NEWSLETTER 10

Issue No.: NL 10 /2013 Date: July 2013 Newsletter Editor: Dr. Nahla Azzam

In this issue: 1. SGA LATEST SCIENTIFIC PARTICIPATIONS:

A. IBD Awareness Campaign 2013(Yes I Can)

B. IBD Clinical Observation Program 2013

C. “Update in Gastroenterology & Liver Diseases”

D. 6th Endoscopy Guide workshop

2. HOT TOPICS IN HEPATOLOGY & GASTROENTEROLOGY..

3. UPCOMING SCIENTIFIC EVENTS

IBD AWARENESS CAMPAIGN

4. GUT CLUB SCHEDULE FOR 2013

SGA Monthly GUT Club Meeting in Riyadh.

For More Information, please contact SGA

Office at:

TEL/FAX: 01-4679130

EMAIL: [email protected]

SGA Website: www.saudigastro.com

SGA journal: www.saudijgastro.com

Our Vision:

SGA aims to be a leading organization in the field of

gastroenterology with a significant positive impact on

patient care in the Middle East .

Our Mission:

To advance the science and practice of Gastroenterology

and Endoscopy in Saudi Arabia.

Current SGA Board of directors:

Dr. Abdulrahman AlJebreen, SGA President

Dr. Abdulllah Al-Ghamdi SGA Vice President

Dr. Ayman A. Abdo, SGA Treasure

Dr. Fahad AL Sohaibani SGA Board Secretary

Dr Faisal Sanai, SGA Board Member

Dr. Faisal Batwa, SGA Board Member

Dr. Mohamed AL Shumrany, SGA Board Member

Dr. Nahla Azzam, SGA Board Member

Dr. Hanan AL Ghamdi, SGA Board Member

1. SGA Latest Scientific Participations:

A. IBD Awareness Campaign 2013(Yes I Can)

11th of April 2013, succeeding Awareness campaign

was held at Al Khozama Hotel and Towers. More or

less than 100 Attendees are our patients from different

hospitals in Riyadh. Lectures took place, some of the

topics discussed were the Disease nature and its

etiology , When is the right time to seek consultation

once symptoms exists, the New Trends in IBD

Treatment, Comparison in the old and new IBD

medications , the relationship of lifestyle with the

disease, and the different surgical options for IBD

patients.

As part of the Program, patients were given an

opportunity to express their doubts, questions and

clarifications related to IBD and our Respected

Speakers: Dr. Othman Al Harbi Dr. Nahla Azzam, Dr.

Abdullah Mtawa, Dr. Ahmed Almalki and Dr. Khyal

Alkhyal generously answered them.

Booths were also made available with Health

Educators and Dieticians to further educate them.

Arabic and English Brochures, T-Shirts, Mugs and

other Souvenirs were distributed. Medical Students

were also present from the beginning until the end of

the Program to help and assist us.

Dinner was served after all the activities.

There’s no time to Stall! 11th of June 2013, “IBD

Awareness Campaign - YES I CAN” in a Mall Clinic

Set up was a success as per attendees’ feedback.

At the Gate 3, Open Grounds of Sahara Mall,

Gastroenterologist’s Booth, Health Educator’s Booth,

Dietician’s Booth and Kid’s Activity Booth was

crowded most of the time.

Please refer to the UPCOMING ACTIVITIES’

SECTION for the next “IBD Awareness Campaign”

Schedule.

KKUH Gastroenterology Unit and Saudi

Gastroenterology Association would like to

acknowledge ABBOTT PHARMACEUTICALS,

Riyadh for their sponsorship and made this Workshop

a Success!

Inflammatory Bowel Disease (IBD) is a chronic disease

of unknown etiology and considered traditionally as a

disease of the Western World. Ulcerative colitis (UC)

and Crohn's disease (CD) are chronic inflammatory

disorders of the gastrointestinal tract that have a

significant lifelong impact on a patient's quality of life

with a highly variable and uncertain clinical course. The

prevalence rate of these inflammatory bowel diseases

(IBDs) reach up to 396/100,000 people worldwide, with

a remarkable and sharply increase in the disease

incidence among Saudi population.

King Khalid University Hospital- Gastroenterology

Division and Saudi Gastroenterology Association never

relinquish to the increasing number of IBD Cases in

Saudi Arabia through continuous studies and research.

In addition to that, activities such as “IBD Awareness

Campaign” precedes to promote health and raise public

awareness of the Disease and its nature.

