric and endoscopic surgery in helping to treat and reverse NAFLD. Experts noted findings of a meta-analysis showing bariatric surgery resolved steatosis 91.6% of the time, but resolution rates post surgery are only 81.3% for steatohepatitis and 65.5% for fibrosis. Moreover, experts cautioned that optimal procedure selection and timing vary by patient factors.
Clearly, improvement is “very much related to the stage of disease, so what does it call for? Earlier intervention,” said John Morton, MD, MPH, of Yale University School of Medicine. Overall, however, bariatric surgeries are a safe and effective option, and data demonstrate their positive impact on the liver function levels that are a marker of NAFLD, Morton said.
The effectiveness of RBX2660 in preventing CDI recurrence was again demonstrated in another abstract presented at the meeting. A subgroup analysis of patients in the randomized, placebo-controlled PUNCH CD2 and PUNCH CD3 trials, looked at data from patients who received 1 dose of either RBX2660 or placebo in both studies, with findings showing the rate of treatment success in this pooled analysis was higher in those receiving the drug compared with placebo (68.3% vs 55.0%; P = .012).
Another poster analyzed data from the PUNCH CD3 trial on patients with documented recurrent CDI who had received standard-of-care antibiotic therapy prior to receipt of RBX2660 or placebo, with similar results demonstrating overall cumulative probability of CDI recurrence at 8 weeks was lower in participants who received RBX2660 (27%) than in those who received placebo (35%).
Sravanthi Parasa, MD, gastroenterologist at Swedish Gastroenterology in Seattle, Washington, spoke with AJMC® on ways that AI is being used to help process medical data in gastroenterology and challenges clinicians are facing when using it.
“There are different ways as to how AI is being used. When we think about AI, it's just not images or dictation or the notes that we do, it's a bunch of different things,” said Parasa.
“Understanding how these algorithms are made and if that question that the AI is trying to answer is relevant to your patient population becomes very important. That's where we want to know how you can interpret the results, so that's where a little bit of clinical education in terms of basics of AI becomes important.”