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Inside Dr. Swathi Eluri’s journey to physician-scientist
Inspired by her father, who was diagnosed with inflammatory bowel disease (IBD), Swathi Eluri, MD, spent time during her college days at the University of North Carolina (UNC), Chapel Hill, in a GI basic science lab hoping to better understand this condition.
After a stint at John Hopkins Hospital in Baltimore for her medical degree and residency, Dr. Eluri returned to UNC Chapel Hill for her GI fellowship, where she remains today as an assistant professor of medicine in the division of gastroenterology and hepatology. Dr. Eluri’s research is focused on increasing early detection of esophageal cancer, to allow for earlier and more effective treatment. The AGA Research Foundation was proud to support Dr. Eluri’s work with a 2018 AGA Research Scholar Award.
Learn more about Dr. Swathi Eluri’s inspiring career by visiting: https://www.gastro.org/news/inside-dr-swathi-eluris-journey-to-physician-scientist.
Help AGA build a community of investigators through the AGA Research Foundation
Your donation to the AGA Research Foundation can fund future success stories by keeping young scientists working to advance our understanding of digestive diseases. Make your year-end donation today at www.gastro.org/donateonline.
Inspired by her father, who was diagnosed with inflammatory bowel disease (IBD), Swathi Eluri, MD, spent time during her college days at the University of North Carolina (UNC), Chapel Hill, in a GI basic science lab hoping to better understand this condition.
After a stint at John Hopkins Hospital in Baltimore for her medical degree and residency, Dr. Eluri returned to UNC Chapel Hill for her GI fellowship, where she remains today as an assistant professor of medicine in the division of gastroenterology and hepatology. Dr. Eluri’s research is focused on increasing early detection of esophageal cancer, to allow for earlier and more effective treatment. The AGA Research Foundation was proud to support Dr. Eluri’s work with a 2018 AGA Research Scholar Award.
Learn more about Dr. Swathi Eluri’s inspiring career by visiting: https://www.gastro.org/news/inside-dr-swathi-eluris-journey-to-physician-scientist.
Help AGA build a community of investigators through the AGA Research Foundation
Your donation to the AGA Research Foundation can fund future success stories by keeping young scientists working to advance our understanding of digestive diseases. Make your year-end donation today at www.gastro.org/donateonline.
Inspired by her father, who was diagnosed with inflammatory bowel disease (IBD), Swathi Eluri, MD, spent time during her college days at the University of North Carolina (UNC), Chapel Hill, in a GI basic science lab hoping to better understand this condition.
After a stint at John Hopkins Hospital in Baltimore for her medical degree and residency, Dr. Eluri returned to UNC Chapel Hill for her GI fellowship, where she remains today as an assistant professor of medicine in the division of gastroenterology and hepatology. Dr. Eluri’s research is focused on increasing early detection of esophageal cancer, to allow for earlier and more effective treatment. The AGA Research Foundation was proud to support Dr. Eluri’s work with a 2018 AGA Research Scholar Award.
Learn more about Dr. Swathi Eluri’s inspiring career by visiting: https://www.gastro.org/news/inside-dr-swathi-eluris-journey-to-physician-scientist.
Help AGA build a community of investigators through the AGA Research Foundation
Your donation to the AGA Research Foundation can fund future success stories by keeping young scientists working to advance our understanding of digestive diseases. Make your year-end donation today at www.gastro.org/donateonline.
A GI society update on MOC reform
Our work was suspended when ABIM announced the creation of a new longitudinal assessment option for maintenance of certification across all specialties.
GI society leaders are in touch with ABIM. Here’s an update on what we know:
- • The ABIM Board of Directors committed to evolve its program to provide a longitudinal assessment option for Maintenance of Certification (MOC), offering a self-paced pathway for physicians to acquire and demonstrate ongoing knowledge. The traditional, long-form assessment will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.
