Charlie Lees @charlie_lees Twitter profile | Pikagi

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Charlie Lees

@charlie_lees

18,383

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2,776

Following

2,067

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8,455

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I write about inflammatory bowel disease providing inspiration, education and deep community. I am Professor of Gastroenterology and UKRIFLF. I also run a lot.

Sign up to Atomic IBD here

https://t.co/1689M9Zj1c

Joined May 2010

Don't wanna be here? Send us removal request.

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@charlie_lees

Charlie Lees

7 months

Advanced therapies for inflammatory bowel disease Fully updated • biologics in green • small molecules in red • biosimilars / generics in italics • late stage development in light grey Future timelines may not be fully accurate - will keep updating with further…

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@charlie_lees

Charlie Lees

4 years

Top 10 tips for people with #IBD during the #COVID19 coronavirus pandemic. Prepared by the UK IBD working group. Thanks to everyone for their input. Please RT and share. We want people to know what the latest advice is. @CrohnsColitisUK @BritSocGastro @ErikRVA @sandybcamera

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Charlie Lees

3 years

1st dose of the Pfizer/BioNTech Covid-19 #vaccine 💉 today. Brilliant team led by Pauline at the Western General. I am recommending vaccination to all my patients with #Crohn ’s & #colitis . You can watch our live Q&A on #covid & IBD 👇 Peace ✌️& hope 🙏

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Charlie Lees

2 years

Head to head studies in IBD - 🧵

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@charlie_lees

Charlie Lees

1 year

Drugs for UC in 2023: what, when and how?

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@charlie_lees

Charlie Lees

1 year

10 principles to guide the management of Crohn's disease

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Charlie Lees

5 years

I am absolutely thrilled to announce that I have been awarded a 7 year @UKRI_News Future Leaders Fellowship #UKRIFLF - This will allow the rapid expansion of my ambitious programme of research in #IBD ( #Crohn 's disease & #UC ).

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@charlie_lees

Charlie Lees

3 years

• I hope that virtual conferences are NOT the future • I wish I was in the USA right now at Digestive Diseases Week • I've been every year since 2004 • Want to know why I want to be there? Read on👇 📍Do you feel this too❓For the same or different reasons❓ #Ship30for30

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@charlie_lees

Charlie Lees

3 years

I have spent 18 years working in the IBD clinic - Tuesday mornings as a fellow & trainee (2003-9); Thursdays as a consultant (2010-present). This has given me a critical long-term perspective on the very nature of Crohn's disease & UC. Here are FIVE lessons on IBD care.

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Charlie Lees

1 year

10 important randomised clinical trials in IBD published in 2022 Thread featuring: • UPA for UC • RISA for CD • ABX464 in UC • Filgotinib for UC • Ozanimod for UC • ADA vs USTE in CD • FMT plus AID for UC • High-dose ADA in IBD

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Charlie Lees

1 year

10 questions to ask your patients with IBD at every clinical interaction

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@charlie_lees

Charlie Lees

3 years

SEVEN (!) new molecules could enter the clinic for IBD within the next THREE years. These 7 new drug therapies include: • two S1P inhibitors in UC • three p19 inhibitors (Crohn's & UC) • two JAK1 selective inhibitors in UC Read on for a break down of what's coming soon [👇]

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Charlie Lees

2 years

Who gets IBD and why? A brief illustrated 🧵

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Charlie Lees

1 year

Top 12 papers on gut inflammation from 2022 These are the scientific / translational papers that had the biggest impact on me this year • Heavily focused on diet and the microbiome • High quality science papers from @Nature @ScienceMagazine and @CellCellPress

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Charlie Lees

3 years

#WorldIBDday2021 - a time for hope & reflection • We must do more to raise awareness • But there is great cause for optimism • With brilliant minds & sufficient research funding • Treatments will begin to look more like cures #NoGoingBack #BreakTheSilence #ship30for30

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Charlie Lees

1 year

Drugs for UC in 2023 - part 2 Vedolizumab, ustekinumab and the new small molecules

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@charlie_lees

Charlie Lees

1 year

Drug therapy for Crohn's disease in 2023 - what, how and when?

