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New guideline provides recommendations for the treatment of mild to moderate UC
Most patients with ulcerative colitis (UC) have mild to moderate disease characterized by periods of activity or remission, but practice variations exist in disease management. A new clinical guideline from AGA published in Gastroenterology, the official journal of AGA, addresses the medical management of these patients, focusing on use of both oral and topical 5-aminosalicylates (5-ASA) medications, rectal corticosteroids, and oral budesonide, to promote high-quality care.
AGA’s new clinical guideline is meant to help with the management of patients with mild to moderate UC, but not all patients will effectively respond to the outlined therapies. In those cases, there may be a need to escalate treatment to systemic corticosteroids, immunomodulators, and/or biologic therapies for induction and maintenance of remission. However, the use of biologic therapies and/or immunomodulators are not specifically addressed within the guideline.
Mild to moderate UC was defined as patients with fewer than four to six bowel movements per day, mild or moderate rectal bleeding, absence of constitutional symptoms, low overall inflammatory burden, and absence of features suggestive of high inflammatory activity. Although disease activity exists on a spectrum, patients in the mild to moderate category who have more frequent bowel movements, more prominent rectal bleeding, or greater overall inflammatory burden should be considered to have moderate disease.
The guideline recommends the following for the medical management of mild-to-moderate ulcerative colitis:
1. Use either standard-dose mesalamine (2-3 grams/day) or diazo-bonded 5-ASA rather than low-dose mesalamine, sulfasalazine, or no treatment in patients with extensive mild-moderate UC. (Strong recommendation, moderate-quality evidence)
2. In patients with extensive or left-sided mild-moderate UC, add rectal mesalamine to oral 5-ASA. (Conditional recommendation, moderate quality evidence)
3. In patients with mild–moderate UC with suboptimal response to standard-dose mesalamine or diazo-bonded 5-ASA or with moderate disease activity, use high-dose mesalamine (more than 3 grams/day) with rectal mesalamine. (Conditional recommendation, moderate-quality evidence [induction of remission], low-quality evidence [maintenance of remission])
4. In patients with mild–moderate UC being treated with oral mesalamine, use once-daily dosing rather than multiple times per day dosing. (Conditional recommendation, moderate-quality evidence)
5. In patients with mild–moderate UC, use standard-dose oral mesalamine or diazo-bonded 5-ASA, rather than budesonide MMX or controlled ileal-release budesonide for induction of remission. (Conditional recommendation, low quality of evidence)
6. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis, use mesalamine enemas (or suppositories) rather than oral mesalamine. (Conditional recommendation, very-low-quality evidence)
7. In patients with mild–moderate ulcerative proctosigmoiditis who choose rectal therapy over oral therapy, use mesalamine enemas rather than rectal corticosteroids.(Conditional recommendation, moderate-quality evidence)
8. In patients with mild–moderate ulcerative proctitis who choose rectal therapy over oral therapy, use mesalamine suppositories. (Strong recommendation, moderate-quality evidence)
9. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis being treated with rectal therapy who are intolerant of or refractory to mesalamine suppositories, use rectal corticosteroid therapy rather than no therapy for induction of remission. (Conditional recommendation, low-quality evidence)
10. In patients with mild–moderate UC refractory to optimized oral and rectal 5-ASA, regardless of disease extent, add either oral prednisone or budesonide MMX. (Conditional recommendation, low-quality evidence)
11. In patients with mild–moderate UC, AGA makes no recommendation for use of probiotics. (No recommendation, knowledge gap)
12. In patients with mild–moderate UC despite 5-ASA therapy, AGA makes no recommendation for use of curcumin. (No recommendation, knowledge gap)
13. In patients with mild–moderate UC without Clostridium difficile infection, AGA recommends fecal microbiota transplantation be performed only in the context of a clinical trial. (No recommendation for treatment of ulcerative colitis, knowledge gap)
The guideline is accompanied by a technical review that is a compilation of the clinical evidence based on which these recommendations were framed.
Most patients with ulcerative colitis (UC) have mild to moderate disease characterized by periods of activity or remission, but practice variations exist in disease management. A new clinical guideline from AGA published in Gastroenterology, the official journal of AGA, addresses the medical management of these patients, focusing on use of both oral and topical 5-aminosalicylates (5-ASA) medications, rectal corticosteroids, and oral budesonide, to promote high-quality care.
AGA’s new clinical guideline is meant to help with the management of patients with mild to moderate UC, but not all patients will effectively respond to the outlined therapies. In those cases, there may be a need to escalate treatment to systemic corticosteroids, immunomodulators, and/or biologic therapies for induction and maintenance of remission. However, the use of biologic therapies and/or immunomodulators are not specifically addressed within the guideline.
Mild to moderate UC was defined as patients with fewer than four to six bowel movements per day, mild or moderate rectal bleeding, absence of constitutional symptoms, low overall inflammatory burden, and absence of features suggestive of high inflammatory activity. Although disease activity exists on a spectrum, patients in the mild to moderate category who have more frequent bowel movements, more prominent rectal bleeding, or greater overall inflammatory burden should be considered to have moderate disease.
The guideline recommends the following for the medical management of mild-to-moderate ulcerative colitis:
1. Use either standard-dose mesalamine (2-3 grams/day) or diazo-bonded 5-ASA rather than low-dose mesalamine, sulfasalazine, or no treatment in patients with extensive mild-moderate UC. (Strong recommendation, moderate-quality evidence)
2. In patients with extensive or left-sided mild-moderate UC, add rectal mesalamine to oral 5-ASA. (Conditional recommendation, moderate quality evidence)
3. In patients with mild–moderate UC with suboptimal response to standard-dose mesalamine or diazo-bonded 5-ASA or with moderate disease activity, use high-dose mesalamine (more than 3 grams/day) with rectal mesalamine. (Conditional recommendation, moderate-quality evidence [induction of remission], low-quality evidence [maintenance of remission])
4. In patients with mild–moderate UC being treated with oral mesalamine, use once-daily dosing rather than multiple times per day dosing. (Conditional recommendation, moderate-quality evidence)
5. In patients with mild–moderate UC, use standard-dose oral mesalamine or diazo-bonded 5-ASA, rather than budesonide MMX or controlled ileal-release budesonide for induction of remission. (Conditional recommendation, low quality of evidence)
6. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis, use mesalamine enemas (or suppositories) rather than oral mesalamine. (Conditional recommendation, very-low-quality evidence)
7. In patients with mild–moderate ulcerative proctosigmoiditis who choose rectal therapy over oral therapy, use mesalamine enemas rather than rectal corticosteroids.(Conditional recommendation, moderate-quality evidence)
8. In patients with mild–moderate ulcerative proctitis who choose rectal therapy over oral therapy, use mesalamine suppositories. (Strong recommendation, moderate-quality evidence)
9. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis being treated with rectal therapy who are intolerant of or refractory to mesalamine suppositories, use rectal corticosteroid therapy rather than no therapy for induction of remission. (Conditional recommendation, low-quality evidence)
10. In patients with mild–moderate UC refractory to optimized oral and rectal 5-ASA, regardless of disease extent, add either oral prednisone or budesonide MMX. (Conditional recommendation, low-quality evidence)
11. In patients with mild–moderate UC, AGA makes no recommendation for use of probiotics. (No recommendation, knowledge gap)
12. In patients with mild–moderate UC despite 5-ASA therapy, AGA makes no recommendation for use of curcumin. (No recommendation, knowledge gap)
13. In patients with mild–moderate UC without Clostridium difficile infection, AGA recommends fecal microbiota transplantation be performed only in the context of a clinical trial. (No recommendation for treatment of ulcerative colitis, knowledge gap)
The guideline is accompanied by a technical review that is a compilation of the clinical evidence based on which these recommendations were framed.
Most patients with ulcerative colitis (UC) have mild to moderate disease characterized by periods of activity or remission, but practice variations exist in disease management. A new clinical guideline from AGA published in Gastroenterology, the official journal of AGA, addresses the medical management of these patients, focusing on use of both oral and topical 5-aminosalicylates (5-ASA) medications, rectal corticosteroids, and oral budesonide, to promote high-quality care.
AGA’s new clinical guideline is meant to help with the management of patients with mild to moderate UC, but not all patients will effectively respond to the outlined therapies. In those cases, there may be a need to escalate treatment to systemic corticosteroids, immunomodulators, and/or biologic therapies for induction and maintenance of remission. However, the use of biologic therapies and/or immunomodulators are not specifically addressed within the guideline.
Mild to moderate UC was defined as patients with fewer than four to six bowel movements per day, mild or moderate rectal bleeding, absence of constitutional symptoms, low overall inflammatory burden, and absence of features suggestive of high inflammatory activity. Although disease activity exists on a spectrum, patients in the mild to moderate category who have more frequent bowel movements, more prominent rectal bleeding, or greater overall inflammatory burden should be considered to have moderate disease.