On the 8th

of April 2013, Opening Ceremony for this

year’s IBD Awareness Campaign entitled “YES I

CAN” was held. The Cutting of Ribbon was lead by Dr.

Othman Al Harbi and Dr. Nahla Azzam with the

presence of our Honorable Dean Prof.Professor

Mubarak Alfaran Physicians, Health Educators,

Dieticians, Medical Students, Company Representatives

and other Supporting Staffs were present and have their

own booth to ensure that the guest needs will be

accommodated. Information dissemination thru health

education to patients and their families is our focal

point. For the children’s booth, Interactive Kids

Activities took place.

B. IBD Clinical Observation Program 2013 C. “Update in Gastroenterology & Liver Diseases”

Under the auspices of Saudi Association for

Gastroenterology and in collaboration with King

Fahad Hospital and the Internal Medicine Department

in Albaha, an Evening symposium held in Al Baha

Tulip Hotel on Wednesday 7th Jumada Thani 1434

corresponding to 17th April 2013 with the title:

“Update in Gastroenterology & Liver Diseases”

This symposium was accredited by Saudi

Commission for Health Specialties with 10 CME

hours. The programme of the conference is created to

provide the participants with the latest recommended

guidelines on, clinical pictures and managements of

common gastrointestinal as well as hapatology

disorders. More than 120 participants from Al Baha

regions attended the conference.

On this occasion and on behalf of Albaha region

people Dr Mohamad Alshumrany, SGA Board

member extended his sincere thanks and appreciation

to Saudi Association for Gastroenterology, led by his

Excellency Dr.Abdul Rahman Al-Jebreen the SGA

President and The SGA Board members for their

industrious hard work and contributions in to increase

Health Education for physicians over all the Kingdom

of Saudi Arabia and provide of the Health Education

Bulletin & Brochures to patients and their families by

the SGAand their contribution in the success of the

very distinguished event.

With the continuous efforts of King Khalid University

Hospital Gastroenterology Unit Team and IBD Chairs

in Collaboration with Saudi Gastroenterology

Association, another successful Activity was conducted

last 3rd

– 4th

of April, 2013. The Program entitled “IBD

Clinical Observation Program” was launched to yield

our Fellows and Junior Gastroenterologist with

multidisciplinary broad base of knowledge in

Inflammatory Bowel Disease that ultimately aims to

improve the quality of care for patients with IBD in

Saudi Arabia.

The programme of the workshop is created to provide

the participants with the latest ECCO guidelines on

Crohn's Disease and Ulcerative Colitis definition,

clinical pictures and managements that were delivered

through lectures, clinical cases illustration by a set of

ECCO Statements. Difficult cases were discussed by the

expert Gastroenterologist. Active discussions and

exchange of ideas among the participants and speakers

were ordained throughout these 2-days. A gala dinner at

Holiday Iz-Dihar was held on the first day.

The highlights of the Program is a Tour Visit in

KKUH’s Day Care Unit where Biological Treatment is

given to IBD Patients.

Among the prestigious Speakers were Dr. Abdulrahman

Al Jebreen (SGA President-KKUH), Dr. Othman Al

Harbi (Head G.E. Unit-KKUH), Dr. Majid Al Madi

(Director, Endoscopy Unit-KKUH), Dr. Nahla Azzam

(SGA Board Member- KKUH), Dr. Khayal Al Khayal

(Colorectal Surgeon-KKUH) and Dr. Reem Al Amro

(Consultant-Riyadh Military Hospital).

15 of the attendees were Consultants, Senior Registrars,

Registrars, Residents and Junior Gastroenterologists

from different regions of Riyadh such as Hail, Al Hasa,

Al Manura, Madinah, Arar, Hofuf, Yanbu, Taif,

Buraidah Qassim and Riyadh as well.

Certificate of Participation plus a 15-SCFHS CME

Credit Hours was awarded to all the Attendees and

participants.

Succeeding ICOP will be announced soon. For any

inquiries and suggestions, please don’t hesitate to send

an email to [email protected].

This Activity is Sponsored by JANSSEN

PHARMACEUTICALS, Riyadh, KSA.

D. 6th

Endoscopy Guide workshop

It is with great pleasure for KKUH-

Gastroenterology Division in Collaboration with

the Saudi Gastroenterology Association to hold a

“Quarterly-based Endoscopy Guide

Workshop” that has always been part of our

Routine Activity for almost 2 years.