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Charlie Lees

7 months

In 10 years time, a newly diagnosed IBD patient will have: • complete disease control >90% of patients • first medicine works >90% persistence • minimal / zero toxicity Completely normal quality of life Hospitalisations & surgeries <10% of patients Not a cure, but closer

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@charlie_lees

Charlie Lees

1 year

Not all high calprotectins are indicative of active IBD. These are the other possible causes. If in doubt retest and / or scope.

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Charlie Lees

6 months

Twelve principles to guide therapy in Crohn's disease 1/ Crohn's disease is progressive With long-term, irreversible bowel damage, disability and poor quality of life the result. - - 2/ Diagnostic delay is associated with worse outcomes Ensure effective systems are in place…

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@charlie_lees

Charlie Lees

5 months

After 2.5 years, today is Bea's last official day working in the Edinburgh IBD Unit. It is difficult to express here what an incredible impact she has made on the entire team in Edinburgh. Her hard work, dedication, passion and joy for the every day has impacted us all and…

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Charlie Lees

2 years

We have an effective toolkit to help many people living with IBD. When deployed early in the disease course we can achieve deep and sustained remission for many patients. The following strategy [👇] is not perfect, but is cost-effective and can be adopted widely. NEW thread 🧵

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Charlie Lees

2 years

Treatment principles in Crohn's disease: a graphical thread 🧵 (n~28) There is lots covered here • impact of CD • early effective therapy • surgical trends • biosimilars • head to head studies • mucosal healing Follow along below👇

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@charlie_lees

Charlie Lees

3 years

Inflammatory bowel disease (IBD) • affects nearly 1% in the West • any age but mostly young people • cause: 🥗 🧬 🦠 • symptoms can be intrusive • treatment can be v effective • but doesn't always work • surgery & stoma often needed IBD is not IBS! #ship30for30

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@charlie_lees

Charlie Lees

2 years

Fermented foods merit proper investigation in Crohn’s disease & UC They perform better than high fibre diets in a randomised study @CellCellPress ⬇️ inflammatory cytokines ⬆️ microbial diversity Unexpected finding: demonstrates the importance of research to test assumptions

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Charlie Lees

1 year

Drug therapy for Crohn's disease in 2023 - part 2

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Charlie Lees

3 years

We now have clear guidance from JCVI on those patients eligible for a 3rd primary dose of COVID vaccine. This includes IBD patients on infliximab, adalimumab, ustekinumab, tofacitinib, prednisolone and some on high-dose aza/mp/mtx. Details here & below

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Charlie Lees

6 months

Crohn's disease is progressive: • strictures and fistulas • surgery and stomas • gut failure and TPN • disability & ↓ QoL There is an inflammatory window of opportunity • avoid diagnostic delay • treat (very) early And use effective therapies • biosimilar…

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Charlie Lees

5 years

PRESS RELEASE Our team have shown that 1 in 125 people in Edinburgh live with Crohn's or ulcerative colitis ... rates will exceed 1% within 10y. This replicates recent data from @gilkaplan in Canada. This is an urgent problem at a vast scale. 1/n

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Charlie Lees

2 years

Initial thoughts from #DDW2022 taking a look at therapies for IBD - new molecules and controlled data on existing molecules #atomicIBD

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Initial thoughts from DDW 2022: IBD therapies

What's new, what's hot and what's falling flat in IBD therapies

charlielees.substack.com

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Charlie Lees

4 years

Advice for people with #Crohn 's & #UC from the UK #IBD #COVID19 working group. Please report confirmed cases to #IOIBD Secure-IBD Registry Full guidance for UK IBD teams imminent via @BritSocGastro Stay safe & keep well

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Charlie Lees

7 months

Some initial thoughts post #UEGWeek2023 Risankizumab looks v good for Crohn's disease; impressive delta vs USTE across all primary and secondary endpoints • Lifting the therapeutic ceiling a little but hardly smashing through it • BUT ... multiple USTE biosimilars ready for…

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Charlie Lees

6 months

My approach to Crohn's disease drug therapy Plenty of nuance in here - a UK perspective where cost is an important factor How does this change in your practice?