The guideline recommends the following for the medical management of mild-to-moderate ulcerative colitis:
1. Use either standard-dose mesalamine (2-3 grams/day) or diazo-bonded 5-ASA rather than low-dose mesalamine, sulfasalazine, or no treatment in patients with extensive mild-moderate UC. (Strong recommendation, moderate-quality evidence)
2. In patients with extensive or left-sided mild-moderate UC, add rectal mesalamine to oral 5-ASA. (Conditional recommendation, moderate quality evidence)
3. In patients with mild–moderate UC with suboptimal response to standard-dose mesalamine or diazo-bonded 5-ASA or with moderate disease activity, use high-dose mesalamine (more than 3 grams/day) with rectal mesalamine. (Conditional recommendation, moderate-quality evidence [induction of remission], low-quality evidence [maintenance of remission])
4. In patients with mild–moderate UC being treated with oral mesalamine, use once-daily dosing rather than multiple times per day dosing. (Conditional recommendation, moderate-quality evidence)
5. In patients with mild–moderate UC, use standard-dose oral mesalamine or diazo-bonded 5-ASA, rather than budesonide MMX or controlled ileal-release budesonide for induction of remission. (Conditional recommendation, low quality of evidence)
6. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis, use mesalamine enemas (or suppositories) rather than oral mesalamine. (Conditional recommendation, very-low-quality evidence)
7. In patients with mild–moderate ulcerative proctosigmoiditis who choose rectal therapy over oral therapy, use mesalamine enemas rather than rectal corticosteroids.(Conditional recommendation, moderate-quality evidence)
8. In patients with mild–moderate ulcerative proctitis who choose rectal therapy over oral therapy, use mesalamine suppositories. (Strong recommendation, moderate-quality evidence)
9. In patients with mild–moderate ulcerative proctosigmoiditis or proctitis being treated with rectal therapy who are intolerant of or refractory to mesalamine suppositories, use rectal corticosteroid therapy rather than no therapy for induction of remission. (Conditional recommendation, low-quality evidence)
10. In patients with mild–moderate UC refractory to optimized oral and rectal 5-ASA, regardless of disease extent, add either oral prednisone or budesonide MMX. (Conditional recommendation, low-quality evidence)
11. In patients with mild–moderate UC, AGA makes no recommendation for use of probiotics. (No recommendation, knowledge gap)
12. In patients with mild–moderate UC despite 5-ASA therapy, AGA makes no recommendation for use of curcumin. (No recommendation, knowledge gap)
13. In patients with mild–moderate UC without Clostridium difficile infection, AGA recommends fecal microbiota transplantation be performed only in the context of a clinical trial. (No recommendation for treatment of ulcerative colitis, knowledge gap)
The guideline is accompanied by a technical review that is a compilation of the clinical evidence based on which these recommendations were framed.
GI leaders recognized by AGA’s prestigious recognition awards
AGA has announced the 2019 recipients of the annual recognition awards, given in honor of outstanding contributions and achievements in gastroenterology.
“AGA members honor their colleagues and peers for outstanding contributions to the field of gastroenterology by nominating them for the AGA Recognition Awards,” said David A. Lieberman, MD, AGAF, president of the AGA Institute. “We are proud to announce the 2019 AGA Recognition Prize winners, who are just a few of the distinguished and talented members who help make AGA such an accomplished organization. We are honored that such esteemed individuals are representative of AGA.”
The AGA Recognition Awards will be presented during Digestive Disease Week® 2019, May 18-21, 2019, in San Diego.
Julius Friedenwald Medal
AGA bequeaths its highest honor, the Julius Friedenwald Medal, to John I. Allen, MD, MBA, AGAF, for his incredible contributions to the field of gastroenterology and AGA over several decades. The Julius Friedenwald Medal, presented annually since 1941, recognizes a physician for lifelong contributions to the field of gastroenterology.
Dr. Allen is internationally renowned for bringing unique and critical knowledge about health care delivery and health care economics to the field of gastroenterology, as well as for his decades of AGA leadership. His experience is unique within the national gastroenterology community, encompassing private practice, nonacademic health systems, and leadership within two academic medical centers. As AGA Institute President, he led the development of AGA’s 5-year strategic plan and made AGA a national player at the federal, state, and local levels during a time of massive health care delivery transformation. Dr. Allen is a clinical professor of medicine in the division of gastroenterology and hepatology and chief clinical officer of the University of Michigan Medical Group at the University of Michigan School of Medicine, Ann Arbor.
Distinguished Achievement Award In Basic Science
AGA honors Harry B. Greenberg, MD, with the AGA Distinguished Achievement Award in Basic Science, for his major accomplishments in basic science research, which have significantly advanced the science and practice of gastroenterology. Throughout his career, Dr. Greenberg’s incredible contributions over several decades contributed to the development of rotavirus vaccines and increased physicians’ understanding of viral pathogenesis, particularly rotavirus, norovirus, and hepatitis. Dr. Greenberg is an associate dean for research at Stanford University School of Medicine, Palo Alto, California.
William Beaumont Prize
AGA honors Timothy C. Wang, MD, AGAF, with the William Beaumont Prize in gastroenterology, which recognizes an individual who has made a unique, outstanding contribution of major importance to the field of gastroenterology. Dr. Wang’s extraordinary contribution to the understanding and practice of modern gastroenterology and digestive science are exemplified through his work, which includes defining the mechanisms and cellular origins of Barrett’s esophagus and gastroesophageal cancer. Dr. Wang, who has served AGA in numerous positions, including as president of the AGA Institute, is currently chief of the division of digestive and liver diseases at Columbia University Medical Center and as the Dorothy L. and Daniel H. Silberberg Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Distinguished Educator Award
AGA recognizes and honors Deborah D. Proctor, MD, AGAF, with the Distinguished Educator Award, which recognizes an individual who has made outstanding contributions as an educator in gastroenterology on both local and national levels, over a lifelong career. Dr. Proctor is a national expert in gastroenterology training and education who has taught and inspired generations of future gastroenterologists, nurses and physician assistants. Currently serving as the AGA Institute Education & Training Councillor, Dr. Proctor is a professor of medicine, and the medical director of the inflammatory bowel disease program, at Yale School of Medicine, New Haven, Connecticut.
Distinguished Clinician Awards
The AGA Distinguished Clinician Award recognizes members of the practicing community who, by example, combine the art of medicine with the skills demanded by the scientific body of knowledge in service to their patients.
AGA presents the Distinguished Clinician Award, Private Practice, to Naresh T. Gunaratnam, MD, AGAF. Dr. Gunaratnam has made a huge impact on patient care in his community and improved gastroenterology-oncology care by starting the endoscopic ultrasound & interventional GI program at St. Joseph Mercy Ann Arbor hospital in Ypsilanti, Michigan. Dr. Gunaratnam is a director of research and obesity management at Huron Gastro.
AGA is honored to present the Distinguished Clinician Award, Clinical Academic Practice, to Edward V. Loftus Jr., MD, AGAF. Dr. Loftus is an outstanding role model in practice, an effective researcher and a recognized leader who is devoted to treating patients with ulcerative colitis and Crohn’s disease with quality clinical care, including understanding the predictors of treatment response. Dr. Loftus is a practicing gastroenterologist at the Mayo Clinic and a professor of medicine at the Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Distinguished Mentor Award
AGA bestows the Distinguished Mentor Award to Fred S. Gorelick, MD, which recognizes an individual who has made a lifelong effort dedicated to the mentoring of trainees in the field of gastroenterology and for achievements as outstanding mentors throughout their careers. Dr. Gorelick has been an inspiration to generations of trainees, many of whom have gone on to successful academic careers as faculty members, section chiefs, program directors, department chairs, and institute directors. Dr. Gorelick is a professor of medicine and cell biology at Yale School of Medicine, and deputy director of the Yale MD-PhD Program, New Haven, Connecticut.
Research Service Award
AGA honors Ann G. Zauber, PhD, with the Research Service Award, which recognizes individuals whose work has significantly advanced gastroenterogical science and research. Dr. Zauber’s accomplishments have changed and advanced the practice of gastroenterology. Her work involving colorectal cancer screening and surveillance studies has had far-reaching effects on public policy. She is well-known for her leadership role in the development of colorectal cancer screening guidelines in the U.S., which has significantly reduced mortality and incidence rates. Dr. Zauber is an attending biostatistician in the department of epidemiology & biostatistics at the Memorial Sloan Kettering Cancer Center, New York, New York.
Young Investigator Awards
The AGA Young Investigator Award recognizes two young investigators, one in basic science and one in clinical science, for outstanding research achievements.
AGA honors Sonia S. Kupfer, MD, with the Young Investigator Award in Clinical Science. Dr. Kupfer is nationally and internationally recognized as an expert in colorectal cancer in high-risk populations including individuals with hereditary cancer syndromes and African Americans. During her clinical and translational research to better understand factors that increase the risk of colorectal cancer, Dr. Kupfer identified distinctions in African-American population compared with Caucasians. Dr. Kupfer is an associate professor of medicine at the University of Chicago, and director of the Gastrointestinal Cancer Risk and Prevention Clinic, Illinois.
