Aliment Pharmacol Ther. 2024 Oct 10. doi: 10.1111/apt.18318. Online ahead of print.

Rupert W Leong ^1 2 3, Anthony Sakiris ^3 4, Arteen Arzivian ², John David Chetwood ^1 3, Thanaboon Chaemsupaphan ^1 5, Miles P Sparrow ⁶, Michael A Kamm ^7 8, Viraj Kariayawasam ^1 2 9; Australian IBD Consensus Working Group

Author information

¹Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.

²Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.

³Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

⁴Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia.

⁵Division of Gastroenterology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

⁶Department of Gastroenterology, School of Translational Medicine, Monash University and Alfred Health, Melbourne, Victoria, Australia.

⁷Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.

⁸Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.

⁹Blacktown Clinical School, Western Sydney University, Sydney, New South Wales, Australia.

Abstract

Background: Given the introduction of new advanced therapies for inflammatory bowel diseases (IBDs), expanded risk mitigation strategies are essential.

Aims: To create a comprehensive set of statements on assessment procedures and vaccinations before starting monoclonal antibodies, Janus kinase (JAK) inhibitors or sphingosine-1-phosphate (S1P) modulators for IBD.

Methods: We examined literature, guidelines and drug product information regarding vaccination and assessment recommendations for initiating advanced IBD therapies. Using a modified Delphi approach, delegates voted anonymously on the acceptability of these statements prior to and following consensus discussion.

Results: We developed eight statements on the domains of infectious diseases screening, vaccinations and assessments prior to commencing JAK inhibitors and S1P modulators. Six statements received agreement. Pre-advanced therapy screening for infectious diseases was established, and the vaccination protocol was revised. Malignancy, cardiovascular and thromboembolic risk assessments are necessary before initiating JAK inhibitors. Those starting S1P modulators need cardiac and ophthalmic assessments.

Conclusions: These consensus statements combine vaccination and assessments on the currently available advanced therapies for IBD as a single comprehensive document that may reduce IBD complications associated with use of advanced therapies. Knowledge gaps identified during the consensus process will provide further research opportunities.