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Charlie Lees

1 year

Fatigue is a major issue for people living with IBD Sleep too - and they cannot be addressed in isolation

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Charlie Lees

2 years

What is inflammatory bowel disease? There appears to still be confusion, so let's clear things up: • IBD is not the same as IBS • IBD consists of Crohn's and UC • IBD is lifelong with no known cure • IBD requires treatment to prevent bowel damage IBD and IBS often co-exist

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Charlie Lees

2 years

Crohn's disease and ulcerative colitis These inflammatory bowel diseases can have a marked impact on a person's life

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Charlie Lees

1 year

When should you get your calprotectin checked as an IBD patient? These are 8 key time points to look out for.

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Charlie Lees

5 months

How I approach every clinical interaction with an IBD patient. “What is on your agenda to discuss today?” Bowel symptoms • stool frequency, consistency, blood, urgency, incontinence, pain Systemic symptoms • Nausea & vomiting, appetite, diet and weight, night sweats…

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Charlie Lees

2 years

Treatment landscape for Crohn's disease and UC. • A timeline based on EMA approval dates • A slide needing regular updates • New molecules and biosimiliars Good news for clinicians and patients. Let's discuss a little more ... 🧵

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Charlie Lees

1 year

10 new papers of interest about IBD - published in the last 2 weeks Thread featuring: • SPARE trial • NMA of zoster risk • IBD diagnostic delay • antibiotics & IBD risk • RWE of tofa and RISA • Monogenic IBD guidance • autoantibodies that antedate UC

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Charlie Lees

6 months

My approach to therapy for UC at the end of 2023 Choice of first line therapy driven by • disease activity • cost of therapy • demographics Many excellent therapies for first line use. Significant variation in practice at the national and international level.…

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Charlie Lees

3 years

Tens of millions of people across the world live with Crohn's disease and ulcerative colitis, but why? What causes inflammatory bowel disease? [NEW THREAD] Answered this KEY question will help us treat (cure) and ultimately prevent IBD.

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Charlie Lees

3 years

I've been thinking about the unmet need in IBD. • What is achievable now? • Therapeutic pipeline is rich (hope) • We have hit a therapeutic ceiling (problem) • What else do patients need? • Prevention & cure = moonshot 👇[click below] to read; pls add comments #ship30for30

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Charlie Lees

2 years

10 unmet needs in Crohn’s disease and ulcerative colitis

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Charlie Lees

6 months

This morning I ran a thought experiment I asked which IBD advanced therapies you would keep if you were only allow three. My response and rationale is as follows: 1/ Infliximab I'm definitely taking an anti-TNF and infliximab is my drug of choice. • highly effective in…

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@charlie_lees

Charlie Lees

6 months

In 2023 we have multiple effective agents approved for use in Crohn’s disease What are the pros and cons of each as first-line agents? Note 1: starting any one of these agents will usually be better than not starting any in moderate or severe Crohn's disease. Note 2: The best…

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Charlie Lees

2 years

Introduction to advanced therapies in IBD My talk to the surgeons @ACPGBI today @eicc 🧵 covering: • therapeutic targets • treatment strategies • therapeutic ceiling • early effective therapies in Crohn's • the pros and cons of anti-TNF • new small molecules for UC

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Charlie Lees

1 year

Each day I am publishing an atomic essay on IBD A master thread 🧵 of essays from the last 2 weeks covering: • Drugs for UC in 2023 • Drugs for CD in 2023 • Positioning of drugs • Managing IBD on a budget • The flare clinic model • And more ... By Atomic IBD

