Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Treatment Options in Gastroenterology
Published in: Current Treatment Options in Gastroenterology 2/2021

01-06-2021 | Fertility | Colon (JC Anderson, Section Editor)

Reproductive Health in IBD Patients

Authors: Sanket Patel, DO, Haleh Vaziri, MD

Published in: Current Treatment Options in Gastroenterology | Issue 2/2021

Login to get access

Abstract

Purpose of review

Many patients with inflammatory bowel disease (IBD) are diagnosed in early adulthood, impacting their reproductive health. We discuss the recent data related to fertility, preconception counseling, the safety of IBD medications during pregnancy and lactation, delivery methods, and postpartum care in women with IBD. Additionally, we will review the psychosocial aspects, the effect of IBD, and its treatment on sexual function (SD) and fertility in men. We address the misconceptions around these topics and help the healthcare providers (HCPs) manage these patients appropriately.

Recent findings

HCPs play a crucial role in educating their patients about fertility, preconception care, efficacy, and safety of IBD therapies during pregnancy and breastfeeding. The pregnancy outcome improves significantly when the mother has been in remission for 3–6 months before conception.
Most IBD therapies are safe during pregnancy and lactation. Reproductive health in men with IBD is often neglected. SD and infertility must be addressed in women and men to achieve the best outcome.

