1. First line therapy/Monitoring
2. stratify the target
3. Anti-TNF LOR
4. TDM

1. To understand the role of prognostic factors in treatment decisions CD
2. To review treatment strategies in CD
3. To describe future vision of markers to guide treatment decisions

•Over the last decades we have become better in assessing treament effect by using more stringent and objective endpoints
•Nonetheless we are stuck with remission rates not over 40 %
•Head-to-head, combination trials and strategy trials are extremely important for the future
•Treat-to-target and early intervention trials have had major impact

Objectives:

1. To conceptualize the chronic management of complex IBD
2. To develop a multi-phased approach to combination therapy in IBD
3. To consider future strategies of management

Summary:

The limitations of current treatments for IBD demand new approaches to management, including novel combinations of therapies. Combination approaches should consider multiple mechanisms, sequencing and de-escalation options. Clinical trials of novel approaches require creative and precision medicine-based strategies to demonstrate efficacy and safety as well as potential cost effectiveness.

Educational objectives: 
1. To understand how risks in clinical trials are defined.
2. To review the way how the risk of clinical trials is communicated by the HCP to the patient and the shortcommings.
3. To understand the factors that influence the perception by the patient of the communicated risk.
4. To have insight in tips and tricks for an optimal communication of risk in a clinical trial setting.

1. To review current approaches to dietary therapy in adult patients with IBD
2. To discuss the use of dietary therapy to modify IBD 
3. To emphasize the role of the dietitian in the multidisciplinary team
 

1. To understand the basics of CEUS and elastography
2. To review the currently available literature on CEUS and elastography in IBD
3. To identify future directions of research

Current knowledge: What is the problem with FMT therapy?
Complexity of multifactorial diseases complicate simple treatment

1. To consider the factors that affect standards in IBD pathology
2. To explore the availability and content of IBD pathology guidelines and datasets

The lecture outlines some of the factors that influence standards and considers approaches to the improvement of IBD pathology reporting quailty.

1. To understand normal physiology of the gastrointestinal tract
2. To review the etiopathogenesis of Inflammatory Bowel Diseases
3. To emphasize the different modalities to diagnose Inflammatory Bowel Diseases
4. To have an overview of the most commonly used clinical and endoscopic activity scores for Inflammatory Bowel Diseases

Although extra-intestinal manifestations are common, inflammatory bowel diseases (IBD) typically affect the intestine. Where ulcerative colitis (UC) is limited to the colon, Crohn’s disease (CD) may involve all parts of the gastrointestinal tract (mouth, oesophagus, stomach, small intestine, colon and rectum). Consequently, the function of all these segments may be compromised.

Although the exact etiopathogenesis of IBD has not been unravelled, the prevailing model states that IBD is driven by environmental factors in genetically susceptible individuals, resulting in a dysregulated immune response towards the intestinal microbiome.

Besides a good clinical history and physical examination, several diagnostic tools will help the physician to diagnose IBD. These tools include lab test (both blood and faeces), radiological examination (ultrasound, CT and MR scan), and endoscopy with biopsies for histological examination.

Clinical disease activity of CD and UC, are most commonly assessed using the Harvey-Bradshaw index and the Mayo score, respectively. However, patient reported outcomes become more frequently implemented. Also endoscopic disease activity indices have been introduced in daily clinical care. For CD, the Crohn’s disease endoscopic index of severity (CDEIS), the simple endoscopic score for Crohn’s disease (SES-CD), and the Rutgeerts score are used. For UC, the Mayo score and the ulcerative colitis endoscopic index of severity (UCEIS) are employed. C-reactive protein (CRP) and faecal calprotectin could be regarded as surrogate markers for endoscopic disease activity, but their accuracy is not optimal.

Artificial Intelligence and Digital Pathology are rapidly growing disciplines that have the potential to revolutionise the field of inflammatory bowel disease. ML and DL approaches offer the ability to synthesise and incorporate large amounts of data to improve diagnostic accuracy, uncover new disease associations, identify at risk individuals, and guide therapeutic decision making. While challenges to the routine use of DP and AI in IBD remain, continued exploration of possible applications are expected to accelerate the drive toward precision medicine.
-To understand basic principles of Digital Pathology and Artificial Intelligence.
-To review pros and cons of DP and AI.
-To have an overview of DP and AI in IBD pathology.