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Charlie Lees

1 year

Drugs for Crohn's disease in 2023 - part 3 - positioning

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Charlie Lees

3 years

Some days the clinic is hard • the drugs aren't working • the disease has progressed • the psychological toll is heavy Today was one of those days when IBD was hard 👇[click below] for my reflections from the clinic #ship30for30

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Charlie Lees

2 years

The rate of progress in IBD is staggeringly fast. This should bring hope to patients, their families and the clinical teams working hard to help them. We have much to do, but very many reasons to be hopeful. On this 13th #worldIBDday I share my annual letter of hope

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Charlie Lees

4 years

While there may be an increased risk of complications with #covid19 for people taking immunosuppressants, please do not stop taking them now. Stopping them risks a disease flare. The biggest risk for infection is active #IBD (of moderate to severe activity). @CrohnsColitisUK

@CrohnsColitisUK

Crohn's & Colitis UK

@CrohnsColitisUK

4 years

We have received a high number of calls/messages from people with #Crohns or #Colitis who are worried about the #Coronavirus (aka #COVID19 ). We will continue to update our website as we receive more information.

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Charlie Lees

6 months

We now have three key head-to-head studies in IBD All have important implications for clinical practice Which would you most like to see next? 👇👇👇 - - VARSITY • Vedo versus ADA in UC • Vedo shows superiority - - SEAVUE • USTE versus ADA in bionaive Crohn's •…

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Charlie Lees

7 months

SEQUENCE phase 3b RCT Clear evidence of superiority for risankizumab over ustekinumab in Crohn’s disease Endoscopic remission at week 48 double with RZB (31.8%) vs UST (16.2%) Hugely important data - for more results including study design keep reading👇

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Charlie Lees

1 year

10 reasons to get your faecal calprotectin checked and know the result as an IBD patient

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Charlie Lees

5 months

The impact of IBD on a person's life is not just physical Physical aspects • diarrhoea, urgency, blood in stool and pain • loss of appetite and weight loss • night sweats and fevers • nausea and vomiting • joint pains, eye problems, skin rashes and mouth ulcers…

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Charlie Lees

2 years

2 new IBD therapies in 3 papers and 1 editorial in @TheLancet today • Upadacitinib in ulcerative colitis • Risankizumab induction in Crohn's disease • Risankizumab maintenance in Crohn's disease Exciting molecules coming to the clinic later this year I will unpack all soon

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Charlie Lees

2 months

The most invigorating ECCO congress in recent years I’m hunkering down in a central Stockholm hotel for the next 24 hours to write my thoughts for Atomic IBD

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Charlie Lees

3 years

Leaving the hospital after the Christmas Eve IBD clinic. I’m looking forward to a few quiet and restful days off. I hope everyone has the chance for a moment of peace. The Edinburgh sky is incredible tonight.

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Charlie Lees

1 year

“Cut the crap” to help earlier diagnosis of Crohn’s disease and ulcerative colitis. At Scottish Parliament for @CrohnsColitisUK

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Charlie Lees

3 years

Today I want to discuss DIET and IBD The most common question in the clinic is "Doctor, what should I EAT?" 👇 [click below] to read my thoughts • I'm interested to hear how you approach this • Look out for tomorrow when i'll discuss @PREdiCCt #ship30for30 #UKRIFLF

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Charlie Lees

1 month

Upadacitinib for Crohn's disease • data from Edinburgh and Exeter • n=93 with median 25w follow-up • effective in highly refractory cohort See 👇 for figures and link @FrontGastro_BMJ

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Charlie Lees

9 months

A full day of IBD clinic where there was no hiding from the unmet need our patients face • treatments that don’t work • unrelenting disease progression • substantial psychosocial morbidity A day when the current tools feel inadequate We work hard to find practical…

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@charlie_lees

Charlie Lees

3 years

The impact of Crohn's disease and UC on a person's life can be devastating. With 1 in 125 of the population living with #IBD it is important we realise what they might be going through. It isn't just physical; here 👇 are just some of the ways IBD affects people.