Summary

Preconception counseling is essential to address reproductive issues in both women and men with IBD. During pregnancy, our main goal is to keep the mother in remission while avoiding adverse effects on the fetus. A multidisciplinary team approach is ideal to improve pregnancy outcomes through collaboration and shared decision-making.
Literature
1.
Alatab S, Sepanlou SG, Ikuta K, Vahedi H, Bisignano C, Safiri S, et al. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol Elsevier. 2020;5:17–30.
2.
•• Mahadevan U, Robinson C, Bernasko N, Boland B, Chambers C, Dubinsky M, et al. Inflammatory bowel disease in pregnancy clinical care pathway: a report from the American Gastroenterological Association IBD Parenthood Project Working Group. Gastroenterology. 2019;156:1508–24 Elsevier. Comprehensive American Gastroenterological Association IBD guidelines in pregnancy for HCPs managing IBD patients who are pregnant or planning pregnancy.
3.
• Park YE, Kim TO. Sexual dysfunction and fertility problems in men with inflammatory bowel disease. World J Mens Health. 2020;38:285–97 Review of current literature highlighting sexual dysfunction and infertility in men with IBD.PubMedCrossRef
4.
Selinger CP, Ghorayeb J, Madill A. What factors might drive voluntary childlessness (VC) in women with IBD? Does IBD-specific pregnancy-related knowledge matter? J Crohns Colitis. 2016;10:1151–8.PubMedCrossRef
5.
Ellul P, Zammita SC, Katsanos KH, Cesarini M, Allocca M, Danese S, et al. Perception of reproductive health in women with inflammatory bowel disease. J Crohns Colitis. 2016;10:886–91.PubMedCrossRef
6.
Huang VW, Chang H-J, Kroeker KI, Goodman KJ, Hegadoren KM, Dieleman LA, et al. Does the level of reproductive knowledge specific to inflammatory bowel disease predict childlessness among women with inflammatory bowel disease? Can J Gastroenterol Hepatol. 2015;29:95–103.PubMedPubMedCentralCrossRef
7.
Friedman S, Nielsen J, Nøhr EA, Jølving LR, Nørgård BM. Comparison of time to pregnancy in women with and without inflammatory bowel diseases. Clin Gastroenterol Hepatol. Elsevier. 2020;18:1537–1544.e1.
8.
Cornish JA, Tan E, Teare J, Teoh TG, Rai R, Darzi AW, et al. The effect of restorative proctocolectomy on sexual function, urinary function, fertility, pregnancy and delivery: a systematic review. Dis Colon Rectum. 2007;50:1128–38.PubMedCrossRef
9.
Wikland M, Jansson I, Asztély M, Palselius I, Svaninger G, Magnusson O, et al. Gynaecological problems related to anatomical changes after conventional proctocolectomy and ileostomy. Int J Color Dis. 1990;5:49–52.CrossRef
10.
• Gorgun E, Cengiz TB, Aytac E, Aiello A, da Silva G, Goldberg JM, et al. Does laparoscopic ileal pouch-anal anastomosis reduce infertility compared with open approach? Surgery. 2019;166:670–7 A large study demonstrating improved fertility rate with laparoscopic versus open IPAA surgery.PubMedCrossRef
11.
Zhao Y, Chen B, He Y, Zhang S, Qiu Y, Feng R, et al. Risk factors associated with impaired ovarian reserve in young women of reproductive age with Crohn’s disease. Intest Res. 2020;18:200–9.PubMedPubMedCentralCrossRef
12.
Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril Elsevier. 2015;103:e44–50.
13.
Friedman S, Larsen PV, Fedder J, Nørgård BM. The reduced chance of a live birth in women with IBD receiving assisted reproduction is due to a failure to achieve a clinical pregnancy. Gut. 2017;66:556–8.PubMedCrossRef
14.•
Nørgård BM, Larsen PV, Fedder J, Silva PS d, Larsen MD, Friedman S. Live birth and adverse birth outcomes in women with ulcerative colitis and Crohn’s disease receiving assisted reproduction: a 20-year nationwide cohort study. Gut. 2016;65:767–76 BMJ Publishing Group. A large nationwide cohort study showing reduced rates of ART success in IBD patients compared to the general population.
15.
16.