AGA honors Costas A. Lyssiotis, PhD, with the Young Investigator Award in Basic Science. His research, work ethic, and innovative approaches have made Dr. Lyssiotis a distinguished leader in pancreatic cancer. His work has broad implications for harnessing the power of the immune system to treat the disease and his laboratory is working to develop new drug therapies that target a pancreatic cancer metabolism-specific enzyme. Dr. Lyssiotis is an assistant professor in the department of molecular and integrative physiology in the division of gastroenterology at University of Michigan Medical School, Ann Arbor.
AGA has announced the 2019 recipients of the annual recognition awards, given in honor of outstanding contributions and achievements in gastroenterology.
“AGA members honor their colleagues and peers for outstanding contributions to the field of gastroenterology by nominating them for the AGA Recognition Awards,” said David A. Lieberman, MD, AGAF, president of the AGA Institute. “We are proud to announce the 2019 AGA Recognition Prize winners, who are just a few of the distinguished and talented members who help make AGA such an accomplished organization. We are honored that such esteemed individuals are representative of AGA.”
The AGA Recognition Awards will be presented during Digestive Disease Week® 2019, May 18-21, 2019, in San Diego.
Julius Friedenwald Medal
AGA bequeaths its highest honor, the Julius Friedenwald Medal, to John I. Allen, MD, MBA, AGAF, for his incredible contributions to the field of gastroenterology and AGA over several decades. The Julius Friedenwald Medal, presented annually since 1941, recognizes a physician for lifelong contributions to the field of gastroenterology.
Dr. Allen is internationally renowned for bringing unique and critical knowledge about health care delivery and health care economics to the field of gastroenterology, as well as for his decades of AGA leadership. His experience is unique within the national gastroenterology community, encompassing private practice, nonacademic health systems, and leadership within two academic medical centers. As AGA Institute President, he led the development of AGA’s 5-year strategic plan and made AGA a national player at the federal, state, and local levels during a time of massive health care delivery transformation. Dr. Allen is a clinical professor of medicine in the division of gastroenterology and hepatology and chief clinical officer of the University of Michigan Medical Group at the University of Michigan School of Medicine, Ann Arbor.
Distinguished Achievement Award In Basic Science
AGA honors Harry B. Greenberg, MD, with the AGA Distinguished Achievement Award in Basic Science, for his major accomplishments in basic science research, which have significantly advanced the science and practice of gastroenterology. Throughout his career, Dr. Greenberg’s incredible contributions over several decades contributed to the development of rotavirus vaccines and increased physicians’ understanding of viral pathogenesis, particularly rotavirus, norovirus, and hepatitis. Dr. Greenberg is an associate dean for research at Stanford University School of Medicine, Palo Alto, California.
William Beaumont Prize
AGA honors Timothy C. Wang, MD, AGAF, with the William Beaumont Prize in gastroenterology, which recognizes an individual who has made a unique, outstanding contribution of major importance to the field of gastroenterology. Dr. Wang’s extraordinary contribution to the understanding and practice of modern gastroenterology and digestive science are exemplified through his work, which includes defining the mechanisms and cellular origins of Barrett’s esophagus and gastroesophageal cancer. Dr. Wang, who has served AGA in numerous positions, including as president of the AGA Institute, is currently chief of the division of digestive and liver diseases at Columbia University Medical Center and as the Dorothy L. and Daniel H. Silberberg Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Distinguished Educator Award
AGA recognizes and honors Deborah D. Proctor, MD, AGAF, with the Distinguished Educator Award, which recognizes an individual who has made outstanding contributions as an educator in gastroenterology on both local and national levels, over a lifelong career. Dr. Proctor is a national expert in gastroenterology training and education who has taught and inspired generations of future gastroenterologists, nurses and physician assistants. Currently serving as the AGA Institute Education & Training Councillor, Dr. Proctor is a professor of medicine, and the medical director of the inflammatory bowel disease program, at Yale School of Medicine, New Haven, Connecticut.
Distinguished Clinician Awards
The AGA Distinguished Clinician Award recognizes members of the practicing community who, by example, combine the art of medicine with the skills demanded by the scientific body of knowledge in service to their patients.
AGA presents the Distinguished Clinician Award, Private Practice, to Naresh T. Gunaratnam, MD, AGAF. Dr. Gunaratnam has made a huge impact on patient care in his community and improved gastroenterology-oncology care by starting the endoscopic ultrasound & interventional GI program at St. Joseph Mercy Ann Arbor hospital in Ypsilanti, Michigan. Dr. Gunaratnam is a director of research and obesity management at Huron Gastro.
AGA is honored to present the Distinguished Clinician Award, Clinical Academic Practice, to Edward V. Loftus Jr., MD, AGAF. Dr. Loftus is an outstanding role model in practice, an effective researcher and a recognized leader who is devoted to treating patients with ulcerative colitis and Crohn’s disease with quality clinical care, including understanding the predictors of treatment response. Dr. Loftus is a practicing gastroenterologist at the Mayo Clinic and a professor of medicine at the Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Distinguished Mentor Award
AGA bestows the Distinguished Mentor Award to Fred S. Gorelick, MD, which recognizes an individual who has made a lifelong effort dedicated to the mentoring of trainees in the field of gastroenterology and for achievements as outstanding mentors throughout their careers. Dr. Gorelick has been an inspiration to generations of trainees, many of whom have gone on to successful academic careers as faculty members, section chiefs, program directors, department chairs, and institute directors. Dr. Gorelick is a professor of medicine and cell biology at Yale School of Medicine, and deputy director of the Yale MD-PhD Program, New Haven, Connecticut.
Research Service Award
AGA honors Ann G. Zauber, PhD, with the Research Service Award, which recognizes individuals whose work has significantly advanced gastroenterogical science and research. Dr. Zauber’s accomplishments have changed and advanced the practice of gastroenterology. Her work involving colorectal cancer screening and surveillance studies has had far-reaching effects on public policy. She is well-known for her leadership role in the development of colorectal cancer screening guidelines in the U.S., which has significantly reduced mortality and incidence rates. Dr. Zauber is an attending biostatistician in the department of epidemiology & biostatistics at the Memorial Sloan Kettering Cancer Center, New York, New York.
Young Investigator Awards
The AGA Young Investigator Award recognizes two young investigators, one in basic science and one in clinical science, for outstanding research achievements.
AGA honors Sonia S. Kupfer, MD, with the Young Investigator Award in Clinical Science. Dr. Kupfer is nationally and internationally recognized as an expert in colorectal cancer in high-risk populations including individuals with hereditary cancer syndromes and African Americans. During her clinical and translational research to better understand factors that increase the risk of colorectal cancer, Dr. Kupfer identified distinctions in African-American population compared with Caucasians. Dr. Kupfer is an associate professor of medicine at the University of Chicago, and director of the Gastrointestinal Cancer Risk and Prevention Clinic, Illinois.
AGA honors Costas A. Lyssiotis, PhD, with the Young Investigator Award in Basic Science. His research, work ethic, and innovative approaches have made Dr. Lyssiotis a distinguished leader in pancreatic cancer. His work has broad implications for harnessing the power of the immune system to treat the disease and his laboratory is working to develop new drug therapies that target a pancreatic cancer metabolism-specific enzyme. Dr. Lyssiotis is an assistant professor in the department of molecular and integrative physiology in the division of gastroenterology at University of Michigan Medical School, Ann Arbor.
AGA has announced the 2019 recipients of the annual recognition awards, given in honor of outstanding contributions and achievements in gastroenterology.
“AGA members honor their colleagues and peers for outstanding contributions to the field of gastroenterology by nominating them for the AGA Recognition Awards,” said David A. Lieberman, MD, AGAF, president of the AGA Institute. “We are proud to announce the 2019 AGA Recognition Prize winners, who are just a few of the distinguished and talented members who help make AGA such an accomplished organization. We are honored that such esteemed individuals are representative of AGA.”
The AGA Recognition Awards will be presented during Digestive Disease Week® 2019, May 18-21, 2019, in San Diego.
Julius Friedenwald Medal
AGA bequeaths its highest honor, the Julius Friedenwald Medal, to John I. Allen, MD, MBA, AGAF, for his incredible contributions to the field of gastroenterology and AGA over several decades. The Julius Friedenwald Medal, presented annually since 1941, recognizes a physician for lifelong contributions to the field of gastroenterology.
Dr. Allen is internationally renowned for bringing unique and critical knowledge about health care delivery and health care economics to the field of gastroenterology, as well as for his decades of AGA leadership. His experience is unique within the national gastroenterology community, encompassing private practice, nonacademic health systems, and leadership within two academic medical centers. As AGA Institute President, he led the development of AGA’s 5-year strategic plan and made AGA a national player at the federal, state, and local levels during a time of massive health care delivery transformation. Dr. Allen is a clinical professor of medicine in the division of gastroenterology and hepatology and chief clinical officer of the University of Michigan Medical Group at the University of Michigan School of Medicine, Ann Arbor.
