Top Content From DDW 2022

Digestive Disease Week (DDW) 2022, held virtually and in San Diego, California, from May 21 to 24, featured several therapeutic innovations in the management of Clostridioides difficile infection (CDI) recurrence, current evidence on the effectiveness of weight loss procedures to reverse non-alcoholic fatty liver disease (NAFLD), and an interview with a gastroenterologist on how artificial intelligence (AI) is used in her specialty and what challenges it faces may contain clinicians.

Here are the conference highlights from DDW 2022.

Posters show success of RBX2660 in reducing recurrence of C difficile, revitalizing microbiome

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 a really exciting time in this space,” given that clinicians across disciplines have struggled to manage CDI for decades.

Following these findings, RBX2660 will 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 .

Complex questions surround potential of weight loss procedures to reverse NAFLD

A panel discussion at DDW 2022 covered current evidence on weight loss achieved through bariatric and endoscopic surgery to help treat and reverse NAFLD. Experts noted findings from a meta-analysis showing that bariatric surgery resolved steatosis 91.6% of the time, but resolution rates after surgery are only 81.3% for steatohepatitis and 65.5% for fibrosis. Furthermore, experts cautioned that optimal procedure selection and timing vary according to patient factors.

Clearly, improvement “is very much related to the stage of the disease, so what does it ask 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 show their positive impact on the liver function levels that are a marker of NAFLD, Morton said.

Investigational biotherapeutics offer relief from CDI recurrence by “filling in the cracks” in the microbiome

The efficacy of RBX2660 in preventing CDI recurrence was demonstrated again 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 that the rate of treatment success in this pooled analysis was higher in those receiving the drug compared to placebo (68.3% vs 55.0%; P = .012).

Another poster analyzed data from the PUNCH CD3 trial on patients with documented recurrent CDI who received standard-of-care antibiotic therapy before receiving RBX2660 or placebo, with similar results showing that overall cumulative probability of CDI recurrence after 8 weeks was lower in participants receiving RBX2660 (27%) than in those receiving placebo (35%).

Dr. Sravanthi Parasa emphasizes the importance of clinical education about AI

Sravanthi Parasa, MD, gastroenterologist at Swedish Gastroenterology in Seattle, Washington, met AJMC^® about ways AI is being used to help process medical data in gastroenterology and challenges clinicians face when using it.

“There are different ways on how AI is 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,” Parasa said.

“Understanding how these algorithms are made and whether that question 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 bit of clinical education in terms of basic principles of AI becomes important.”