Closing Ceremony was conducted last April 30,

2013 at King Khalid University Hospital lead by

Dr. Othman Al Harbi, on behalf of all the

benefactors of the Workshop and Internal

Speakers: Dr. Khalid Al Swat, Dr. Abdulrahman

Al Jebreen, Dr. Nahla Azzam, Dr. Ayman Abdo

,and Dr. Majid Al Madi,Supporting Staffs from

Clinical Skills Simulation Department, Saudi

Gastroenterology Association Staff, Sponsoring

Company Representatives and Workshop

Organizers were present to receive the Plaque of

Appreciation and Certificates for their continued

support for the activity. Prestigious Speakers from

different Health Institutions of Saudi Arabia were

also invited such as Dr. Abed Lehibi,Dr. Khalid

Sayari and Dr. Abdullah Mtawa (King Fahed

Medical City ) to give recognition for their never-

ending Support.

We truly appreciate the exceptional efforts of our

distinguished speakers that from the very first day

of the workshop until its last day shared their

knowledge and skills thru Lectures and Interactive

Clinical Hands-on Training using the Olympus

Scope Guide.

To all the energetic and passionate Junior

Gastroenterologists and Colleagues who

participated, Thank you for attending the activity,

we hope that you found the workshop informative

and worthwhile.

Our primary goal was achieved. Many topics

covered during the workshop and the presenters

did an outstanding job of sharing their expertise.

After receiving positive feedback, the Unit may

possibly conduct the same activity in the future and

we will keep you posted.

KKUH Gastroenterology Unit and Saudi

Gastroenterology Association would like to

acknowledge SALEHIYA OLYMPUS, Riyadh for

their sponsorship and made this Workshop a

Success!

Faldaprevir is a potent selective inhibitor of

hepatitis C virus NS3/4A protease, and has antiviral activity against hepatitis C genotypes 1,

2, 4, 5, and 6 in vitro. It can be administered orally

once a day.

STARTVerso 1 a phase III placebo-controlled

trial,conducted in Europe and Japan for chronic

hepatitis c naive patients with genotype 1 .The

study was presented at the International Liver CongressTM (ILC), The 48th Annual Meeting of

the European Association for the Study of the

Liver (EASL), 24-28 April, 2013

Investigators randomized participants to 1 of 3

groups in a 1:2:2 ratio One group took placebo

plus interferon alfa-2a 180 μg/week plus weight-based ribavirin for 24 weeks, with an additional 24

weeks of interferon and ribavirin (control group; n

= 132). Another group took faldaprevir 120 mg

daily for 12 or 24 weeks (guided by response) plus interferon and ribavirin (low-dose group; n = 259).

The third group took faldaprevir 240 mg daily for

12 weeks with interferon and ribavirin for the entire 24 weeks (high-dose group; n = 261).

Patients in the 2 faldaprevir groups had

significantly better virologic responses 12 weeks

after the end of therapy than those in the control group (80 % vs52 ) with similar response rates for

both doses of faldsprevir (120 and 240 mg)

With regards the safety, more than 90% of patients in each group experienced an adverse event, but

only 4% to 5% in each group discontinued all

medication. Serious adverse events affected only 6% to 7%. Anemia was the most frequent adverse

event, and was related to ribavirin. Rash was also

common, affecting 6% to 9% of patients.

Treatment with sofosbuvir results in a rapid and sustained virologic response in patients with

hepatitis C virus (HCV), it is nucleotide analogue

that inhibits HCV replication which showing promise when given together with ribavirin or in

addition to pegylated interferon (peginterferon)

alfa-2a for a variety of genotypes1,2 and 3 and in

different patient populations in phase 2 trial, several studies involving sofosbuvir resulted in a

significant paradigm shift in the management of

hepatitis C.

Those studies were presented at the International

Liver CongressTM (ILC), The 48th Annual

Meeting of the European Association for the Study of the Liver (EASL), 24-28 April, 2013and

the findings are published online April 23 in the

New England Journal of Medicine .

In the NEUTRINO open-label study, 327 patients infected with HCV genotypes 1(more than 90%),

4, 5, or 6 received sofosbuvir, ribavirin, and

peginterferon alfa-2a for 12 weeks. Sofosbuvir was given orally at a dose of 400 mg, once a day,

along with ribavirin, also given orally in a dose

based on weight. Patients who weighed less than

75 kg received 1000 mg/d, and heavier patients received 1200 mg/d. Patients received

peginterferon alfa-2a subcutaneously once a week

at a dose of 180 μg. In this single-group study, investigators report a sustained virologic response

in 90% of patients

In the noninferiority study known as the FISSION trial, patients with hepatitis C genotype 2 or 3

were randomly assigned to 12 weeks of treatment

with sofosbuvir plus ribavirin or to 24 weeks of

treatment with peginterferon alfa-2a plus ribavirin. For the peginterferon-ribavirin group,

the ribavirin dose was 800 mg/d given in 2

divided doses.The sofosbuvir-based regimen was successful in 97% of patients with genotype 2

infection and 56% successful in those with

genotype 3 infection compared with 78% and 63% in the standard peginterferon alfa-2a plus ribavirin

group.