Distinguished Achievement Award In Basic Science
AGA honors Harry B. Greenberg, MD, with the AGA Distinguished Achievement Award in Basic Science, for his major accomplishments in basic science research, which have significantly advanced the science and practice of gastroenterology. Throughout his career, Dr. Greenberg’s incredible contributions over several decades contributed to the development of rotavirus vaccines and increased physicians’ understanding of viral pathogenesis, particularly rotavirus, norovirus, and hepatitis. Dr. Greenberg is an associate dean for research at Stanford University School of Medicine, Palo Alto, California.
William Beaumont Prize
AGA honors Timothy C. Wang, MD, AGAF, with the William Beaumont Prize in gastroenterology, which recognizes an individual who has made a unique, outstanding contribution of major importance to the field of gastroenterology. Dr. Wang’s extraordinary contribution to the understanding and practice of modern gastroenterology and digestive science are exemplified through his work, which includes defining the mechanisms and cellular origins of Barrett’s esophagus and gastroesophageal cancer. Dr. Wang, who has served AGA in numerous positions, including as president of the AGA Institute, is currently chief of the division of digestive and liver diseases at Columbia University Medical Center and as the Dorothy L. and Daniel H. Silberberg Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Distinguished Educator Award
AGA recognizes and honors Deborah D. Proctor, MD, AGAF, with the Distinguished Educator Award, which recognizes an individual who has made outstanding contributions as an educator in gastroenterology on both local and national levels, over a lifelong career. Dr. Proctor is a national expert in gastroenterology training and education who has taught and inspired generations of future gastroenterologists, nurses and physician assistants. Currently serving as the AGA Institute Education & Training Councillor, Dr. Proctor is a professor of medicine, and the medical director of the inflammatory bowel disease program, at Yale School of Medicine, New Haven, Connecticut.
Distinguished Clinician Awards
The AGA Distinguished Clinician Award recognizes members of the practicing community who, by example, combine the art of medicine with the skills demanded by the scientific body of knowledge in service to their patients.
AGA presents the Distinguished Clinician Award, Private Practice, to Naresh T. Gunaratnam, MD, AGAF. Dr. Gunaratnam has made a huge impact on patient care in his community and improved gastroenterology-oncology care by starting the endoscopic ultrasound & interventional GI program at St. Joseph Mercy Ann Arbor hospital in Ypsilanti, Michigan. Dr. Gunaratnam is a director of research and obesity management at Huron Gastro.
AGA is honored to present the Distinguished Clinician Award, Clinical Academic Practice, to Edward V. Loftus Jr., MD, AGAF. Dr. Loftus is an outstanding role model in practice, an effective researcher and a recognized leader who is devoted to treating patients with ulcerative colitis and Crohn’s disease with quality clinical care, including understanding the predictors of treatment response. Dr. Loftus is a practicing gastroenterologist at the Mayo Clinic and a professor of medicine at the Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Distinguished Mentor Award
AGA bestows the Distinguished Mentor Award to Fred S. Gorelick, MD, which recognizes an individual who has made a lifelong effort dedicated to the mentoring of trainees in the field of gastroenterology and for achievements as outstanding mentors throughout their careers. Dr. Gorelick has been an inspiration to generations of trainees, many of whom have gone on to successful academic careers as faculty members, section chiefs, program directors, department chairs, and institute directors. Dr. Gorelick is a professor of medicine and cell biology at Yale School of Medicine, and deputy director of the Yale MD-PhD Program, New Haven, Connecticut.
Research Service Award
AGA honors Ann G. Zauber, PhD, with the Research Service Award, which recognizes individuals whose work has significantly advanced gastroenterogical science and research. Dr. Zauber’s accomplishments have changed and advanced the practice of gastroenterology. Her work involving colorectal cancer screening and surveillance studies has had far-reaching effects on public policy. She is well-known for her leadership role in the development of colorectal cancer screening guidelines in the U.S., which has significantly reduced mortality and incidence rates. Dr. Zauber is an attending biostatistician in the department of epidemiology & biostatistics at the Memorial Sloan Kettering Cancer Center, New York, New York.
Young Investigator Awards
The AGA Young Investigator Award recognizes two young investigators, one in basic science and one in clinical science, for outstanding research achievements.
AGA honors Sonia S. Kupfer, MD, with the Young Investigator Award in Clinical Science. Dr. Kupfer is nationally and internationally recognized as an expert in colorectal cancer in high-risk populations including individuals with hereditary cancer syndromes and African Americans. During her clinical and translational research to better understand factors that increase the risk of colorectal cancer, Dr. Kupfer identified distinctions in African-American population compared with Caucasians. Dr. Kupfer is an associate professor of medicine at the University of Chicago, and director of the Gastrointestinal Cancer Risk and Prevention Clinic, Illinois.
AGA honors Costas A. Lyssiotis, PhD, with the Young Investigator Award in Basic Science. His research, work ethic, and innovative approaches have made Dr. Lyssiotis a distinguished leader in pancreatic cancer. His work has broad implications for harnessing the power of the immune system to treat the disease and his laboratory is working to develop new drug therapies that target a pancreatic cancer metabolism-specific enzyme. Dr. Lyssiotis is an assistant professor in the department of molecular and integrative physiology in the division of gastroenterology at University of Michigan Medical School, Ann Arbor.
AGA Legacy Society members bolster research
The AGA Research Foundation has funded more than $50 million in research funding since its inception in 1984. Gifts from AGA members have helped fuel discoveries in the GI field. The most generous of AGA members are our Legacy Society members.
Members of the AGA Legacy Society provide tax-deductible gifts to the AGA Research Foundation of $5,000 or more per year for 5 years ($25,000 total) or $50,000 or more in a planned gift, such as a bequest. Legacy Society member donations directly support young GI investigators as they establish independent research careers.
“The support of the AGA Research Foundation indicates that our peers share in our enthusiasm for research and gives me and my group added confidence to pursue questions about the pathology of IBD. Our overall plan is to translate this work into key components of larger federally funded grants in the near future,” states David L. Boone, PhD, Indiana University School of Medicine, Indianapolis, 2017 AGA Research Foundation Pilot Research Award grant recipient.
Donors, who make gifts at the Legacy Society level before Digestive Disease Week® (DDW), will receive an invitation to the annual Benefactors’ Dinner, which will be held at the San Diego Wine and Culinary Center this year. Individuals interested in learning more about Legacy Society membership may contact Stacey Hinton Tuneski, Senior Director of Development at [email protected] or via phone (301) 222-4005. More information on the AGA Legacy Society including the current roster and acceptance form is available on the foundation’s web site.
A celebration of research support
Beginning with a memorable gathering at the United States Library of Congress in 2007, the AGA Benefactors’ Dinner has welcomed members of the AGA Legacy Society and other AGA dignitaries to special locations nationwide. The San Diego Wine and Culinary Center will be the location of the 2019 AGA Research Foundation Benefactors’ Dinner during DDW® in San Diego. Located near the convention center, the San Diego Wine and Culinary Center feels worlds away and will allow guests to relax and enjoy time with friends. Members of the AGA Legacy Society will be among the distinguished honorees at the annual event.
The AGA Research Foundation has funded more than $50 million in research funding since its inception in 1984. Gifts from AGA members have helped fuel discoveries in the GI field. The most generous of AGA members are our Legacy Society members.
Members of the AGA Legacy Society provide tax-deductible gifts to the AGA Research Foundation of $5,000 or more per year for 5 years ($25,000 total) or $50,000 or more in a planned gift, such as a bequest. Legacy Society member donations directly support young GI investigators as they establish independent research careers.
“The support of the AGA Research Foundation indicates that our peers share in our enthusiasm for research and gives me and my group added confidence to pursue questions about the pathology of IBD. Our overall plan is to translate this work into key components of larger federally funded grants in the near future,” states David L. Boone, PhD, Indiana University School of Medicine, Indianapolis, 2017 AGA Research Foundation Pilot Research Award grant recipient.
Donors, who make gifts at the Legacy Society level before Digestive Disease Week® (DDW), will receive an invitation to the annual Benefactors’ Dinner, which will be held at the San Diego Wine and Culinary Center this year. Individuals interested in learning more about Legacy Society membership may contact Stacey Hinton Tuneski, Senior Director of Development at [email protected] or via phone (301) 222-4005. More information on the AGA Legacy Society including the current roster and acceptance form is available on the foundation’s web site.
A celebration of research support
Beginning with a memorable gathering at the United States Library of Congress in 2007, the AGA Benefactors’ Dinner has welcomed members of the AGA Legacy Society and other AGA dignitaries to special locations nationwide. The San Diego Wine and Culinary Center will be the location of the 2019 AGA Research Foundation Benefactors’ Dinner during DDW® in San Diego. Located near the convention center, the San Diego Wine and Culinary Center feels worlds away and will allow guests to relax and enjoy time with friends. Members of the AGA Legacy Society will be among the distinguished honorees at the annual event.