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Charlie Lees

5 years

Why do I travel? To TEACH about IBD. To SHAKE UP old dogma. To use new DATA to promote EARLY appropriate treatment with EFFECTIVE drugs. To INSPIRE teams to RESEARCH & COLLABORATE. To provide HOPE to patients. IBD is a global disease; it has no respect for cultural boundaries.

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@charlie_lees

Charlie Lees

3 years

Starting May 15 I'll post an atomic essay & video every day for 30 days #ship30for30 #UKRIFLF I'm going to write about #IBD exploring • unanswered questions • unmet need • improving outcomes • environment, diet, the microbiome& genetics • digital health • & resilience

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Charlie Lees

3 years

I have an important message for our entire global IBD community. A message to: • our patients • my fellow healthcare professionals • academics, clinician scientists, industry & biotech partners • patient organisations, charities & funding bodies It is a message of hope ✌️

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Charlie Lees

3 years

I've started to think about life for our patients post-pandemic. We face many challenges but I'm optimistic. Advances in drug development, genomics, digital health, AI & more. This is the start of a new series on Innovations in IBD & the story of the innovators. #ship30for30

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Charlie Lees

4 years

This is my talented and beautiful daughter Holly playing her pipes - every Thursday at 8pm outside our house. We are all in this together. Wish i'd swept the yard! Every week a different tune.

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Charlie Lees

1 year

Twelve different drugs are available to treat UC in 2023. How do you choose the right drug for the right patient at the right time?

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Charlie Lees

20 days

The 1 in 100 living with IBD ...

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@charlie_lees

Charlie Lees

1 year

An illustrated thread 🧵 on JAK inhibitors for IBD Game-changing small molecules that • work fast • work when TNF fails • don't need steroids to work Follow along as I outline the key themes 👇

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Charlie Lees

5 months

10 reasons to get your faecal calprotectin checked and know the result as an IBD patient Calprotectin is not a perfect test and we know it is fiddly to collect; but it is a very powerful tool to monitor levels of gut inflammation. 1. The goals of treatment in Crohn's disease…

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@charlie_lees

Charlie Lees

18 days

Fatigue and IBD

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@charlie_lees

Charlie Lees

2 years

A patient comes to the IBD clinic. I know him very well but I have not seen him for some time. He has had troublesome IBD for many years. Multiple admissions, several surgeries and lots of different medicines. But something is different ... 1/n

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Charlie Lees

1 year

Excellent piece on Crohn’s disease and cricket in today’s @thetimes Mike Atherton (who has UC) writes sensitively and accurately about Jack Leach who has Crohn’s disease (and takes adalimumab). Great to see such a positive story @Athersmike @jackleach1991 @CrohnsColitisUK

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Charlie Lees

23 days

Atomic IBD Uncut - Episode One Something new • daily videos • one take, uncut • here and on YouTube Talking about IBD • therapies new and old • evolving IBD management • holistic care

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Charlie Lees

2 years

Let's talk about equity of care in IBD Every person living with Crohn's disease or ulcerative colitis should have access to good care No matter geography, age, gender, ethnicity, social status, wealth This is an urgent issue for our global community

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Charlie Lees

3 years

Looking for a simple guide for treating Crohn's disease? • Here is a set of principles • Should work with current effective therapies • The field is moving fast • This framework will help you integrate new data • And new therapies 👇[click below to read] #ship30for30

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Charlie Lees

3 years

Crohn's disease and ulcerative colitis can have a significant impact on a person's life. • physical symptoms • psychological aspects • long-term complications of disease • impact on everyday life With good medical care from an IBD team this can be minimised. #ship30for30

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Charlie Lees

1 year

All of this happened in IBD this month 👇 🧵 thread featuring: • VEGA pub • UPFs & Crohn's • ADA descalation • pharma news items • an amazing 5-ASA story • serological signatures & CD • IFX biosimilar multi-switching • a brilliant new website of IBD trials

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Charlie Lees

6 years

ANNOUNCEMENT: I’m going to start a new series of patient education events across Scotland for people affected by IBD ... starting in Edinburgh early October. Are you keen to get involved or help out? Please get in touch. Aiming to make it fun, informative, educational & social.