Our next steps include seeking clarity from ABIM including:
1. The milestones in the process to create the new pathway.
2. When the new pathway will be available to diplomates.
3. Consideration and integration of the GI societies’ principles in the development of the new pathway for recertification, including:
a. MOC needs to be simpler, less intrusive and less expensive.
b. We continue to support alternatives to the high-stakes, every-10-year recertification exam.
c. We do not support single source or time-limited assessments, as they do not represent the current realities of medicine in the digital age.
d. We support the concept that, for the many diplomates who specialize within certain areas of gastroenterology and hepatology, MOC should not include high-stakes assessments of areas in which the diplomate may not practice.
e. We support the principles of lifelong learning, as evidenced by ongoing CME activities, rather than lifelong testing.
4. The role the GI societies, as representatives for thousands of U.S. members who are ABIM diplomates, play in the creation and implementation of the new pathway.
AASLD, ACG, AGA and ASGE want to be fully informed and fully respected partners in an endeavor that touches upon one of the toughest challenges facing our members and the single issue we hear about most often requesting our help.
We will continue to update our members as we learn the answers to these questions from ABIM.
Together, our first priority on the MOC issue remains ensuring that GI diplomates have a pathway for recertification that meets your needs.
ginews@gastro.org
Our work was suspended when ABIM announced the creation of a new longitudinal assessment option for maintenance of certification across all specialties.
GI society leaders are in touch with ABIM. Here’s an update on what we know:
- • The ABIM Board of Directors committed to evolve its program to provide a longitudinal assessment option for Maintenance of Certification (MOC), offering a self-paced pathway for physicians to acquire and demonstrate ongoing knowledge. The traditional, long-form assessment will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.
Our next steps include seeking clarity from ABIM including:
1. The milestones in the process to create the new pathway.
2. When the new pathway will be available to diplomates.
3. Consideration and integration of the GI societies’ principles in the development of the new pathway for recertification, including:
a. MOC needs to be simpler, less intrusive and less expensive.
b. We continue to support alternatives to the high-stakes, every-10-year recertification exam.
c. We do not support single source or time-limited assessments, as they do not represent the current realities of medicine in the digital age.
d. We support the concept that, for the many diplomates who specialize within certain areas of gastroenterology and hepatology, MOC should not include high-stakes assessments of areas in which the diplomate may not practice.
e. We support the principles of lifelong learning, as evidenced by ongoing CME activities, rather than lifelong testing.
4. The role the GI societies, as representatives for thousands of U.S. members who are ABIM diplomates, play in the creation and implementation of the new pathway.
AASLD, ACG, AGA and ASGE want to be fully informed and fully respected partners in an endeavor that touches upon one of the toughest challenges facing our members and the single issue we hear about most often requesting our help.
We will continue to update our members as we learn the answers to these questions from ABIM.
Together, our first priority on the MOC issue remains ensuring that GI diplomates have a pathway for recertification that meets your needs.
ginews@gastro.org
Our work was suspended when ABIM announced the creation of a new longitudinal assessment option for maintenance of certification across all specialties.
GI society leaders are in touch with ABIM. Here’s an update on what we know:
- • The ABIM Board of Directors committed to evolve its program to provide a longitudinal assessment option for Maintenance of Certification (MOC), offering a self-paced pathway for physicians to acquire and demonstrate ongoing knowledge. The traditional, long-form assessment will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.
Our next steps include seeking clarity from ABIM including:
1. The milestones in the process to create the new pathway.
2. When the new pathway will be available to diplomates.
3. Consideration and integration of the GI societies’ principles in the development of the new pathway for recertification, including:
a. MOC needs to be simpler, less intrusive and less expensive.
b. We continue to support alternatives to the high-stakes, every-10-year recertification exam.
c. We do not support single source or time-limited assessments, as they do not represent the current realities of medicine in the digital age.
d. We support the concept that, for the many diplomates who specialize within certain areas of gastroenterology and hepatology, MOC should not include high-stakes assessments of areas in which the diplomate may not practice.
e. We support the principles of lifelong learning, as evidenced by ongoing CME activities, rather than lifelong testing.
4. The role the GI societies, as representatives for thousands of U.S. members who are ABIM diplomates, play in the creation and implementation of the new pathway.
AASLD, ACG, AGA and ASGE want to be fully informed and fully respected partners in an endeavor that touches upon one of the toughest challenges facing our members and the single issue we hear about most often requesting our help.
We will continue to update our members as we learn the answers to these questions from ABIM.