The AGA Research Foundation has funded more than $50 million in research funding since its inception in 1984. Gifts from AGA members have helped fuel discoveries in the GI field. The most generous of AGA members are our Legacy Society members.
Members of the AGA Legacy Society provide tax-deductible gifts to the AGA Research Foundation of $5,000 or more per year for 5 years ($25,000 total) or $50,000 or more in a planned gift, such as a bequest. Legacy Society member donations directly support young GI investigators as they establish independent research careers.
“The support of the AGA Research Foundation indicates that our peers share in our enthusiasm for research and gives me and my group added confidence to pursue questions about the pathology of IBD. Our overall plan is to translate this work into key components of larger federally funded grants in the near future,” states David L. Boone, PhD, Indiana University School of Medicine, Indianapolis, 2017 AGA Research Foundation Pilot Research Award grant recipient.
Donors, who make gifts at the Legacy Society level before Digestive Disease Week® (DDW), will receive an invitation to the annual Benefactors’ Dinner, which will be held at the San Diego Wine and Culinary Center this year. Individuals interested in learning more about Legacy Society membership may contact Stacey Hinton Tuneski, Senior Director of Development at [email protected] or via phone (301) 222-4005. More information on the AGA Legacy Society including the current roster and acceptance form is available on the foundation’s web site.
A celebration of research support
Beginning with a memorable gathering at the United States Library of Congress in 2007, the AGA Benefactors’ Dinner has welcomed members of the AGA Legacy Society and other AGA dignitaries to special locations nationwide. The San Diego Wine and Culinary Center will be the location of the 2019 AGA Research Foundation Benefactors’ Dinner during DDW® in San Diego. Located near the convention center, the San Diego Wine and Culinary Center feels worlds away and will allow guests to relax and enjoy time with friends. Members of the AGA Legacy Society will be among the distinguished honorees at the annual event.
New online resource from the AGA IBD Parenthood Project provides guidance, dispels fears about pregnancy for women with IBD
AGA launched the IBD Parenthood Project to address misperceptions and fears women with inflammatory bowel disease and their health care providers experience throughout all phases of family planning. This patient-directed initiative, which was created by gastroenterologists, maternal-fetal medicine subspecialists and patients, is led by AGA with support from the Society for Maternal-Fetal Medicine, the Crohn’s & Colitis Foundation, and patient support network, Girls With Guts.
Health care providers are encouraged to visit the program’s new website, www.IBDParenthoodProject.org, which houses medical facts about IBD and pregnancy and share it with their patients. The website provides answers to common questions and provides a downloadable patient toolkit that features visual and patient-friendly information. Resources include easy-to-digest lists of key questions to ask a provider as women are thinking of becoming pregnant, a flow diagram outlining the various HCPs potentially involved in a woman’s care, a guide to postnatal care and provider locator tools. These tools are a direct response to AGA survey findings that reported women with IBD want more and better information about managing their disease (BabyCenter. 2018. IBD and Preconception, Pregnancy, Early Motherhood).
AGA launched the IBD Parenthood Project to address misperceptions and fears women with inflammatory bowel disease and their health care providers experience throughout all phases of family planning. This patient-directed initiative, which was created by gastroenterologists, maternal-fetal medicine subspecialists and patients, is led by AGA with support from the Society for Maternal-Fetal Medicine, the Crohn’s & Colitis Foundation, and patient support network, Girls With Guts.
Health care providers are encouraged to visit the program’s new website, www.IBDParenthoodProject.org, which houses medical facts about IBD and pregnancy and share it with their patients. The website provides answers to common questions and provides a downloadable patient toolkit that features visual and patient-friendly information. Resources include easy-to-digest lists of key questions to ask a provider as women are thinking of becoming pregnant, a flow diagram outlining the various HCPs potentially involved in a woman’s care, a guide to postnatal care and provider locator tools. These tools are a direct response to AGA survey findings that reported women with IBD want more and better information about managing their disease (BabyCenter. 2018. IBD and Preconception, Pregnancy, Early Motherhood).
AGA launched the IBD Parenthood Project to address misperceptions and fears women with inflammatory bowel disease and their health care providers experience throughout all phases of family planning. This patient-directed initiative, which was created by gastroenterologists, maternal-fetal medicine subspecialists and patients, is led by AGA with support from the Society for Maternal-Fetal Medicine, the Crohn’s & Colitis Foundation, and patient support network, Girls With Guts.
Health care providers are encouraged to visit the program’s new website, www.IBDParenthoodProject.org, which houses medical facts about IBD and pregnancy and share it with their patients. The website provides answers to common questions and provides a downloadable patient toolkit that features visual and patient-friendly information. Resources include easy-to-digest lists of key questions to ask a provider as women are thinking of becoming pregnant, a flow diagram outlining the various HCPs potentially involved in a woman’s care, a guide to postnatal care and provider locator tools. These tools are a direct response to AGA survey findings that reported women with IBD want more and better information about managing their disease (BabyCenter. 2018. IBD and Preconception, Pregnancy, Early Motherhood).
What’s next for the AGA Center for Gut Microbiome Research and Education?
AGA established its Center for Gut Microbiome Research and Education in 2012 as the microbiome was just beginning to explode in the scientific literature. I have been privileged to chair the center’s scientific advisory board over the last 3 years. As I enter my final few months in this role, I wanted to look ahead to the issues we’ve prioritized for 2019 – many of which build on our accomplishments in 2018.
Diet and nutrition
More than ever before, clinicians and patients appreciate that what we eat can have an important impact on our digestive health and our gut microbes. Recognizing the need for a stronger evidence base, the NIH developed a nutrition research strategic plan, which AGA wrote in support of late last year. We will continue providing updates on the latest advances in the new year. In March, AGA will host the eighth annual Gut Microbiota for Health World Summit in Miami, Florida. This continues our long-standing collaboration with the European Society of Neurogastroenterology and Motility and the 2019 edition will focus on the interplay between what we eat and the microbes that live on and in us. Materials from the meeting will be made available through AGA’s educational platform, AGA University, later in the year.
Pro-, pre-, and synbiotics
Last fall, the center published its first two scientific statements on several important clinical studies on the gut microbiome. We collaborated with AGA’s GI Patient Center to issue patient-friendly resources on probiotics. Probiotics will continue to be a key topic for AGA guidance in 2019. In the spring issue of this newsletter, look for the first of a four-part educational series on prebiotics and digestive health. AGA also continues to develop a technical review and clinical guideline on the role of probiotics in the management of GI disease. A “first look” can be found on AGA’s clinical guidelines page under “Upcoming Guidelines.”
Microbiome-based diagnostics
As clinicians, we’ve experienced the growing popularity of direct-to-consumer genetic tests and questions from patients wanting to know what their results mean for existing or potential medical conditions. Inspired by discussions among clinicians within the AGA Community, scientific advisory board member Alexander Khoruts, MD, wrote a primer for clinicians on microbiome-based tests which was published recently; it was also disseminated through this newsletter and MedPage Today’s KevinMD.com. This issue will continue to be a challenge for researchers and clinicians as the research moves beyond correlation to causative relationships between our gut microbiome and human health and disease. The center will continue to provide guidance on this issue as the field evolves.
Microbiome-based therapeutics
The FMT National Registry announced the enrollment of its first patient this time last year. As it continues to recruit new sites, the registry’s steering committee (under the leadership of AGA members Colleen Kelly, MD, Loren Laine, MD, AGAF, and Gary Wu, MD, AGAF) will begin looking at data to develop an interim publication on lessons learned from the earliest-enrolled patients. FMT, of course, is the just the beginning of a revolution in microbiome-based therapeutics. As new pharmaceuticals targeting the gut microbiome advance in clinical trials, the center will help prepare health care professionals for what this will mean for their patients and their practices.
2019 promises to be another banner year in gut microbiome research. AGA and its Center for Gut Microbiome Research and Education will continue to provide evidence-based information and guidance on one of the most exciting emerging areas of science and medicine.
Dr. Hecht is professor of medicine and microbiology/immunology and chief, gastroenterology and nutrition, Loyola University Medical Center, and chair of the AGA Center for Gut Microbiome Research and Education scientific advisory board.
AGA established its Center for Gut Microbiome Research and Education in 2012 as the microbiome was just beginning to explode in the scientific literature. I have been privileged to chair the center’s scientific advisory board over the last 3 years. As I enter my final few months in this role, I wanted to look ahead to the issues we’ve prioritized for 2019 – many of which build on our accomplishments in 2018.
