We spoke to Matteo Frasson, coordinator of the Research Group in Digestive Surgery and Clinical Associate Professor at University La Fe in Valencia, in the run up to his session on the MASC Trials at ESCP Virtually Vilnius 2020.
Matteo is also the Chair of ESCP’s Young ESCP Group and specialises in colorectal cancer, IBD and anastomotic leaks.
Please can you provide an overview of the subject?
Acute severe ulcerative colitis can be a life-threatening condition. Corticosteroids remain the cornerstone of initial medical therapy both for inducing clinical remission as well as reducing mortality. However, up to 30-40% of patients show no or only partial response to steroids and will need rescue therapy with cyclosporine or infliximab. When rescue therapy also fails, surgery is necessary in the form of a colectomy. Co-ordinated and patient-specific decision-making is paramount in patients with acute severe ulcerative colitis because prolonged but ultimately unsuccessful medical treatment could increase the risks of morbidity and mortality in those subsequently undergoing surgery.
Why is the MASC Trial an important topic?
This session will be centered on the results of the MASC trial which is an ESCP-promoted multicentre, international audit focused on the management of patients with acute severe ulcerative colitis. The audit has been delivered through the collaboration between colorectal surgeons and gastroenterologists and is the largest study done so far in this field.
What are the key points attendees should be aware of?
The objective of the audit was to explore variabilities in the medical and surgical management of acute severe ulcerative colitis and to determine its apparent impact on patient-level outcomes. Secondarily, the parameters that predict which patients may benefit from medical salvage therapy and who are likely to need colectomy were assessed.
Why is the session useful to attend and who will benefit most from it?
The session will be centered on the MASC trial's results, trying to identify risk factors for failure of medical treatment and therefore allowing an early surgical treatment of these patients when necessary. All colorectal surgeons and especially the ones that have collaborated to the study will see how this large multicentric world-wide study can potentially change our way of working when treating patients with acute severe ulcerative colitis.
Are there any developments in the field worth noting?
The data obtained regarding areas of variability in provision or practice, and how this may impact upon outcomes, will allow international benchmarking to improve the standard of care provided to this patient group, as well as generating hypotheses and inform future randomised research which is incredibly valuable.
The MASC Trials session will take place at 17:25pm on Wednesday 21 September at ESCP Virtually Vilnius 2020.