Allocca M, Gilardi D, Fiorino G, Furfaro F, Peyrin-Biroulet L, Danese S. Sexual and reproductive issues and inflammatory bowel disease: a neglected topic in men. Eur J Gastroenterol Hepatol. 2018;30:316–22.PubMedCrossRef
17.
Gutierrez JC, Hwang K. The toxicity of methotrexate in male fertility and paternal teratogenicity. Expert Opin Drug Metab Toxicol. 2017;13:51–8.PubMedCrossRef
18.
Grosen A, Kelsen J, Hvas CL, Bellaguarda E, Hanauer SB. The influence of methotrexate treatment on male fertility and pregnancy outcome after paternal exposure. Inflamm Bowel Dis. 2017;23:561–9.PubMedCrossRef
19.
Eluri S, Cross RK, Martin C, Weinfurt KP, Flynn KE, Long MD, et al. Inflammatory bowel diseases can adversely impact domains of sexual function such as satisfaction with sex life. Dig Dis Sci. 2018;63:1572–82.PubMedPubMedCentralCrossRef
20.
O’Toole A, de Silva PS, Marc LG, Ulysse CA, Testa MA, Ting A, et al. Sexual dysfunction in men with inflammatory bowel disease: a new IBD-specific scale. Inflamm Bowel Dis. 2018;24:310–6.PubMedPubMedCentralCrossRef
21.
de Lima A, Zelinkova Z, Mulders AGMGJ, van der Woude CJ. Preconception care reduces relapse of inflammatory bowel disease during pregnancy. Clin Gastroenterol Hepatol. 2016;14:1285–1292.e1.PubMedCrossRef
22.
Martin J, Kane SV, Feagins LA. Fertility and contraception in women with inflammatory bowel disease. Gastroenterol Hepatol. 2016;12:101–9.
23.
Williams JF, Smith VC, COMMITTEE ON SUBSTANCE ABUSE. Fetal alcohol spectrum disorders. Pediatrics. 2015;136:e1395–406.PubMedCrossRef
24.
Dolan-Mullen P, Ramírez G, Groff JY. A meta-analysis of randomized trials of prenatal smoking cessation interventions. Am J Obstet Gynecol. 1994;171:1328–34.
25.
Committee on Obstetric Practice. Committee opinion no. 722: marijuana use during pregnancy and lactation. Obstet Gynecol. 2017;130:e205–9.CrossRef
26.
Santos MPC, Gomes C, Torres J. Familial and ethnic risk in inflammatory bowel disease. Ann Gastroenterol. 2018;31:14–23.PubMed
27.
Moller FT, Andersen V, Wohlfahrt J, Jess T. Familial risk of inflammatory bowel disease: a population-based cohort study 1977-2011. Am J Gastroenterol. 2015;110:564–71.PubMedCrossRef
28.
Bennett RA, Rubin PH, Present DH. Frequency of inflammatory bowel disease in offspring of couples both presenting with inflammatory bowel disease. Gastroenterology. Elsevier. 1991;100:1638–43.
29.
30.
DeLisser M, Wei J, Ramalingam N, Velayos F, Hassid B. Variation in IBD prevalence by race/ethnicity within an integrated healthcare delivery system: 607. Off J Am Coll Gastroenterol ACG. 2018;113:S348.CrossRef
31.
Nguyen GC, Chong CA, Chong RY. National estimates of the burden of inflammatory bowel disease among racial and ethnic groups in the United States. J Crohns Colitis. 2014;8:288–95.PubMedCrossRef
32.
Bengtson M-B, Martin CF, Aamodt G, Vatn MH, Mahadevan U. Inadequate gestational weight gain predicts adverse pregnancy outcomes in mothers with inflammatory bowel disease: results from a prospective US pregnancy cohort. Dig Dis Sci. 2017;62:2063–9.PubMedCrossRef
33.
Bischoff SC, Escher J, Hébuterne X, Kłęk S, Krznaric Z, Schneider S, et al. ESPEN practical guideline: clinical nutrition in inflammatory bowel disease. Clin Nutr. 2020;39:632–53.PubMedCrossRef
34.
Lee S, Metcalfe A, Raman M, Leung Y, Aghajafari F, Letourneau N, et al. Pregnant women with inflammatory bowel disease are at increased risk of vitamin D insufficiency: a cross-sectional study. J Crohns Colitis. 2018;12:702–9.PubMedPubMedCentralCrossRef
35.
Pedersen N, Bortoli A, Duricova D, Inca RD, Panelli MR, Gisbert JP, et al. The course of inflammatory bowel disease during pregnancy and postpartum: a prospective European ECCO-EpiCom Study of 209 pregnant women. Aliment Pharmacol Ther. 2013;38:501–12.PubMedCrossRef
36.
37.
38.