Diet and nutrition
More than ever before, clinicians and patients appreciate that what we eat can have an important impact on our digestive health and our gut microbes. Recognizing the need for a stronger evidence base, the NIH developed a nutrition research strategic plan, which AGA wrote in support of late last year. We will continue providing updates on the latest advances in the new year. In March, AGA will host the eighth annual Gut Microbiota for Health World Summit in Miami, Florida. This continues our long-standing collaboration with the European Society of Neurogastroenterology and Motility and the 2019 edition will focus on the interplay between what we eat and the microbes that live on and in us. Materials from the meeting will be made available through AGA’s educational platform, AGA University, later in the year.
Pro-, pre-, and synbiotics
Last fall, the center published its first two scientific statements on several important clinical studies on the gut microbiome. We collaborated with AGA’s GI Patient Center to issue patient-friendly resources on probiotics. Probiotics will continue to be a key topic for AGA guidance in 2019. In the spring issue of this newsletter, look for the first of a four-part educational series on prebiotics and digestive health. AGA also continues to develop a technical review and clinical guideline on the role of probiotics in the management of GI disease. A “first look” can be found on AGA’s clinical guidelines page under “Upcoming Guidelines.”
Microbiome-based diagnostics
As clinicians, we’ve experienced the growing popularity of direct-to-consumer genetic tests and questions from patients wanting to know what their results mean for existing or potential medical conditions. Inspired by discussions among clinicians within the AGA Community, scientific advisory board member Alexander Khoruts, MD, wrote a primer for clinicians on microbiome-based tests which was published recently; it was also disseminated through this newsletter and MedPage Today’s KevinMD.com. This issue will continue to be a challenge for researchers and clinicians as the research moves beyond correlation to causative relationships between our gut microbiome and human health and disease. The center will continue to provide guidance on this issue as the field evolves.
Microbiome-based therapeutics
The FMT National Registry announced the enrollment of its first patient this time last year. As it continues to recruit new sites, the registry’s steering committee (under the leadership of AGA members Colleen Kelly, MD, Loren Laine, MD, AGAF, and Gary Wu, MD, AGAF) will begin looking at data to develop an interim publication on lessons learned from the earliest-enrolled patients. FMT, of course, is the just the beginning of a revolution in microbiome-based therapeutics. As new pharmaceuticals targeting the gut microbiome advance in clinical trials, the center will help prepare health care professionals for what this will mean for their patients and their practices.
2019 promises to be another banner year in gut microbiome research. AGA and its Center for Gut Microbiome Research and Education will continue to provide evidence-based information and guidance on one of the most exciting emerging areas of science and medicine.
Dr. Hecht is professor of medicine and microbiology/immunology and chief, gastroenterology and nutrition, Loyola University Medical Center, and chair of the AGA Center for Gut Microbiome Research and Education scientific advisory board.
AGA established its Center for Gut Microbiome Research and Education in 2012 as the microbiome was just beginning to explode in the scientific literature. I have been privileged to chair the center’s scientific advisory board over the last 3 years. As I enter my final few months in this role, I wanted to look ahead to the issues we’ve prioritized for 2019 – many of which build on our accomplishments in 2018.
Diet and nutrition
More than ever before, clinicians and patients appreciate that what we eat can have an important impact on our digestive health and our gut microbes. Recognizing the need for a stronger evidence base, the NIH developed a nutrition research strategic plan, which AGA wrote in support of late last year. We will continue providing updates on the latest advances in the new year. In March, AGA will host the eighth annual Gut Microbiota for Health World Summit in Miami, Florida. This continues our long-standing collaboration with the European Society of Neurogastroenterology and Motility and the 2019 edition will focus on the interplay between what we eat and the microbes that live on and in us. Materials from the meeting will be made available through AGA’s educational platform, AGA University, later in the year.
Pro-, pre-, and synbiotics
Last fall, the center published its first two scientific statements on several important clinical studies on the gut microbiome. We collaborated with AGA’s GI Patient Center to issue patient-friendly resources on probiotics. Probiotics will continue to be a key topic for AGA guidance in 2019. In the spring issue of this newsletter, look for the first of a four-part educational series on prebiotics and digestive health. AGA also continues to develop a technical review and clinical guideline on the role of probiotics in the management of GI disease. A “first look” can be found on AGA’s clinical guidelines page under “Upcoming Guidelines.”
Microbiome-based diagnostics
As clinicians, we’ve experienced the growing popularity of direct-to-consumer genetic tests and questions from patients wanting to know what their results mean for existing or potential medical conditions. Inspired by discussions among clinicians within the AGA Community, scientific advisory board member Alexander Khoruts, MD, wrote a primer for clinicians on microbiome-based tests which was published recently; it was also disseminated through this newsletter and MedPage Today’s KevinMD.com. This issue will continue to be a challenge for researchers and clinicians as the research moves beyond correlation to causative relationships between our gut microbiome and human health and disease. The center will continue to provide guidance on this issue as the field evolves.
Microbiome-based therapeutics
The FMT National Registry announced the enrollment of its first patient this time last year. As it continues to recruit new sites, the registry’s steering committee (under the leadership of AGA members Colleen Kelly, MD, Loren Laine, MD, AGAF, and Gary Wu, MD, AGAF) will begin looking at data to develop an interim publication on lessons learned from the earliest-enrolled patients. FMT, of course, is the just the beginning of a revolution in microbiome-based therapeutics. As new pharmaceuticals targeting the gut microbiome advance in clinical trials, the center will help prepare health care professionals for what this will mean for their patients and their practices.
2019 promises to be another banner year in gut microbiome research. AGA and its Center for Gut Microbiome Research and Education will continue to provide evidence-based information and guidance on one of the most exciting emerging areas of science and medicine.
Dr. Hecht is professor of medicine and microbiology/immunology and chief, gastroenterology and nutrition, Loyola University Medical Center, and chair of the AGA Center for Gut Microbiome Research and Education scientific advisory board.
Three key points: AGA comments on vision for continued board certification
Reforming MOC is a priority for AGA so our comments were extensive. Here are three key points we made.
Recertification shouldn’t burden physicians
In an era of epidemic physician burnout threatening access to care from reductions in the physician workforce, we seek a recertification pathway that is not unnecessarily burdensome, while maintaining relevance to the practice of a matured, experienced clinician.
Requirements should be relevant to practice
Requirements need to be relevant to practice and able to be adopted by our physicians with minimal additional investment in an already overburdened practice environment. Physicians have a narrowly defined practice and that assessments and certification should be “tailored to a diplomate’s area of practice.” However, it is necessary that physicians have knowledge outside of a narrow subspecialty, and thus the specialty societies should help the Boards identify what constitutes the key “core knowledge, judgment and skills” for the specialty. It is AGA’s view that this knowledge should be much less detailed than the expectations for initial board certification.
Certification ≠ credential
The issue of continuous certification being misappropriated as an employment credential is not acceptable. AGA calls on the commission to make it unequivocally clear that board certification should not be used in any way as a requirement for hospital credentialing.
MOC is a hot topic on the AGA Community. We’re listening.
Reforming MOC is a priority for AGA so our comments were extensive. Here are three key points we made.
Recertification shouldn’t burden physicians
In an era of epidemic physician burnout threatening access to care from reductions in the physician workforce, we seek a recertification pathway that is not unnecessarily burdensome, while maintaining relevance to the practice of a matured, experienced clinician.
Requirements should be relevant to practice
Requirements need to be relevant to practice and able to be adopted by our physicians with minimal additional investment in an already overburdened practice environment. Physicians have a narrowly defined practice and that assessments and certification should be “tailored to a diplomate’s area of practice.” However, it is necessary that physicians have knowledge outside of a narrow subspecialty, and thus the specialty societies should help the Boards identify what constitutes the key “core knowledge, judgment and skills” for the specialty. It is AGA’s view that this knowledge should be much less detailed than the expectations for initial board certification.
Certification ≠ credential
The issue of continuous certification being misappropriated as an employment credential is not acceptable. AGA calls on the commission to make it unequivocally clear that board certification should not be used in any way as a requirement for hospital credentialing.
MOC is a hot topic on the AGA Community. We’re listening.
Reforming MOC is a priority for AGA so our comments were extensive. Here are three key points we made.
Recertification shouldn’t burden physicians
In an era of epidemic physician burnout threatening access to care from reductions in the physician workforce, we seek a recertification pathway that is not unnecessarily burdensome, while maintaining relevance to the practice of a matured, experienced clinician.
Requirements should be relevant to practice
Requirements need to be relevant to practice and able to be adopted by our physicians with minimal additional investment in an already overburdened practice environment. Physicians have a narrowly defined practice and that assessments and certification should be “tailored to a diplomate’s area of practice.” However, it is necessary that physicians have knowledge outside of a narrow subspecialty, and thus the specialty societies should help the Boards identify what constitutes the key “core knowledge, judgment and skills” for the specialty. It is AGA’s view that this knowledge should be much less detailed than the expectations for initial board certification.
Certification ≠ credential
The issue of continuous certification being misappropriated as an employment credential is not acceptable. AGA calls on the commission to make it unequivocally clear that board certification should not be used in any way as a requirement for hospital credentialing.