Together, our first priority on the MOC issue remains ensuring that GI diplomates have a pathway for recertification that meets your needs.
ginews@gastro.org
Dr. Anil Rustgi and Dr. Raymond DuBois elected to National Academy of Medicine
Anil Rustgi, MD, AGAF, and Raymond DuBois, MD, PhD, AGAF, were elected to the National Academy of Medicine, considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.
Share your congratulations with both Dr. Rustgi and Dr. DuBois on the AGA Community.
Dr. Rustgi is recognized for illuminating the importance of GI cancers, genomics, and genetics and demonstrating that p120-catenin, part of the adherens junctions, is a tumor suppressor gene in cancers and the first to link p120-catenin to mesenchymal-epithelial transition (MET) in tumor metastasis, advancing therapeutic opportunities.
Dr. Rustgi is Irving Professor of Medicine and director of the Herbert Irving Comprehensive Cancer Center, and associate dean of oncology, department of medicine, Vagelos College of Physicians and Surgeons at Columbia University, New York.
Dr. DuBois is recognized for discovering the critical and mechanistic role of prostaglandins (PGs)/cyclooxygenase in colon cancer and its malignant progression, elucidating the role of PGs in the tumor microenvironment, and spearheading the now common use of drugs for human cancer prevention that target the PG pathway, like aspirin and other NSAIDs.
Dr. DuBois is dean of the College of Medicine, and professor of biochemistry and medicine at The Medical University of South Carolina, Charleston.
Anil Rustgi, MD, AGAF, and Raymond DuBois, MD, PhD, AGAF, were elected to the National Academy of Medicine, considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.
Share your congratulations with both Dr. Rustgi and Dr. DuBois on the AGA Community.
Dr. Rustgi is recognized for illuminating the importance of GI cancers, genomics, and genetics and demonstrating that p120-catenin, part of the adherens junctions, is a tumor suppressor gene in cancers and the first to link p120-catenin to mesenchymal-epithelial transition (MET) in tumor metastasis, advancing therapeutic opportunities.
Dr. Rustgi is Irving Professor of Medicine and director of the Herbert Irving Comprehensive Cancer Center, and associate dean of oncology, department of medicine, Vagelos College of Physicians and Surgeons at Columbia University, New York.
Dr. DuBois is recognized for discovering the critical and mechanistic role of prostaglandins (PGs)/cyclooxygenase in colon cancer and its malignant progression, elucidating the role of PGs in the tumor microenvironment, and spearheading the now common use of drugs for human cancer prevention that target the PG pathway, like aspirin and other NSAIDs.
Dr. DuBois is dean of the College of Medicine, and professor of biochemistry and medicine at The Medical University of South Carolina, Charleston.
Anil Rustgi, MD, AGAF, and Raymond DuBois, MD, PhD, AGAF, were elected to the National Academy of Medicine, considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.
Share your congratulations with both Dr. Rustgi and Dr. DuBois on the AGA Community.
Dr. Rustgi is recognized for illuminating the importance of GI cancers, genomics, and genetics and demonstrating that p120-catenin, part of the adherens junctions, is a tumor suppressor gene in cancers and the first to link p120-catenin to mesenchymal-epithelial transition (MET) in tumor metastasis, advancing therapeutic opportunities.
Dr. Rustgi is Irving Professor of Medicine and director of the Herbert Irving Comprehensive Cancer Center, and associate dean of oncology, department of medicine, Vagelos College of Physicians and Surgeons at Columbia University, New York.
Dr. DuBois is recognized for discovering the critical and mechanistic role of prostaglandins (PGs)/cyclooxygenase in colon cancer and its malignant progression, elucidating the role of PGs in the tumor microenvironment, and spearheading the now common use of drugs for human cancer prevention that target the PG pathway, like aspirin and other NSAIDs.
Dr. DuBois is dean of the College of Medicine, and professor of biochemistry and medicine at The Medical University of South Carolina, Charleston.
Top AGA Community patient cases
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe lower GI bleed (http://ow.ly/iTrS30pOKaP) – A 15-year-old male patient was sent to the ER with severe lower GI bleed after a general physical exam revealed he was experiencing hypotension and tachycardia. The GI community discusses diagnostic possibilities for severe lower GI bleed at such young age and management options.