Hatch Q, Champagne BJ, Maykel JA, Davis BR, Johnson EK, Bleier JS, et al. Crohn’s disease and pregnancy: the impact of perianal disease on delivery methods and complications. Dis Colon Rectum. 2014;57:174–8.PubMedCrossRef
39.
Mahadevan U, McConnell RA, Chambers CD. Drug safety and risk of adverse outcomes for pregnant patients with inflammatory bowel disease. Gastroenterology. Elsevier. 2017;152:451–462.e2.
40.
Shergill AK, Ben-Menachem T, Chandrasekhara V, Chathadi K, Decker GA, Evans JA, et al. Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc. Elsevier. 2012;76:18–24.
41.
Food and Drug Administration, HHS. Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. Final rule. Fed Regist. 2014;79:72063–103.
42.
•• Drugs and Lactation Database (LactMed). National Library of Medicine (US); 2006. Large database of drugs showing transfer of maternal-fetal drugs levels and its effects on breastfed infants.
43.
44.
Leung YPY, Kaplan GG, Coward S, Tanyingoh D, Kaplan BJ, Johnston DW, et al. Intrapartum corticosteroid use significantly increases the risk of gestational diabetes in women with inflammatory bowel disease. J Crohns Colitis. 2015;9:223–30.PubMedCrossRef
45.
Polifka JE, Friedman JM. Teratogen update: azathioprine and 6-mercaptopurine. Teratology. 2002;65:240–61.PubMedCrossRef
46.
Bröms G, Granath F, Linder M, Stephansson O, Elmberg M, Kieler H. Birth outcomes in women with inflammatory bowel disease: effects of disease activity and drug exposure. Inflamm Bowel Dis. 2014;20:1091–8.PubMed
47.
Casanova MJ, Chaparro M, Domènech E, Barreiro-de Acosta M, Bermejo F, Iglesias E, et al. Safety of thiopurines and anti-TNF-α drugs during pregnancy in patients with inflammatory bowel disease. Am J Gastroenterol. 2013;108:433–40.PubMedCrossRef
48.
•• Mahadevan U, Martin CF, Sandler RS, Kane SV, Dubinsky M, Lewis JD, et al. 865 PIANO: A 1000 patient prospective registry of pregnancy outcomes in women with IBD exposed to immunomodulators and biologic therapy. Gastroenterology. 2012;142:S-149 Multicenter study of women with IBD during pregnancy and effects of various IBD treatments on maternal-fetal outcomes.CrossRef
49.
Jharap B, de Boer NKH, Stokkers P, Hommes DW, Oldenburg B, Dijkstra G, et al. Intrauterine exposure and pharmacology of conventional thiopurine therapy in pregnant patients with inflammatory bowel disease. Gut. 2014;63:451–7.PubMedCrossRef
50.
Hyoun SC, Običan SG, Scialli AR. Teratogen update: methotrexate. Birt Defects Res A Clin Mol Teratol. 2012;94:187–207.CrossRef
51.
Wu B, Tong J, Ran Z. Tacrolimus therapy in steroid-refractory ulcerative colitis: a review. Inflamm Bowel Dis. Oxford Academic. 2020;26:24–32.
52.
Paziana K, Del Monaco M, Cardonick E, Moritz M, Keller M, Smith B, et al. Ciclosporin use during pregnancy. Drug Saf. 2013;36:279–94.PubMedCrossRef
53.
54.
Baumgart DC, Sturm A, Wiedenmann B, Dignass AU. Uneventful pregnancy and neonatal outcome with tacrolimus in refractory ulcerative colitis. Gut. 2005;54:1822–3.PubMedPubMedCentralCrossRef
55.
Shibuya T, Haga K, Kamei M, Okahara K, Ito S, Takahashi M, et al. Successful remission of ulcerative colitis flare-up during pregnancy with adsorptive granulomonocytapheresis plus tacrolimus. Intest Res. Korean Association for the Study of Intestinal Diseases. 2018;16:484–8.PubMedPubMedCentralCrossRef
56.
Julsgaard M, Christensen LA, Gibson PR, Gearry RB, Fallingborg J, Hvas CL, et al. Concentrations of adalimumab and infliximab in mothers and newborns, and effects on infection. Gastroenterology. 2016;151:110–9.PubMedCrossRef
57.
• Chaparro M, Verreth A, Lobaton T, Gravito-Soares E, Julsgaard M, Savarino E, et al. Long-term safety of in utero exposure to anti-TNFα drugs for the treatment of inflammatory bowel disease: results from the Multicenter European TEDDY Study. Am J Gastroenterol. 2018;113:396–403 Large multicenter study demonstrating long-term safety of anti-TNFs in infants of treated pregnant women.PubMedCrossRef
58.