MOC is a hot topic on the AGA Community. We’re listening.
Guideline public comment period framework
AGA is dedicated to integrity and transparency in the development of clinical guidance.
W In addition, to keep academic integrity of the AGA guideline, clinical practice update, and clinical pathway process, AGA follows the framework outlined by the Council of Medical Specialty Societies (CMSS) in The Code for Interaction with Companies.
The Code for Interaction with Companies states:
“7.15. Societies will not permit Guideline development panel members or staff to discuss a Guideline’s development with Company employees or representatives, will not accept unpublished data from Companies, and will not permit Companies to review Guidelines in draft form, except if a Society permits public or member comment on draft Guidelines as a part of the Society’s published Guideline development process.”
The Clinical Guidelines Committee and Clinical Practice Updates Committee strive to keep AGA’s clinical practice tools independent of industry influence and remain solely based on scientific evidence. As a result of this effort, AGA’s writing panels and chairs will have no direct communication with industry. Companies will have the opportunity to submit feedback during the public comment period. The panel will review any comments submitted through the online platform along with feedback from the public. The writing panel will take these suggestions into consideration when making revisions following the public comment period.
AGA is dedicated to integrity and transparency in the development of clinical guidance.
W In addition, to keep academic integrity of the AGA guideline, clinical practice update, and clinical pathway process, AGA follows the framework outlined by the Council of Medical Specialty Societies (CMSS) in The Code for Interaction with Companies.
The Code for Interaction with Companies states:
“7.15. Societies will not permit Guideline development panel members or staff to discuss a Guideline’s development with Company employees or representatives, will not accept unpublished data from Companies, and will not permit Companies to review Guidelines in draft form, except if a Society permits public or member comment on draft Guidelines as a part of the Society’s published Guideline development process.”
The Clinical Guidelines Committee and Clinical Practice Updates Committee strive to keep AGA’s clinical practice tools independent of industry influence and remain solely based on scientific evidence. As a result of this effort, AGA’s writing panels and chairs will have no direct communication with industry. Companies will have the opportunity to submit feedback during the public comment period. The panel will review any comments submitted through the online platform along with feedback from the public. The writing panel will take these suggestions into consideration when making revisions following the public comment period.
AGA is dedicated to integrity and transparency in the development of clinical guidance.
W In addition, to keep academic integrity of the AGA guideline, clinical practice update, and clinical pathway process, AGA follows the framework outlined by the Council of Medical Specialty Societies (CMSS) in The Code for Interaction with Companies.
The Code for Interaction with Companies states:
“7.15. Societies will not permit Guideline development panel members or staff to discuss a Guideline’s development with Company employees or representatives, will not accept unpublished data from Companies, and will not permit Companies to review Guidelines in draft form, except if a Society permits public or member comment on draft Guidelines as a part of the Society’s published Guideline development process.”
The Clinical Guidelines Committee and Clinical Practice Updates Committee strive to keep AGA’s clinical practice tools independent of industry influence and remain solely based on scientific evidence. As a result of this effort, AGA’s writing panels and chairs will have no direct communication with industry. Companies will have the opportunity to submit feedback during the public comment period. The panel will review any comments submitted through the online platform along with feedback from the public. The writing panel will take these suggestions into consideration when making revisions following the public comment period.
2018 AGA legislative wins
To those who took time to advocate on behalf of your profession and patients, thank you. Because of your efforts, we achieved several key successes that benefit clinicians, researchers and patients.
Together we were able to help advance several AGA policy priorities — administrative burden relief, digestive disease research and funding, and patient access and protection — as well as the science and practice of gastroenterology.
This year, we will be counting on you, our members, to again lead the charge to achieve AGA’s mission — empowering clinicians and researchers to improve digestive health — by calling on legislators and regulators to ensure the voice of gastroenterology continue to be heard.
NIH funding increase
AGA advocated and secured a $2 billion increase in NIH funding for fiscal year (FY) 2019. When added to increases from the two previous fiscal years, NIH’s funding has increased by 30 percent over the past three years, which is the largest increase since the doubling period in the last decade.
IPAB repeal prevents automatic Medicare cuts
Congress repealed the Independent Payment Advisory Board (IPAB) that was created as part of the Affordable Care Act (ACA). AGA and all of organized medicine long opposed IPAB since its sole purpose was to make budgetary cuts to Medicare if it reached a certain threshold of spending.
MIPS changes means more flexibility for physicians
AGA and the physician community were successful in securing flexibility under the new Medicare Quality Payment Program and the Merit-based Incentive Payment System (MIPS) that were created under the Medicare Access and CHIP Reauthorization Act. The changes give CMS more flexibility in implementing the program and will ensure that physicians have an opportunity to be successful in MIPS.
500 AGA members prevent radical changes to outpatient documentation
In response to a CMS proposal to radically change how outpatient evaluation and management (E/M) services are documented, more than 500 AGA members urged CMS not to move forward with its plan. As a result, CMS withdrew or delayed many of the proposed changes to E/M services that negatively impacted reimbursement. CMS did move forward with several changes to E/M documentation in an effort to reduce administrative burden.
AGA members send more than 940 letters to Congress
AGA launched the Congressional Advocates Program to provide an infrastructure and tools for members to effectively advocate on behalf of their profession and patients. AGA members heeded our calls to action and sent more than 940 letters sent to Congress and federal agencies throughout 2018. We thank our advocates whose participation makes a difference.
To those who took time to advocate on behalf of your profession and patients, thank you. Because of your efforts, we achieved several key successes that benefit clinicians, researchers and patients.
Together we were able to help advance several AGA policy priorities — administrative burden relief, digestive disease research and funding, and patient access and protection — as well as the science and practice of gastroenterology.
This year, we will be counting on you, our members, to again lead the charge to achieve AGA’s mission — empowering clinicians and researchers to improve digestive health — by calling on legislators and regulators to ensure the voice of gastroenterology continue to be heard.
NIH funding increase
AGA advocated and secured a $2 billion increase in NIH funding for fiscal year (FY) 2019. When added to increases from the two previous fiscal years, NIH’s funding has increased by 30 percent over the past three years, which is the largest increase since the doubling period in the last decade.
IPAB repeal prevents automatic Medicare cuts
Congress repealed the Independent Payment Advisory Board (IPAB) that was created as part of the Affordable Care Act (ACA). AGA and all of organized medicine long opposed IPAB since its sole purpose was to make budgetary cuts to Medicare if it reached a certain threshold of spending.
MIPS changes means more flexibility for physicians
AGA and the physician community were successful in securing flexibility under the new Medicare Quality Payment Program and the Merit-based Incentive Payment System (MIPS) that were created under the Medicare Access and CHIP Reauthorization Act. The changes give CMS more flexibility in implementing the program and will ensure that physicians have an opportunity to be successful in MIPS.
500 AGA members prevent radical changes to outpatient documentation
In response to a CMS proposal to radically change how outpatient evaluation and management (E/M) services are documented, more than 500 AGA members urged CMS not to move forward with its plan. As a result, CMS withdrew or delayed many of the proposed changes to E/M services that negatively impacted reimbursement. CMS did move forward with several changes to E/M documentation in an effort to reduce administrative burden.
AGA members send more than 940 letters to Congress
AGA launched the Congressional Advocates Program to provide an infrastructure and tools for members to effectively advocate on behalf of their profession and patients. AGA members heeded our calls to action and sent more than 940 letters sent to Congress and federal agencies throughout 2018. We thank our advocates whose participation makes a difference.
To those who took time to advocate on behalf of your profession and patients, thank you. Because of your efforts, we achieved several key successes that benefit clinicians, researchers and patients.
Together we were able to help advance several AGA policy priorities — administrative burden relief, digestive disease research and funding, and patient access and protection — as well as the science and practice of gastroenterology.
This year, we will be counting on you, our members, to again lead the charge to achieve AGA’s mission — empowering clinicians and researchers to improve digestive health — by calling on legislators and regulators to ensure the voice of gastroenterology continue to be heard.
NIH funding increase
AGA advocated and secured a $2 billion increase in NIH funding for fiscal year (FY) 2019. When added to increases from the two previous fiscal years, NIH’s funding has increased by 30 percent over the past three years, which is the largest increase since the doubling period in the last decade.
IPAB repeal prevents automatic Medicare cuts
Congress repealed the Independent Payment Advisory Board (IPAB) that was created as part of the Affordable Care Act (ACA). AGA and all of organized medicine long opposed IPAB since its sole purpose was to make budgetary cuts to Medicare if it reached a certain threshold of spending.
MIPS changes means more flexibility for physicians
AGA and the physician community were successful in securing flexibility under the new Medicare Quality Payment Program and the Merit-based Incentive Payment System (MIPS) that were created under the Medicare Access and CHIP Reauthorization Act. The changes give CMS more flexibility in implementing the program and will ensure that physicians have an opportunity to be successful in MIPS.