2. Refractory nausea and vomiting in a transgender patient (http://ow.ly/Di9C30pOKbq) – In this case of a 45-year-old transgender male-to-female patient, the community deliberates on several clinical issues, including a non-binary gender option on patient identification forms, treatment options for the patient and if hormonal therapy is contributing to GI symptoms.
3. Multidisciplinary guidelines (http://ow.ly/BtUK30pOKC8) – Are multidisciplinary guidelines with related specialty societies “the need of the hour” or too rare and short-lived for the effort?
Also in the forum: The AGA Clinical Practice Updates Committee is soliciting topics for future clinical expert review and commentaries commissioned by AGA. Share your ideas with the GI community (http://ow.ly/siV930pOJS1).
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe lower GI bleed (http://ow.ly/iTrS30pOKaP) – A 15-year-old male patient was sent to the ER with severe lower GI bleed after a general physical exam revealed he was experiencing hypotension and tachycardia. The GI community discusses diagnostic possibilities for severe lower GI bleed at such young age and management options.
2. Refractory nausea and vomiting in a transgender patient (http://ow.ly/Di9C30pOKbq) – In this case of a 45-year-old transgender male-to-female patient, the community deliberates on several clinical issues, including a non-binary gender option on patient identification forms, treatment options for the patient and if hormonal therapy is contributing to GI symptoms.
3. Multidisciplinary guidelines (http://ow.ly/BtUK30pOKC8) – Are multidisciplinary guidelines with related specialty societies “the need of the hour” or too rare and short-lived for the effort?
Also in the forum: The AGA Clinical Practice Updates Committee is soliciting topics for future clinical expert review and commentaries commissioned by AGA. Share your ideas with the GI community (http://ow.ly/siV930pOJS1).
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe lower GI bleed (http://ow.ly/iTrS30pOKaP) – A 15-year-old male patient was sent to the ER with severe lower GI bleed after a general physical exam revealed he was experiencing hypotension and tachycardia. The GI community discusses diagnostic possibilities for severe lower GI bleed at such young age and management options.
2. Refractory nausea and vomiting in a transgender patient (http://ow.ly/Di9C30pOKbq) – In this case of a 45-year-old transgender male-to-female patient, the community deliberates on several clinical issues, including a non-binary gender option on patient identification forms, treatment options for the patient and if hormonal therapy is contributing to GI symptoms.
3. Multidisciplinary guidelines (http://ow.ly/BtUK30pOKC8) – Are multidisciplinary guidelines with related specialty societies “the need of the hour” or too rare and short-lived for the effort?
Also in the forum: The AGA Clinical Practice Updates Committee is soliciting topics for future clinical expert review and commentaries commissioned by AGA. Share your ideas with the GI community (http://ow.ly/siV930pOJS1).
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Meet Donald Payne, Jr. – A staunch advocate for increasing access to colorectal cancer screening
Rep. Donald Payne Jr., D-N.J., has been representing the 10th congressional district of New Jersey which includes the Newark area and the thriving life-sciences community in the region since 2012. Rep. Payne Jr. ran to serve in the seat that his father, the late Rep.
Donald M. Payne, D-N.J., held for eleven terms until his untimely death in March 2012. The elder Payne succumbed to colon cancer 1 month after his initial diagnosis, and Rep. Payne Jr. has made it his personal mission since assuming his father’s seat to increase awareness of colorectal cancer screenings. In fact, shortly after entering office, Rep. Payne Jr. wrote an op-ed with AGA member Carla Ginsburg, MD, MPH, AGAF, on the importance of screening, relaying in deeply personal terms the cost of not getting screened.
Rep. Payne Jr. also made it a top priority to push national awareness of colon cancer screening beyond the halls of Congress. To that end, Rep. Payne Jr. successfully lobbied the Obama administration in 2014 to designate March as National Colorectal Cancer Awareness Month – the first colorectal cancer presidential proclamation in over than a decade. The presidential proclamation was subsequently reissued in both 2015 and 2016 by the Obama administration and in 2018 and 2019 by the Trump administration. Additionally, Rep. Payne Jr. introduces a resolution in the House of Representatives every year to designate March as National Colorectal Cancer Awareness Month in an effort to further promote awareness and educational activities of colorectal cancer screening in the chamber.