Seow CH, Leung Y, Vande Casteele N, Ehteshami Afshar E, Tanyingoh D, Bindra G, et al. The effects of pregnancy on the pharmacokinetics of infliximab and adalimumab in inflammatory bowel disease. Aliment Pharmacol Ther. 2017;45:1329–38.PubMedCrossRef
59.
Landi D Continuation of natalizumab versus interruption is associated with lower risk of relapses during pregnancy and postpartum in women with MS [Internet]. 2019 [cited 2020 Jul 31]. Available from: https://​onlinelibrary.​ectrims-congress.​eu/​ectrims/​2019/​stockholm/​279583/​doriana.​landicontinuatio​n.​of.​natalizumab.​versus.​interruption.​is.​associated.​html
60.
Demortiere S. What is the best time to stop natalizumab in patients with active.... ECTRIMS Online Library. Demortière S. Sep 12 2019; 279141 [Internet]. [cited 2020 Jul 31]. Available from: https://​onlinelibrary.​ectrims-congress.​eu/​ectrims/​2019/​stockholm/​279141/​sarah.​demortire.​what.​is.​the.​best.​time.​to.​stop.​natalizumab.​in.​patients.​with.​html?​f=​menu%3D6%2Abrowseby%3D8%2Asortby%3D2%2Amedia%3D3%2Ace_id%3D1603%2Aot_id%3D21674
61.
Ebrahimi N, Herbstritt S, Gold R, Amezcua L, Koren G, Hellwig K. Pregnancy and fetal outcomes following natalizumab exposure in pregnancy. A prospective, controlled observational study. Mult Scler Houndmills Basingstoke Engl. 2015;21:198–205.CrossRef
62.
Chakraborti TK. Pharmacology Review(s) of Vedolizumab (Entyvio, MLN0002) [Internet]. 2013 [cited 2020 Oct 18]. Available from: http://​www.​accessdata.​fda.​gov/​drugsatfda_​docs/​nda/​2014/​125476Orig1s000P​harmR.​pdf.​
63.
Mahadevan U, Vermeire S, Lasch K, Abhyankar B, Bhayat F, Blake A, et al. Vedolizumab exposure in pregnancy: outcomes from clinical studies in inflammatory bowel disease. Aliment Pharmacol Ther. 2017;45:941–50.PubMedCrossRef
64.
Moens A, van der Woude CJ, Julsgaard M, Humblet E, Sheridan J, Baumgart DC, et al. Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti-TNF or conventional therapy: results of the European CONCEIVE study. Aliment Pharmacol Ther. 2020;51:129–38.PubMedCrossRef
65.
Glassner K, Abraham BP. The use of vedolizumab in pregnancy and breastfeeding in women with inflammatory bowel disease. Inflamm Bowel Dis. 2019;5.
66.
Schaufelberg BW, Horn E, Rahawi K. Pregnancy outcomes in women exposed to ustekinumab in the psoriasis clinical development program. J Am Acad Dermatol. 2014;70:AB178.CrossRef
67.
Puchner A, Gröchenig HP, Sautner J, Helmy-Bader Y, Juch H, Reinisch S, et al. Immunosuppressives and biologics during pregnancy and lactation. Wien Klin Wochenschr. 2019;131:29–44.PubMedPubMedCentralCrossRef
68.
Martin PL, Sachs C, Imai N, Tsusaki H, Oneda S, Jiao Q, et al. Development in the cynomolgus macaque following administration of ustekinumab, a human anti-IL-12/23p40 monoclonal antibody, during pregnancy and lactation. Birth Defects Res B Dev Reprod Toxicol. 2010;89:351–63.PubMedCrossRef
69.
Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016;75:795–810.PubMedCrossRef
70.
71.
Mahadevan U, Dubinsky MC, Su C, Lawendy N, Jones TV, Marren A, et al. Outcomes of pregnancies with maternal/paternal exposure in the tofacitinib safety databases for ulcerative colitis. Inflamm Bowel Dis Oxford Academic. 2018;24:2494–500.
72.
73.
Friedman JM, Polifka JE. Teratogenic effects of drugs: a resource for clinicians (TERIS). Baltimore: Johns Hopkins University Press; 2000.
74.
Diav-Citrin O, Shechtman S, Gotteiner T, Arnon J, Ornoy A. Pregnancy outcome after gestational exposure to metronidazole: a prospective controlled cohort study. Teratology. 2001;63:186–92.PubMedCrossRef
75.
Koss CA, Baras DC, Lane SD, Aubry R, Marcus M, Markowitz LE, et al. Investigation of metronidazole use during pregnancy and adverse birth outcomes. Antimicrob Agents Chemother. 2012;56:4800–5.PubMedPubMedCentralCrossRef
76.
Sheehy O, Santos F, Ferreira E, Berard A. The use of metronidazole during pregnancy: a review of evidence. Curr Drug Saf. 2015;10:170–9.PubMedCrossRef
