Advanced Fellowship Training in IBD: A Worthwhile Fourth Year

Excerpt

Inflammatory bowel disease (IBD) is a fast-moving and dynamic field that is bursting at the seams with new discoveries and ideas. Over the past year alone, three new drugs were approved for maintenance therapy: ozanimod, upadacitinib, and risankizumab, reflecting the extraordinary growth of IBD treatment in recent years [1]. This is especially remarkable considering that immunomodulators were first used in the 1960s, tumor necrosis factor (TNF) inhibitors in the 1990s, and the first monoclonal antibody not directed at TNF was approved by the FDA in 2016 [2]. Of course, the introduction of each new drug requires the treating clinician to be informed about their unique adverse effects, monitoring parameters, and potential changes in the treatment algorithm, in addition to evolving dietary and surgical interventions. These striking therapeutic advances have been informed and accompanied by advances in the understanding of basic mechanisms underlying mucosal inflammation and related pathologies universally present in patients with IBD. …