Malcolm Tan
@ibdgastrodocsg.bsky.social
Gastroenterologist | IBD Service Director | Singapore General Hospital.
7/🧵
Clinical response rates were consistent.... even for those with 4+ prior AT: 55% clinical response
In JAK-IR: 55% clinical response
Clinical response rates were consistent.... even for those with 4+ prior AT: 55% clinical response
In JAK-IR: 55% clinical response
October 20, 2025 at 1:48 AM
7/🧵
Clinical response rates were consistent.... even for those with 4+ prior AT: 55% clinical response
In JAK-IR: 55% clinical response
Clinical response rates were consistent.... even for those with 4+ prior AT: 55% clinical response
In JAK-IR: 55% clinical response
6/🧵
Obefazimod works in patients with prior AT-IR, perhaps not as well as in AT-naive patients.
Obefazimod works in patients with prior AT-IR, perhaps not as well as in AT-naive patients.
October 20, 2025 at 1:48 AM
6/🧵
Obefazimod works in patients with prior AT-IR, perhaps not as well as in AT-naive patients.
Obefazimod works in patients with prior AT-IR, perhaps not as well as in AT-naive patients.
5/🧵
Obefazimod was generally well-tolerated. Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) were comparable across all three groups (Placebo, 25mg, 50mg). Headaches did not result in treatment cessation.
Obefazimod was generally well-tolerated. Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) were comparable across all three groups (Placebo, 25mg, 50mg). Headaches did not result in treatment cessation.
October 20, 2025 at 1:48 AM
5/🧵
Obefazimod was generally well-tolerated. Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) were comparable across all three groups (Placebo, 25mg, 50mg). Headaches did not result in treatment cessation.
Obefazimod was generally well-tolerated. Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) were comparable across all three groups (Placebo, 25mg, 50mg). Headaches did not result in treatment cessation.
4/🧵
Both Obefazimod doses achieved clinically meaningful improvements across ALL efficacy endpoints in the pooled dataset. The (higher) 50mg dose showed superior outcomes.
Both Obefazimod doses achieved clinically meaningful improvements across ALL efficacy endpoints in the pooled dataset. The (higher) 50mg dose showed superior outcomes.
October 20, 2025 at 1:48 AM
4/🧵
Both Obefazimod doses achieved clinically meaningful improvements across ALL efficacy endpoints in the pooled dataset. The (higher) 50mg dose showed superior outcomes.
Both Obefazimod doses achieved clinically meaningful improvements across ALL efficacy endpoints in the pooled dataset. The (higher) 50mg dose showed superior outcomes.
3/ 🧵
Notably, the study included a highly refractory population, with ~21% having prior AT-IR (inadequate response) failing a JAK inhibitor.
Notably, the study included a highly refractory population, with ~21% having prior AT-IR (inadequate response) failing a JAK inhibitor.
October 20, 2025 at 1:48 AM
3/ 🧵
Notably, the study included a highly refractory population, with ~21% having prior AT-IR (inadequate response) failing a JAK inhibitor.
Notably, the study included a highly refractory population, with ~21% having prior AT-IR (inadequate response) failing a JAK inhibitor.
2/🧵
The ABTECT Phase 3 program includes 2 induction trials & 1 maintenance trial. Our focus today is on the strong safety and efficacy results from the ABTECT 1 & 2 induction phases.
The ABTECT Phase 3 program includes 2 induction trials & 1 maintenance trial. Our focus today is on the strong safety and efficacy results from the ABTECT 1 & 2 induction phases.
October 20, 2025 at 1:48 AM
2/🧵
The ABTECT Phase 3 program includes 2 induction trials & 1 maintenance trial. Our focus today is on the strong safety and efficacy results from the ABTECT 1 & 2 induction phases.
The ABTECT Phase 3 program includes 2 induction trials & 1 maintenance trial. Our focus today is on the strong safety and efficacy results from the ABTECT 1 & 2 induction phases.