77.
Czeizel AE, Rockenbauer M, Sørensen HT, Olsen J. Augmentin treatment during pregnancy and the prevalence of congenital abnormalities: a population-based case-control teratologic study. Eur J Obstet Gynecol Reprod Biol. 2001;97:188–92.PubMedCrossRef
78.
79.
Dozois EJ, Wolff BG, Tremaine WJ, Watson WJ, Drelichman ER, Carne PWG, et al. Maternal and fetal outcome after colectomy for fulminant ulcerative colitis during pregnancy: case series and literature review. Dis Colon Rectum. 2006;49:64–73.PubMedCrossRef
80.
Burke KE, Haviland MJ, Hacker MR, Shainker SA, Cheifetz AS. Indications for mode of delivery in pregnant women with inflammatory bowel disease. Inflamm Bowel Dis. 2017;23:721–6.PubMedPubMedCentralCrossRef
81.
Foulon A, Dupas J-L, Sabbagh C, Chevreau J, Rebibo L, Brazier F, et al. Defining the most appropriate delivery mode in women with inflammatory bowel disease: a systematic review. Inflamm Bowel Dis. 2017;23:712–20.PubMedCrossRef
82.
Ravid A, Richard CS, Spencer LM, O’Connor BI, Kennedy ED, MacRae HM, et al. Pregnancy, delivery, and pouch function after ileal pouch-anal anastomosis for ulcerative colitis. Dis Colon Rectum. 2002;45:1283–8.PubMedCrossRef
83.
Remzi FH, Gorgun E, Bast J, Schroeder T, Hammel J, Philipson E, et al. Vaginal delivery after ileal pouch-anal anastomosis: a word of caution. Dis Colon Rectum. 2005;48:1691–9.PubMedCrossRef
84.
Nguyen GC, Bernstein CN, Bitton A, Chan AK, Griffiths AM, Leontiadis GI, et al. Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian Association of Gastroenterology. Gastroenterology. Elsevier. 2014;146:835–848.e6.PubMedCrossRef
85.
Bates SM, Middeldorp S, Rodger M, James AH, Greer I. Guidance for the treatment and prevention of obstetric-associated venous thromboembolism. J Thromb Thrombolysis. 2016;41:92–128.PubMedPubMedCentralCrossRef
86.
Breastfeeding SO. Breastfeeding and the use of human milk. Pediatrics:American Academy of Pediatrics. 2012;129:e827–41.CrossRef
87.
88.
89.
Academy Of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #9: Use of galactogogues in initiating or augmenting the rate of maternal milk secretion (First Revision January 2011). Breastfeed Med: Off J Acad Breastfeed Med. 2011;6:41–9.CrossRef
90.
91.
Kane SV, Acquah LA. Placental transport of immunoglobulins: a clinical review for gastroenterologists who prescribe therapeutic monoclonal antibodies to women during conception and pregnancy. Am J Gastroenterol. 2009;104:228–33.PubMedCrossRef
92.
Mahadevan U, Wolf DC, Dubinsky M, Cortot A, Lee SD, Siegel CA, et al. Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. Clin Gastroenterol Hepatol: Off Clin Pract J Am Gastroenterol Assoc. 2013;11:286–92 quiz e24.
Metadata
Title
Reproductive Health in IBD Patients
Authors
Sanket Patel, DO
Haleh Vaziri, MD
Publication date
01-06-2021
Publisher
Springer US
Published in
Current Treatment Options in Gastroenterology / Issue 2/2021
Print ISSN: 1092-8472
Electronic ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-021-00334-1

Other articles of this Issue 2/2021

Current Treatment Options in Gastroenterology 2/2021 Go to the issue

Endoscopy (P Siersema, Section Editor)

Diagnosis and Management of Epithelial Precancerous Conditions and Lesions in the Stomach

Genetics in Gastroenterology Practice (BW Katona, Section Editor)

Management of Familial Adenomatous Polyposis

Liver (J Bajaj, Section Editor)

Recent Progress in Systemic Therapy for Hepatocellular Cancer (HCC)

Liver (J Bajaj, Section Editor)

Strategies to Improve Delivery of Cirrhosis Care

Genetics in Gastroenterology Practice (BW Katona, Section Editor)

Clinical Management of Oligopolyposis of Unknown Etiology

Liver (J Bajaj, Section Editor)

Metabolomics in Advanced Liver Disease
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits