Loss of response to Anti-TNFs is common in Crohn’s disease, categorised into primary and secondary loss of response. To minimise loss of response treat disease effectively at the earliest opportunity by supporting patient compliance, and optimising Anti-TNF/combination therapy. Once loss of response is established with objective evidence of active disease switching in class for mild to moderate disease and out of class for moderate to severe and perianal disease is the most appropriate strategy. The role of surgery and advanced combination therapies are alternative options, guided by an IBD MDT.

Biographies

Dr Shahida Din

Dr Shahida Din completed her medical and basic science degrees at the University of Dundee and postgraduate training in Edinburgh including a PhD in the molecular biology of colorectal cancer. Dr Din was appointed as a consultant gastroenterologist in 2015 at the Western General Hospital in Edinburgh with a specialist interest in inflammatory bowel disease. Her research programme includes clinical trials and complications of long-term bowel inflammation including Crohn’s disease fibrosis and IBD-associated colorectal cancer. She is chair of the British Society of Gastroenterology IBD committee and leads several initiatives to improve patient care through data with the patient charity Crohn’s and Colitis UK and IBDUK.

Prof Jimmy Limdi

Jimmy Limdi is a Consultant Gastroenterologist and Head of the Inflammatory Bowel Disease Section at Northern Care Alliance NHS Foundation Trust (NE Sector) and Professor of Clinical Gastroenterology at the Manchester Academic Health Sciences Centre, University of Manchester. He is also Hon. Professor at the Manchester Metropolitan University and Deputy Director of Research &Innovation at the Northern Care Alliance NHS Foundation Trust, Manchester.

Jimmy qualified in 1993 and completed postgraduate training in Internal Medicine and Gastroenterology in Yorkshire and Manchester, followed by a period of research at the ICMS, Barts and The London, and University College Hospitals, London and a Visiting Fellowship at Boston University and Harvard, Boston, USA. His clinical research interests in IBD include diet, gut permeability and nutriceuticals, early diagnosis and outcomes, IBD therapeutics, IBD in older persons, neuromotility in IBD exercise and IBD, dysplasia in IBD and women’s health related issues in IBD.

He is a Principal and Chief Investigator to several IBD studies, is Associate editor of the Inflammatory Bowel Diseases journal and Therapeutic Advances in Gastroenterology, holds Editorial board and peer review appointments with leading gastroenterology journals and has published and lectured widely in the field. He has participated in several national and international peer review processes, Delphi panels and co-authored national and international IBD guidelines. He is currently a member of the BSG IBD Committee, BSG IBD section representative to the BSG Education Committee, BSG Education representative to the International Committee and previously BSG representative to the Association of Colo-Proctologists of GB&I and the BSG Food and Function CRG. He was the UK National Representative at the American College of Gastroenterology (ACG) between 2012 and 2021.