Obefazimod in mod-severe UC
- week 8 induction data presented at #UEGWeek
- first in class for IBD
1/🧵
MoA: ⬆️expression of miR-124, which regulates inflammatory response & restores mucosal homeostasis.
- week 8 induction data presented at #UEGWeek
- first in class for IBD
1/🧵
MoA: ⬆️expression of miR-124, which regulates inflammatory response & restores mucosal homeostasis.
October 20, 2025 at 1:48 AM
Obefazimod in mod-severe UC
- week 8 induction data presented at #UEGWeek
- first in class for IBD
1/🧵
MoA: ⬆️expression of miR-124, which regulates inflammatory response & restores mucosal homeostasis.
- week 8 induction data presented at #UEGWeek
- first in class for IBD
1/🧵
MoA: ⬆️expression of miR-124, which regulates inflammatory response & restores mucosal homeostasis.
5/ Our findings 😲
63% in clinical remission…
But only 32% in transmural remission on IUS
➡️ Almost HALF of “well” patients still had active disease
63% in clinical remission…
But only 32% in transmural remission on IUS
➡️ Almost HALF of “well” patients still had active disease
August 10, 2025 at 6:31 AM
5/ Our findings 😲
63% in clinical remission…
But only 32% in transmural remission on IUS
➡️ Almost HALF of “well” patients still had active disease
63% in clinical remission…
But only 32% in transmural remission on IUS
➡️ Almost HALF of “well” patients still had active disease
2/ What is IUS?
No prep 🛑
No radiation ☢️
Point-of-care, takes minutes ⏱️
Sees transmural inflammation, not just mucosa
Minimal carbon footprint ♻️
No prep 🛑
No radiation ☢️
Point-of-care, takes minutes ⏱️
Sees transmural inflammation, not just mucosa
Minimal carbon footprint ♻️
August 10, 2025 at 6:31 AM
2/ What is IUS?
No prep 🛑
No radiation ☢️
Point-of-care, takes minutes ⏱️
Sees transmural inflammation, not just mucosa
Minimal carbon footprint ♻️
No prep 🛑
No radiation ☢️
Point-of-care, takes minutes ⏱️
Sees transmural inflammation, not just mucosa
Minimal carbon footprint ♻️
How intestinal ultrasound (IUS) changes IBD care – clinical impact, cost savings & greener healthcare
1/ #IBD is rising fast in SE Asia 📈
We need tools that are accurate, patient-friendly, and sustainable.
Our SGH pilot study shows #IntestinalUltrasound ticks all 3 boxes ✅
1/ #IBD is rising fast in SE Asia 📈
We need tools that are accurate, patient-friendly, and sustainable.
Our SGH pilot study shows #IntestinalUltrasound ticks all 3 boxes ✅
August 10, 2025 at 6:31 AM
How intestinal ultrasound (IUS) changes IBD care – clinical impact, cost savings & greener healthcare
1/ #IBD is rising fast in SE Asia 📈
We need tools that are accurate, patient-friendly, and sustainable.
Our SGH pilot study shows #IntestinalUltrasound ticks all 3 boxes ✅
1/ #IBD is rising fast in SE Asia 📈
We need tools that are accurate, patient-friendly, and sustainable.
