Miguel Regueiro, MD, Updates on "Outside the Box" Treatments for IBD

In this video, Dr Regueiro recaps updates on "outside the box" treatments and therapies for inflammatory bowel disease, presented at the Advances in Inflammatory Bowel Disease 2021 regional conference.

Miguel Regueiro, MD, is chair for Digestive Disease and Surgery Institute at Cleveland Clinic in Cleveland, Ohio.

TRANSCRIPT:

Dr. Miguel Regueiro:  I'm Dr. Miguel Regueiro. I'm the Chair for Digestive Disease and Surgery Institute at Cleveland Clinic in Cleveland, Ohio. At AIBD Regionals, I gave an update on outside-the-box treatments and management for inflammatory bowel disease.

Now, what's outside-the-box management? I focused on a few topics. Combining biologic therapies, hyperbaric oxygen, cannabis for inflammatory bowel disease, low-dose naltrexone, exclusive enteral nutrition, and then medical homes.

What I discussed was combining biologics as an emerging interest, and that maybe we can use two medicines with different mechanism of actions to treat inflammatory bowel disease. This is outside the box, because this is not yet FDA-approved, and we obviously need to take caution with safety.

I did review some of the data and some of the interests we have in looking for this combination approach. Hyperbaric oxygen is a unique approach to the management of certain skin conditions, but we've now used this for ulcerative colitis and also perianal Crohn's, and I reviewed some of the data on that.

There's been a lot of interest in cannabis and other cannabinoid activity in inflammatory bowel disease as a potential treatment. Unfortunately, the data to-date have not panned out that this is an effective medicine, yet our patients still use this quite a bit, and it's important that we know this.

Similarly, low-dose naltrexone is something I reviewed at AIBD Regionals as a treatment that had initial promise. However, larger studies have not shown efficacy, and many of our patients still are on this treatment or desire this treatment, which really speaks to the interest patients have in looking for alternative therapies.

I reviewed enteral nutrition, which has been very effective for pediatric inflammatory bowel disease and maybe in select adult populations. Then finally, I reviewed our medical home at Cleveland Clinic, which is this novel multidisciplinary team approach to the treatment of Crohn's and ulcerative colitis.

These are the outside-the-box treatments that I discussed at AIBD Regionals. I think there's certainly a role for other therapies as well, aside from our traditional treatments, and I hope you enjoyed my presentation. Thank you very much.