This course has been developed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to provide evidence-based guidance for clinical practice so that physicians can make informed decisions in partnership with their patients regarding their optimal exit strategies.

After this course you will:

• To recognise risks, benefits and timing of stopping anti-TNF used as monotherapy or in combination with IM in IBD.
• To know optimal monitoring following withdrawal of biologic therapy

This sub-course is adapted from the course "Anaemia in Crohn's Disease”, which was developed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD).  This course has been developed for all nurses who care for patients with IBD. For more advanced knowledge, please follow the main e-learning case, "Anaemia in Crohn's Disease”.

The aim of this e-learning activity is to increase competence and knowledge with regard to the management and care of patients with Crohn's Disease and anaemia in order to improve patient outcomes.

Upon completion of this activity learners will:

• Have basic knowledge about anaemia in Crohn's Disease patients
• Have basic knowledge about the symptoms and treatment of anaemia in Crohn's Disease patients

This course was developed by Professor. Simon Travis and Dr. Rebecca Palmer in cooperation with Leading Edge Medical Education. This course is designed for gastroenterologists, paediatricians, surgeons, nurses and other interdisciplinary medical professional interested in the endoscopy of ulcerative colitis (UC) The intended result of this activity is competence and knowledge of endoscopy, in the assessment and follow-up of patients with UC.  The course is divided into three parts: the first is about the UCEIS and descriptors; the second is Self Assessment, which does not contribute to the final score and the third is the UCEIS Certification itself, to confirm  competence in using the UCEIS.  

Upon completion of this activity learners will:

• Be trained in the evaluation of endoscopic images in the assessment of activity in UC
• Understand why UCEIS was developed
• Understand how UCEIS was developed
• Understand the role of UCEIS
• Utilise UCEIS in clinical practice

This course is designed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to increase competence and knowledge with regard to IBD and Malignancies and to harmonise diagnostics and treatment in order to improve patient outcomes.

This course will follow the following cases on:

1. Colorectal cancer in IBD
   
2. Lymphoma risk following immunosuppressive therapy with thiopurines in IBD patients - cancer and IBD
   
3. Skin cancer in IBD
4. Chemotherapy in chronically active ulcerative colitis

Upon completion of this activity learners will have gained knowledge on:

• IBD and Solid Tumours
  
• IBD and Haematological Malignancies
  
• IBD and Skin Malignancies
• Management of IBD patients with a past history of malignancy

This course is designed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to increase competence and knowledge with regard to the prediction, diagnosis and management of stricturing Crohn's Disease (CD) patients and to harmonise diagnostics and treatment in order to improve patient outcomes.

Upon completion of this activity learners will:

• Achieve familiarity with predictors of fibrostenosing CD.

• Understand the role of cross-sectional imaging in the diagnostic work-up of patients with suspected fibrostenosing CD.
• Understand the current management of fibrostenosing CD.
• Recognise the therapeutic capabilities of anti-inflammatory therapy, endoscopic dilatation and surgery in the setting of fibrostenosing CD.

This course has been developed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to increase competence and knowledge with regard to the management of CD patients and to harmonise indications and technical considerations for surgery in order to improve patient outcomes.

Upon completion of this activity learners will:

• - Know how to identify surgical indications in patients with Crohn's Disease (CD)
  
• - Be able to adequately treat different complications in CD patients that require surgery
  
• - Be able to recommend appropriate changes in perioperative treatment and management

This course is designed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to increase competence and knowledge with regard to the prediction, diagnosis and management of Ulcerative Colitis (UC) patients and to harmonise diagnostics and treatment in order to improve patient outcomes.

Upon completion of this activity learners will:

• Have insights into the basic epidemiology of ulcerative colitis
• Know current treatment options for severe ulcerative colitis, including colectomy
• Be able to use ciclosporin correctly in severe ulcerative colitis
• Understand when to order thiopurine methyltransferase (TPMT) activity when starting azathioprine

This course is designed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). The intended result of this activity is increased competence, knowledge, performance and improved patient outcomes.