Our SGH pilot study shows #IntestinalUltrasound ticks all 3 boxes ✅
Biomarker & histology insights:
- ↓ hsCRP & fecal calprotectin by Week 6
- ↓ Th1, Th17 cytokines (IL-17A, IL-22, IL-9)
- ↓ fibrotic gene expression (e.g., COL1A1, MMP3)
- Histologic remission (RHI <3) in 18%
- ↓ hsCRP & fecal calprotectin by Week 6
- ↓ Th1, Th17 cytokines (IL-17A, IL-22, IL-9)
- ↓ fibrotic gene expression (e.g., COL1A1, MMP3)
- Histologic remission (RHI <3) in 18%
June 27, 2025 at 7:56 AM
Biomarker & histology insights:
- ↓ hsCRP & fecal calprotectin by Week 6
- ↓ Th1, Th17 cytokines (IL-17A, IL-22, IL-9)
- ↓ fibrotic gene expression (e.g., COL1A1, MMP3)
- Histologic remission (RHI <3) in 18%
- ↓ hsCRP & fecal calprotectin by Week 6
- ↓ Th1, Th17 cytokines (IL-17A, IL-22, IL-9)
- ↓ fibrotic gene expression (e.g., COL1A1, MMP3)
- Histologic remission (RHI <3) in 18%
Safety:
- AEs: 78% (mostly mild-moderate)
- SAEs: 15% (none drug-related)
- No deaths, no infusion reactions
- Most common AE: infection (45%), incl. COVID-19 (11%)
- AEs: 78% (mostly mild-moderate)
- SAEs: 15% (none drug-related)
- No deaths, no infusion reactions
- Most common AE: infection (45%), incl. COVID-19 (11%)
June 27, 2025 at 7:56 AM
Safety:
- AEs: 78% (mostly mild-moderate)
- SAEs: 15% (none drug-related)
- No deaths, no infusion reactions
- Most common AE: infection (45%), incl. COVID-19 (11%)
- AEs: 78% (mostly mild-moderate)
- SAEs: 15% (none drug-related)
- No deaths, no infusion reactions
- Most common AE: infection (45%), incl. COVID-19 (11%)
Primary efficacy results (Week 12):
- Endoscopic response (≥50% ↓ in SES-CD): 26.0%
vs historical placebo 12% (p=0.0023)
- Clinical remission (CDAI <150): 49.1%
vs historical placebo 16% (p<0.0001)
- Endoscopic response (≥50% ↓ in SES-CD): 26.0%
vs historical placebo 12% (p=0.0023)
- Clinical remission (CDAI <150): 49.1%
vs historical placebo 16% (p<0.0001)
June 27, 2025 at 7:56 AM
Primary efficacy results (Week 12):
- Endoscopic response (≥50% ↓ in SES-CD): 26.0%
vs historical placebo 12% (p=0.0023)
- Clinical remission (CDAI <150): 49.1%
vs historical placebo 16% (p<0.0001)
- Endoscopic response (≥50% ↓ in SES-CD): 26.0%
vs historical placebo 12% (p=0.0023)
- Clinical remission (CDAI <150): 49.1%
vs historical placebo 16% (p<0.0001)
Trial design (N=55):
- Multicentre, open-label
- Moderate-to-severe CD
- IV tulisokibart: 1000 mg (Day 1), 500 mg (Weeks 2, 6, 10)
- Endoscopic response at Week 12 = primary endpoint
71% had prior biologic exposure; 35% had ≥3 agents
- Multicentre, open-label
- Moderate-to-severe CD
- IV tulisokibart: 1000 mg (Day 1), 500 mg (Weeks 2, 6, 10)
- Endoscopic response at Week 12 = primary endpoint
71% had prior biologic exposure; 35% had ≥3 agents
June 27, 2025 at 7:56 AM
Trial design (N=55):
- Multicentre, open-label
- Moderate-to-severe CD
- IV tulisokibart: 1000 mg (Day 1), 500 mg (Weeks 2, 6, 10)
- Endoscopic response at Week 12 = primary endpoint
71% had prior biologic exposure; 35% had ≥3 agents
- Multicentre, open-label
- Moderate-to-severe CD
- IV tulisokibart: 1000 mg (Day 1), 500 mg (Weeks 2, 6, 10)
- Endoscopic response at Week 12 = primary endpoint
71% had prior biologic exposure; 35% had ≥3 agents
2025 guidelines for IBD from @amcollegegastro.bsky.social
Crohn's: journals.lww.com/ajg/fulltext...
UC: journals.lww.com/ajg/fulltext...
#IBDSky #MedSky #GISky
Crohn's: journals.lww.com/ajg/fulltext...
UC: journals.lww.com/ajg/fulltext...