Investigators report that discontinuation rates due

to adverse effects were low (2%) among patients receiving sofosbuvir-containing regimens.

2. HOT TOPICS IN HEPATOLOGY & GASTROENTEROLOGY

1. News from EASL April 2013

A. Faldaprevir achieved viral cure in 80%

of treatment-naïve hepatitis C patients

B. Sofosbuvir for Previously Untreated

Chronic Hepatitis C Infection

Stem Cell Transplantation is a promising solution

for moderate-severe Crohn's Disease ,based on

study presented in DDW 2013 This is not the first

study to evaluate bone marrow transplantation in

Crohn's disease however, it is the first randomized

trial looking at the effect of stem cell transplantation

for moderate to severe crohn's disease on at least 3

immunosuppressive drugs. At 1 year the patients in

the treatment arm (stem cell therapy) were able to

stop the immunosuppressive therapy and around

50% had clinical response with decrease in Crohn's

Disease Activity Index score (CDAI) in the

treatment group than in the control group

(approximately 165 vs 50 points) but more studies

needed to look at the long term risk/benefit.

Inflammatory bowel disease (IBD) affects a

substantial number of female patients in their

reproductive years. Therefore, many physicians face

the dilemma whether thiopurines, prescribed to

maintain remission, can be taken safely during

pregnancy. Data on long-term development

outcome of children exposed to maternal thiopurine

therapy are very limited.

The aim of the study was to assess the long-term

effects of in utero exposure to thiopurines during

pregnancy on infant health status.

It is a prospective multicentre follow-up study was

performed in children exposed intrauterine to

maternal thiopurine therapy. Physical, cognitive

and social aspects of infant health status were

assessed with the 43-item TNO-AZL Preschool

Children Quality of Life Questionnaire (TAPQOL).

Furthermore, information on visits to general

practitioner and medical specialists, and physician's

advice regarding lactation was evaluated. Data

were compared with normative data from a control

group consisting of 340 children.

Thirty children were included in this study [median

3.8 years (IQR 2.9–4.7)]. No differences on global

medical and psychosocial health status were found

between children exposed to intrauterine

thiopurines and the reference group. Exposure to

intrauterine thiopurines was not associated with

increased susceptibility to infection or

immunodeficiency in childhood. Twenty-one of 30

children were exclusively formula-fed based on a

negative advice of medical specialists directed at

thiopurine use during lactation.

The authors concluded that thiopurine use during

pregnancy did not affect long-term development or

immune function of children up to 6 years of age.

Alimentary Pharmacology & Therapeutics, July

2013, Issue 1(38), pages 38–43.

2.NEWS from DDW May 2013

A. Stem Cell Transplantation for

treatment of moderate-severe Crohn's

Disease

3. Long-term follow-up of children exposed

intrauterine to maternal thiopurine therapy

during pregnancy in females with inflammatory

bowel disease

HOSPITAL TIME DATE DAY

RKH

8:30 pm

26/10/1434 (02.09.2013)

Monday

KFSH&RC

8:30 pm

24/11/1434 (30.09.2013)

Monday

KSMC

8:30 pm

23/12/1434 (28.10.2013)

Monday

DAY DATE LOCATION

TIME

Wednesday-

Thursday 25-26/9/2013 Sahara Mall 6pm-9pm.

Wednesday-

Thursday 13-14/11/2013 Gurnadah Mall 6pm-9pm.

Wednesday-

Thursday 25-26/12/2013 Salam Mall 6pm-9pm.

4. GUT CLUB Schedule for 2013

SGA MONTHLY GUT CLUB

MEETING IN RIYADH.

VENUE: KFHU TIME: 8:00 – 10:00 PM

This is a public activities in Arabic which

will be conducted throughout the whole year

Our target is IBD patients as well as the

public to get to know more about the

disease.

IBD AWARENESS CAMPAIGN

(YES, I CAN…….)

3. Upcoming Scientific Events

Thank You,

Greetings from SGA

Team