Upon completion of this activity learners will:

• Identify patients at risk of opportunistic infections and understand the principles of screening for opportunistic infections
• Understand the issues associated with vaccinating people at risk of opportunistic infections
• Be familiar with the assessment and management of some of the more commonly encountered and serious opportunistic infections (HBV, TB, VZV, CMV etc.)
• Understand requirements for people with IBD when travelling and returning from travel
• Recognise the opportunistic infections which should be considered in acute flares of colitis

This course is designed for gastroenterologists, paediatricians, surgeons and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). The intended result of this activity is increased competence and knowledge of the role of imaging techniques, particularly ultrasonography, in the diagnosis and follow-up of IBD patients.

Upon completion of this activity learners will:

• Understand the role of ultrasonography (US) in the initial diagnostic work-up of suspected IBD
  
• Be able to provide a comprehensive overview of normal and abnormal findings in bowel US, with a focus on IBD
• Be able to understand the usefulness of bowel US in the follow-up of IBD, in assessing disease activity, response to therapy and monitoring disease progression and complications such as stenosis, fistulae and abscesses

This course is designed for gastroenterologists, surgeons, paediatricians, pathologists and other interdisciplinary medical experts interested in Inflammatory Bowel Disease(s) (IBD). One major aim of this e-learning activity is to increase competence and knowledge with regard to the management of CD patients and to harmonise diagnostics and treatment of anaemia in order to improve patient outcomes.

Upon completion of this activity learners will:

• Know how to diagnose anaemia in Crohn's disease (CD) patients
• Be able to adequatly treat iron deficiency anaemia in CD patients

 
Educational objectives:

1. Typical symptoms presented by a patient

2. Epidemiological IBD data from Austria

3. Ulcerative colitis: typical symptoms, endoscopy examples, complications, extraintestinal involvement, differential diagnoses

4. Crohn´s disease: typical symptoms, clinical investigation, typical endoscpy, differential diagnoses, environmental risk factors, extraintestinal complications

1. To understand the key tests and investigations that complete the work up of the presenting symptoms 
2. To understand the scope of factors that affect IBD patients and which patients need to be educated about 
3. To learn the principles of a collaborative approach when initiating a treat-to-target treatment strategy 
4. To recognise the different factors that affect quality of life for an IBD patient and to develop a patient-centred approach to improvement in quality of life. 

Learning Objectives:
1. Screening before immunosuppression and immunisation
2. Indications for biological therapy
3. Evaluation of response

IBD patients are eligible to treatment with biologic agents if they have failed or cannot tolerate conventional treatment with corticosteroids and/or immunomodulators (IMMs) or are corticosteroid dependent. Early introduction of biologic therapy is also recommended for patients who at diagnosis have clinical features that predict a disabling course of disease. Ideally, patients should be screened for infectious diseases, malignancies, and complete all essential vaccinations before starting any therapy. Selecting the best biologic amongst the currently available different classes, depends on several patient- and disease-related parameters, such as age, disease activity, comorbidities, and the overall burden of disease. As for any therapy, it is important to define short-, medium- and long-term goals, monitor the progress of disease and adapt treatment accordingly (treat to target).

The first biologic is the best shot. Thus, it is key to adapt dosing to disease activity to avoid primary non-response or partial response and thus achieve a better long-term response. Co-treatment with an IMM may influence the pharmacokinetics in particular of anti-TNF and prevent early development of anti-drug antibodies ADA). Once clinical remission has been achieved, patients should be closely followed by monitoring clinical activity (patient reported outcomes), biomarkers (serum CRP, faecal calprotectin), imaging (US, MRE), endoscopy and/or histology. Treatment optimization in case patient loses response can be achieved either empirically (Standard of Care) by increasing the dose of the biologic or halving the administration interval, or both, or by adding an IMM, or by therapeutic drug monitoring (TDM), i.e., by measuring drug levels and ADA. Pro-active TDM has not been proven superior to reactive TDM, still, it serves to discriminate between pharmacokinetic and pharmacodynamic failure of treatment. However, proactive TDM is increasingly used to achieve clinical response and/or remission during induction, to de-escalate, or stop biologic therapy.

4. Screening before immunosuppression and immunisation
5. Indications for biological therapy
6. Evaluation of response