that cross-check/boarding absolutely should have come with a game susp.

🎙️Tomorrow, Duke GI Grand Rounds welcomes guest speaker @frankiscottmd.bsky.social , @cugastrohep.bsky.social, presenting “Optimizing Advanced Therapy Initiation and Disease Activity Monitoring in IBD.”
🎉We're beyond excited for this one and to host Dr. Scott live & in person! Join us at 8AM!
#IBD

Flyers just need to shoot from the blue line or farther and should eventually work out

WHAT A MOVE WHAT A FINISH #USAHOCKEY

That pass, that move, that finish, UNBELIEVABLE

US looks kind of flat since that goal.

Im at an ice protest….. I’m at the health club store.

Rubbish paper "Is Pee Stored in the Balls" with broken diagram, broken, table, and bullshit text.

So initial experiments with Open AI's vibe-coding science tool Prism are going about as well as expected.

Incredible framing here. Superb mastery of the English language. If only we had a word for when someone makes statements in opposition of clear fact

Alex Pretti was a colleague at the VA. We hired him to recruit for our trial. He became an ICU nurse- I lover working with him. He was a good kind person who lived to help and these fuckers executed him.

White. Hot. Rage.

Starting my 48th trip around the sun with a little bit of 4am grant app review ;)

Surprised I had to scroll so far to find this. Pitch perfect ending to a show that resonated with me deeply

Thrilled to congratulate our incoming First-Year Fellows to the
@cuanschutz.bsky.social Division of GI & Hep! 🎉We welcome this incredible lineup to @cugastrohep.bsky.social & can’t wait to work w/ these future leaders! #FutureofGI #Match2026 💪 @bilalmohammadmd.bsky.social @jchristiemd.bsky.social

Our new clinical practice guideline, published in AGA-Gastro.bsky.social, offers 16 evidence-based recommendations for treating moderate-to-severe #Crohnsdisease.

Read more here: gastro.org/news/new-aga...

@frankiscottmd.bsky.social

#GISky

Last, what are living guidelines? 🧑🍼
🔹With how quickly drug-development 💊 and treatment strategies ♟️ change, AGA will review new lit. 📄 and update recommendations as needed every 6 months 📝.

Stay tuned for updates in the future!

10/10

✳️15. For patients w/ mod-severe disease:
👍 Early advanced therapy
❌ No step-up 🪜 therapy

✳️16.🤷♂️Knowledge gap re: treating to a target of mucosal healing vs clinical remission. More data needed!

✳️13, ✳️14 For TNF + IMM therapy, should you stop?
👍 Consider stopping IMM if in steroid-free remission >6mo
❌ Don’t stop TNF
Should involve shared decision making, consideration of disease severity + history, comorbidities, and risk of immunogenicity

8/10

✳️9, ✳️10, ✳️11, ✳️12 Combo therapy 💊+💊
🔹 IFX + thiopurine > IFX or thiopurine alone, particularly if no prior thiopurine use.
🤷♂️Knowledge gaps: Combo therapy with MTX, ADA+ IMM, or non-TNF biologics + IMM
7/10

✳️5, ✳️6, ✳️7.✳️ 8 Immunomodulators 💊
❌ Thiopurines for induction
👍 Okay to use thiopurines for maintenance
👍Methotrexate SQ for induction or maintenance
❌Methotrexate PO for induction or maintenance
6/10

❗️Important❗️
🔑High🪣or med🪣 > lower🪣 🔑

You need to factor in the patient when making tx choices, not just focus on which efficacy bucket each medication is in.
Consider age 👨🦳, pregnancy status 🤰, comorbidities 🤒, functional status 👩🦽, prior med exposures, & patient preferences.

5/10

What about comparative efficacy for bio-naïve & bio-exposed?
✳️3. Bio naive: Higher 🪣> Lower 🪣
Higher🪣: IFX, ADA, VDZ, UST, RIS, MIR, GUS
Lower🪣: CTP, UPA
✳️4. Exposed: Higher 🪣 or Med 🪣 > Lower 🪣
Higher🪣: ADA, RIS, GUS, UPA
Med🪣: UST, MIR
Lower🪣: VDZ, CTP

4/10

✳️1 & 2: What therapies are recommended compared to placebo?
Strong rec: IFX, ADA, UST, RIS, GUS, MIR, UPA
Conditional rec: CTP, VDZ
Considerations:
1. Biosimilar = originator
2. SQ = IV
3. If severe disease, consider extended induction, dose esc, and higher maintenance doses.
3/10

📍Used GRADE framework
📍Thresholds for clinically meaningful benefits across txs: >10% vs. pbo & >5% vs. other 💊
📍For those with no prior adv tx exposure, meds were stratified into higher vs lower efficacy. For adv tx-exposed, higher-, medium-, and lower-eff. buckets were used.
2/10

🚨AGA New Guideline Alert🚨
@amergastroassn.bsky.social
🔗https://smplu.link/aga_CD_guidelines
▶️AGA Living Guideline: Pharmacologic Management of Moderate-to-Severe Crohn’s Disease
I’ll break down its 16 recommendations down over the next 10 tweets 🧵 👇
#AGA #GI #CD #IBD #MedTwitter
1/10

Ugly game

Forever in camp OC

Comparative Efficacy of Advanced Therapies for Management of Moderate-to-Severe Crohn’s Disease: 2025 AGA Evidence Synthesis We performed an updated systematic review and network meta-analysis to inform the 2025 American Gastroenterological Association Clinical Guidelines on the management of moderate-to-severe Crohn’s dise...

🎉 Congrats @frankiscottmd.bsky.social & @benclickmd.bsky.social on their updated systematic review & network meta-analysis informing the 2025
@amergastroassn.bsky.social Clinical Guidelines on the mgmt of mod-to-severe Crohn’s disease in Gastroenterology! www.gastrojournal.org/article/S001...

Appropriately so. Easily the most peripheral and unnecessary subscription I have. Garmin is my recorder, any serious analytics are happening in trainerroad or trainingpeaks. I often wonder why i still even pay for Strava, other than an easy interface for the grams.

lotta potential cavities in that basket of cookies though. He's looking out for your future dental health

Excited for the 7th annual IBD101 course, hosted by @amcollegegastro.bsky.social in Dallas, TX today! Fantastic educational program for first year gi fellows