500 AGA members prevent radical changes to outpatient documentation
In response to a CMS proposal to radically change how outpatient evaluation and management (E/M) services are documented, more than 500 AGA members urged CMS not to move forward with its plan. As a result, CMS withdrew or delayed many of the proposed changes to E/M services that negatively impacted reimbursement. CMS did move forward with several changes to E/M documentation in an effort to reduce administrative burden.
AGA members send more than 940 letters to Congress
AGA launched the Congressional Advocates Program to provide an infrastructure and tools for members to effectively advocate on behalf of their profession and patients. AGA members heeded our calls to action and sent more than 940 letters sent to Congress and federal agencies throughout 2018. We thank our advocates whose participation makes a difference.
Help spark scientific breakthroughs with the AGA Research Foundation
The way we diagnose and treat patients is the result of years of research. But securing the future of the field is no small task. A donation to the charitable arm of the American Gastroenterological Association (AGA), the AGA Research Foundation, will help fill the funding gap and contribute to this tradition of discovery.
The foundation provides a key source of funding at a critical juncture in a young investigator’s career.
Help spark the scientific breakthroughs of today, so clinicians will have the tools to improve care tomorrow. Your tax-deductible donation will make a critical difference in retaining talented GI scientists, like Won Jae Huh, MD, whose research will impact the future care of patients.
“As a clinical researcher, funding for investigation is critical in scientific breakthroughs to promote more efficient and robust patient care. My project will provide novel insights into the role of distensibility in the treatment of patients with esophageal eosinophilia, potentially resulting in more efficient treatment selection and disease management.”
“This funding mechanism will secure my research time to investigate signaling pathways involved in the pathogenesis of Ménétrier’s disease, and will provide resources and support to launch my research career. The results from my research project will be helpful for treating Ménétrier’s disease patients.”
Help spark the scientific breakthroughs of today, so clinicians will have the tools to improve care tomorrow. Your tax-deductible donation will make a critical difference in retaining talented GI scientists, like Dr. Won Jae Huh, whose research will impact the future care of patients.
Donate on the foundation’s website at www.gastro.org/donateonline or by mail to 4930 Del Ray Avenue, Bethesda, MD 20814.
The way we diagnose and treat patients is the result of years of research. But securing the future of the field is no small task. A donation to the charitable arm of the American Gastroenterological Association (AGA), the AGA Research Foundation, will help fill the funding gap and contribute to this tradition of discovery.
The foundation provides a key source of funding at a critical juncture in a young investigator’s career.
Help spark the scientific breakthroughs of today, so clinicians will have the tools to improve care tomorrow. Your tax-deductible donation will make a critical difference in retaining talented GI scientists, like Won Jae Huh, MD, whose research will impact the future care of patients.
“As a clinical researcher, funding for investigation is critical in scientific breakthroughs to promote more efficient and robust patient care. My project will provide novel insights into the role of distensibility in the treatment of patients with esophageal eosinophilia, potentially resulting in more efficient treatment selection and disease management.”
“This funding mechanism will secure my research time to investigate signaling pathways involved in the pathogenesis of Ménétrier’s disease, and will provide resources and support to launch my research career. The results from my research project will be helpful for treating Ménétrier’s disease patients.”
Help spark the scientific breakthroughs of today, so clinicians will have the tools to improve care tomorrow. Your tax-deductible donation will make a critical difference in retaining talented GI scientists, like Dr. Won Jae Huh, whose research will impact the future care of patients.
Donate on the foundation’s website at www.gastro.org/donateonline or by mail to 4930 Del Ray Avenue, Bethesda, MD 20814.
The way we diagnose and treat patients is the result of years of research. But securing the future of the field is no small task. A donation to the charitable arm of the American Gastroenterological Association (AGA), the AGA Research Foundation, will help fill the funding gap and contribute to this tradition of discovery.
The foundation provides a key source of funding at a critical juncture in a young investigator’s career.
Help spark the scientific breakthroughs of today, so clinicians will have the tools to improve care tomorrow. Your tax-deductible donation will make a critical difference in retaining talented GI scientists, like Won Jae Huh, MD, whose research will impact the future care of patients.
“As a clinical researcher, funding for investigation is critical in scientific breakthroughs to promote more efficient and robust patient care. My project will provide novel insights into the role of distensibility in the treatment of patients with esophageal eosinophilia, potentially resulting in more efficient treatment selection and disease management.”
“This funding mechanism will secure my research time to investigate signaling pathways involved in the pathogenesis of Ménétrier’s disease, and will provide resources and support to launch my research career. The results from my research project will be helpful for treating Ménétrier’s disease patients.”
Help spark the scientific breakthroughs of today, so clinicians will have the tools to improve care tomorrow. Your tax-deductible donation will make a critical difference in retaining talented GI scientists, like Dr. Won Jae Huh, whose research will impact the future care of patients.
Donate on the foundation’s website at www.gastro.org/donateonline or by mail to 4930 Del Ray Avenue, Bethesda, MD 20814.
AGA to FDA: We support new labeling recommendations for probiotics
In a new comment letter to FDA, AGA commends FDA’s recent draft guidance – “Policy Regarding Quantitative Labeling of Dietary Supplements Containing Live Microbials” – clarifying the expectations of probiotics manufacturers who choose to specify the amount of a live microbial component in their product in colony forming units (CFUs).
Though manufacturers are not currently required to report CFUs, AGA feels strongly that all manufacturers of probiotic supplements should voluntarily report the composition of live microbials in their products as CFUs.
However, reporting CFUs alone provides insufficient information to consumers and health care professionals who may recommend probiotic supplements to their patients. In our comment letter, AGA encourages FDA to expand what information manufacturers are required to include. In addition to the conditions already outlined in FDA’s draft guidance, AGA recommends including the conditions of storage as well as an expiration or “use by” date.
We acknowledge that researchers are evaluating other methods and units of measure besides CFUs for not only live microbials but also microbial bioactivity. However, in the absence of a widely accepted alternative, which may take several years to develop and adopt, AGA strongly encourages FDA and manufacturers to take the small step forward of using CFUs now rather than waiting for another solution to emerge.
Probiotics have been an important focus for the AGA Center for Gut Microbiome Research and Education due to the need for evidence-based guidance for health care providers and their patients. The center will continue to work to educate physicians, patients and industry on best practices to ensure safe use of probiotics.
In a new comment letter to FDA, AGA commends FDA’s recent draft guidance – “Policy Regarding Quantitative Labeling of Dietary Supplements Containing Live Microbials” – clarifying the expectations of probiotics manufacturers who choose to specify the amount of a live microbial component in their product in colony forming units (CFUs).
Though manufacturers are not currently required to report CFUs, AGA feels strongly that all manufacturers of probiotic supplements should voluntarily report the composition of live microbials in their products as CFUs.
However, reporting CFUs alone provides insufficient information to consumers and health care professionals who may recommend probiotic supplements to their patients. In our comment letter, AGA encourages FDA to expand what information manufacturers are required to include. In addition to the conditions already outlined in FDA’s draft guidance, AGA recommends including the conditions of storage as well as an expiration or “use by” date.
We acknowledge that researchers are evaluating other methods and units of measure besides CFUs for not only live microbials but also microbial bioactivity. However, in the absence of a widely accepted alternative, which may take several years to develop and adopt, AGA strongly encourages FDA and manufacturers to take the small step forward of using CFUs now rather than waiting for another solution to emerge.
Probiotics have been an important focus for the AGA Center for Gut Microbiome Research and Education due to the need for evidence-based guidance for health care providers and their patients. The center will continue to work to educate physicians, patients and industry on best practices to ensure safe use of probiotics.
In a new comment letter to FDA, AGA commends FDA’s recent draft guidance – “Policy Regarding Quantitative Labeling of Dietary Supplements Containing Live Microbials” – clarifying the expectations of probiotics manufacturers who choose to specify the amount of a live microbial component in their product in colony forming units (CFUs).
Though manufacturers are not currently required to report CFUs, AGA feels strongly that all manufacturers of probiotic supplements should voluntarily report the composition of live microbials in their products as CFUs.
However, reporting CFUs alone provides insufficient information to consumers and health care professionals who may recommend probiotic supplements to their patients. In our comment letter, AGA encourages FDA to expand what information manufacturers are required to include. In addition to the conditions already outlined in FDA’s draft guidance, AGA recommends including the conditions of storage as well as an expiration or “use by” date.
We acknowledge that researchers are evaluating other methods and units of measure besides CFUs for not only live microbials but also microbial bioactivity. However, in the absence of a widely accepted alternative, which may take several years to develop and adopt, AGA strongly encourages FDA and manufacturers to take the small step forward of using CFUs now rather than waiting for another solution to emerge.
Probiotics have been an important focus for the AGA Center for Gut Microbiome Research and Education due to the need for evidence-based guidance for health care providers and their patients. The center will continue to work to educate physicians, patients and industry on best practices to ensure safe use of probiotics.