Researchers join forces to reduce steroid use by Crohn's and colitis patients

Crohn's and Colitis Canada has announced the country's first national network of leading Crohn's disease and ulcerative colitis patient care and research centres. Promoting Access and Care through Centres of Excellence (PACE) is the largest Canadian collaboration for adults living with Crohn's disease and ulcerative colitis, the two main forms of inflammatory bowel disease (IBD).

Over the past 15 years, an accomplished team of University of Calgary and Alberta Health Services clinicians and researchers have established Calgary as one of the top three IBD centres in the world. The IBD clinic at Cumming School of Medicine has produced more than 600 scientific publications and is ranked fifth in the world for academic output.

Dr. Remo Panaccione is an acknowledged global expert in the field and has been the director of the UCalgary IBD clinic since 2001. He is one of five expert clinicians involved in PACE and will lead the centre in Calgary alongside Dr. Robert Fedorak, at the University of Alberta. Other centres in the collaborative network are at McMaster University in Hamilton, McGill University in Montreal, and the Mount Sinai Hospital in Toronto.

Unique model for Crohn's and colitis care in Canada

PACE will structure research and learning in an interesting way. The model is unique for Crohn's and colitis care in Canada. PACE will facilitate a combination of independent research and collaborative learning that will take place over a four-year period. During the first year, each centre of excellence will drive their own research. Following that, the centres will work collaboratively in order to develop their own competencies in each area.

Each centre in the PACE network will receive $500,000 in funding from Crohn's and Colitis Canada, and will focus on one aspect of clinical care delivery.

In Alberta, the University of Calgary has teamed with the University of Alberta to focus on developing a clinical care pathway to standardize treatments, specifically addressing the chronic use of steroids. Steroids work to reduce inflammation and, for many, symptoms are improved within a short time. The challenge is that steroids are not a long-term solution and are associated with significant potential side effects. They must be used selectively in the treatment path to keep the total amount as low as possible over the years.

Priority is to reduce patient steroid use

"Our priority is reducing steroid use in Crohn's disease and ulcerative colitis patients," says Panaccione who is a member of the Snyder Institute for Chronic Diseases in the Cumming School of Medicine. "Three quarters of patients referred to a specialist are on steroid treatment and our work will address this issue."

The goal of the Calgary centre will be to elevate the consistency of care by standardizing clinical practices and treatments across Canada. Their work will evolve around introducing technology to integrate best practices into the healthcare system to ensure all patients are getting the best care.

"The vision of PACE and the Calgary Inflammatory Bowel Disease Research Centre is to improve the quality of life of our patients with IBD —we will work to identify and target immune pathways in order to develop personalized therapies and biomarkers for disease surveillance," adds Panaccione.

UCalgary research is helping to change treatment practices

The ultimate aim is to improve and transform the lives of patients around the world through the integration of excellence in patient care and research. Research from Calgary is changing practice and helping to develop treatment, diagnostic and monitoring innovations that will continue to improve the lives of those suffering from IBD globally.

There are 1,000 new diagnoses of IBD in Alberta every year, which are added to the more than 20,000 established cases in the province. On a per capita basis these figures demonstrate that Alberta has among the highest burden of IBD in the world. The prevalence of IBD in Alberta is expected to increase by greater than 40 per cent in the next decade.

Panaccione adds, "Thanks to the Crohn's and Colitis Foundation of Canada, PACE will build upon the success of the University of Calgary IBD Clinic and serve as a beacon to the global IBD community as a model of how to best deliver care and education to IBD patients."

The University of Calgary is uniquely positioned to find solutions to key global challenges. Through the research strategy for Infections, Inflammation, and Chronic Diseases in the Changing Environment (IICD), top scientists lead multidisciplinary teams to understand and prevent the complex factors that threaten our health and economies.