#IBDSky #MedSky #GISky
June 21, 2025 at 12:21 AM
2025 guidelines for IBD from @amcollegegastro.bsky.social
Crohn's: journals.lww.com/ajg/fulltext...
UC: journals.lww.com/ajg/fulltext...
#IBDSky #MedSky #GISky
Crohn's: journals.lww.com/ajg/fulltext...
UC: journals.lww.com/ajg/fulltext...
#IBDSky #MedSky #GISky
6/ 12-month remission rate:
- Any clinical remission: 37%
- Steroid-free remission: only 16%
- 66% were still on therapy at 12 months.
🛑 ICI was stopped in 80% due to colitis — but discontinuation did NOT impact remission (P=0.48).
- Any clinical remission: 37%
- Steroid-free remission: only 16%
- 66% were still on therapy at 12 months.
🛑 ICI was stopped in 80% due to colitis — but discontinuation did NOT impact remission (P=0.48).
June 2, 2025 at 3:10 AM
6/ 12-month remission rate:
- Any clinical remission: 37%
- Steroid-free remission: only 16%
- 66% were still on therapy at 12 months.
🛑 ICI was stopped in 80% due to colitis — but discontinuation did NOT impact remission (P=0.48).
- Any clinical remission: 37%
- Steroid-free remission: only 16%
- 66% were still on therapy at 12 months.
🛑 ICI was stopped in 80% due to colitis — but discontinuation did NOT impact remission (P=0.48).
4/ Faecal calprotectin was significantly elevated in nearly all cases (median ~765 μg/g).
CRP? Mildly elevated.
➡️ Don’t underestimate colitis just because systemic markers look ‘okay’.
CRP? Mildly elevated.
➡️ Don’t underestimate colitis just because systemic markers look ‘okay’.
June 2, 2025 at 3:10 AM
4/ Faecal calprotectin was significantly elevated in nearly all cases (median ~765 μg/g).
CRP? Mildly elevated.
➡️ Don’t underestimate colitis just because systemic markers look ‘okay’.
CRP? Mildly elevated.
➡️ Don’t underestimate colitis just because systemic markers look ‘okay’.
2/ Most common culprit cancers:
- Lung (42.7%)
- Melanoma (31.2%)
📆 Median time to colitis onset: 4 months after starting ICI.
💩 100% had diarrhoea, often moderate to severe.
- Lung (42.7%)
- Melanoma (31.2%)
📆 Median time to colitis onset: 4 months after starting ICI.
💩 100% had diarrhoea, often moderate to severe.
June 2, 2025 at 3:10 AM
2/ Most common culprit cancers:
- Lung (42.7%)
- Melanoma (31.2%)
📆 Median time to colitis onset: 4 months after starting ICI.
💩 100% had diarrhoea, often moderate to severe.
- Lung (42.7%)
- Melanoma (31.2%)
📆 Median time to colitis onset: 4 months after starting ICI.
💩 100% had diarrhoea, often moderate to severe.
Checkpoint inhibitor-induced colitis (ICI-colitis): a serious, often under-recognized complication in cancer patients receiving immunotherapy.
1/ ICI-induced colitis
📈 Affects up to 30% of patients on ICIs.
🔬 This study followed 96 patients with 12-month outcomes.
www.esmoopen.com/article/S205...
1/ ICI-induced colitis
📈 Affects up to 30% of patients on ICIs.
🔬 This study followed 96 patients with 12-month outcomes.
www.esmoopen.com/article/S205...
June 2, 2025 at 3:10 AM
Checkpoint inhibitor-induced colitis (ICI-colitis): a serious, often under-recognized complication in cancer patients receiving immunotherapy.
1/ ICI-induced colitis
📈 Affects up to 30% of patients on ICIs.
🔬 This study followed 96 patients with 12-month outcomes.
www.esmoopen.com/article/S205...
1/ ICI-induced colitis
📈 Affects up to 30% of patients on ICIs.
🔬 This study followed 96 patients with 12-month outcomes.
www.esmoopen.com/article/S205...