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Charlie Lees

1 year

Inflammatory bowel disease can have a profound impact on the individual. And we are seeing a global surge in unmet needs. In this illustrated thread we'll unravel the key challenges.

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Charlie Lees

2 months

Thiopurine monotherapy is essentially no more in the updated ECCO Crohn’s guidelines 👏👏👏

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Charlie Lees

5 years

Watch my #ECCO19 plenary talk on #PrecisionMedicine in #IBD in full here thanks to amazing webcast. Stratifying by disease biology to choose the right drug for the right patient.

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Charlie Lees

1 year

A simple guide to the workings of the Edinburgh IBD flare clinic

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Charlie Lees

4 years

Two fundamental principles in Crohn's disease: 1. Disease is progressive 2. Disconnect between symptoms & inflammation Treat inflammation early & effectively to stop disease progression. So important we made a video about it: @ErikRVA @CrohnsColitisUK

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Charlie Lees

1 year

First wow moment #ECCO23 for me Vedolizumab highly effective in post-operative recurrence in Crohn’s disease (high-risk population) Practice changing data

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Charlie Lees

3 years

FIVE simple ways to transform care in the IBD clinic today. • ASK about fatigue, mood and sleep • Enquire about diet • Be curious about IBD and impact on life • Think about medication adherence • Check calprotectin Moving close to holistic care. #ship30for30

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Charlie Lees

7 years

For #WorldIBDDay I've written a blog post. It's for everyone involved with #IBD It's important. Please read & share

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Charlie Lees

6 months

10 tips to improve outcomes for your IBD patients in 2023 1) ADOPT early effective therapy in Crohn’s disease This is best way to stop the disease from progressing. 2) Manage flares expediently in UC with advanced therapies Stopping flares quickly is good for patients and…

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Charlie Lees

2 years

Upadacitinib meets key primary efficacy endpoints in Crohn's disease U-ENDURE: phase 3 RCT of upadacitinib maintenance in moderate to severely active Crohn's disease Data taken from Abbvie Press Release 11th May 2022

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Charlie Lees

2 years

It is a beautiful morning in Vienna @my_ueg #UEGWeek22 Have a wonderful day filled with great science, clinical updates and networking ✌️

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Charlie Lees

2 years

Anti-TNF drugs are highly effective and affordable therapies for Crohn’s disease and UC But they have 3 main problems: 1. They don’t work for everyone 2. They lose effectiveness over time 3. Subsequent therapies work less well

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Charlie Lees

4 years

➡️IBD and live in the UK? ➡️Please go to ➡️On-line risk tool generated by my brilliant friend @DrNickKennedy & @IBDRegistry & @CrohnsColitisUK ➡️It takes 5 minutes ➡️Based on the @BritSocGastro risk grid ➡️Secure & GDPR compliant ➡️Help us help you

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Charlie Lees

1 year

From fatigue to food choices, inflammatory bowel disease can impact every aspect of a person's life. Learn more about the many ways this chronic disease affects daily life.

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Charlie Lees

1 year

Who else just loves Chicago for #DDW2023

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Charlie Lees

22 days

The PANTS-extension study out today @LancetGastroHep After 3 years of therapy only 1/3 IFX and 1/3 ADA patients are still on drug in remission • notable that proportion exiting due to drug failure higher with ADA versus IFX (remember this is NOT randomised h2h) Most…

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Charlie Lees

7 months

Requests for IBD sessions @my_ueg #UEGWeek next year • bring back proper poster session • put all post-hoc analysis of phase 3 RCTs in poster sessions • more oral presentations for academic work • don’t give abstract prizes to old professors presenting pharma data 🙏

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Charlie Lees

6 years

Current therapies for #IBD with a few key pointers: - do not use 5ASA medicines in #Crohn 's disease - avoid excess use of steroids - azathioprine & MP are maintenance agents (so should not be used to induce remssion) - anti-TNF therapy works best when started early

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