Most importantly, Rep. Payne Jr. is the lead champion of legislative efforts in the House to increase access to colorectal cancer screenings. Specifically, Rep. Payne Jr. is the lead sponsor of H.R. 1570, the Removing Barriers to Colorectal Cancer Screening Act, legislation that has been one of AGA’s top policy priorities. The legislation, which enjoys broad bipartisan support with over 300 cosponsors in the House, would correct the Medicare beneficiary coinsurance issue when a screening colonoscopy becomes therapeutic. He also is a strong supporter of biomedical research funding, noting in an op-ed with former Rep. Charlie Dent, R-Pa., that “scientists need stable, consistent, and robust funding to ensure that we can continue ... breakthroughs for the colorectal cancer community and beyond.”
AGA looks forward to continuing to work with Rep. Payne Jr. and his office in the 116th Congress on these critical issues and on policies affecting our patients and the field of gastroenterology.
Rep. Donald Payne Jr., D-N.J., has been representing the 10th congressional district of New Jersey which includes the Newark area and the thriving life-sciences community in the region since 2012. Rep. Payne Jr. ran to serve in the seat that his father, the late Rep.
Donald M. Payne, D-N.J., held for eleven terms until his untimely death in March 2012. The elder Payne succumbed to colon cancer 1 month after his initial diagnosis, and Rep. Payne Jr. has made it his personal mission since assuming his father’s seat to increase awareness of colorectal cancer screenings. In fact, shortly after entering office, Rep. Payne Jr. wrote an op-ed with AGA member Carla Ginsburg, MD, MPH, AGAF, on the importance of screening, relaying in deeply personal terms the cost of not getting screened.
Rep. Payne Jr. also made it a top priority to push national awareness of colon cancer screening beyond the halls of Congress. To that end, Rep. Payne Jr. successfully lobbied the Obama administration in 2014 to designate March as National Colorectal Cancer Awareness Month – the first colorectal cancer presidential proclamation in over than a decade. The presidential proclamation was subsequently reissued in both 2015 and 2016 by the Obama administration and in 2018 and 2019 by the Trump administration. Additionally, Rep. Payne Jr. introduces a resolution in the House of Representatives every year to designate March as National Colorectal Cancer Awareness Month in an effort to further promote awareness and educational activities of colorectal cancer screening in the chamber.
Most importantly, Rep. Payne Jr. is the lead champion of legislative efforts in the House to increase access to colorectal cancer screenings. Specifically, Rep. Payne Jr. is the lead sponsor of H.R. 1570, the Removing Barriers to Colorectal Cancer Screening Act, legislation that has been one of AGA’s top policy priorities. The legislation, which enjoys broad bipartisan support with over 300 cosponsors in the House, would correct the Medicare beneficiary coinsurance issue when a screening colonoscopy becomes therapeutic. He also is a strong supporter of biomedical research funding, noting in an op-ed with former Rep. Charlie Dent, R-Pa., that “scientists need stable, consistent, and robust funding to ensure that we can continue ... breakthroughs for the colorectal cancer community and beyond.”
AGA looks forward to continuing to work with Rep. Payne Jr. and his office in the 116th Congress on these critical issues and on policies affecting our patients and the field of gastroenterology.
Rep. Donald Payne Jr., D-N.J., has been representing the 10th congressional district of New Jersey which includes the Newark area and the thriving life-sciences community in the region since 2012. Rep. Payne Jr. ran to serve in the seat that his father, the late Rep.
Donald M. Payne, D-N.J., held for eleven terms until his untimely death in March 2012. The elder Payne succumbed to colon cancer 1 month after his initial diagnosis, and Rep. Payne Jr. has made it his personal mission since assuming his father’s seat to increase awareness of colorectal cancer screenings. In fact, shortly after entering office, Rep. Payne Jr. wrote an op-ed with AGA member Carla Ginsburg, MD, MPH, AGAF, on the importance of screening, relaying in deeply personal terms the cost of not getting screened.
Rep. Payne Jr. also made it a top priority to push national awareness of colon cancer screening beyond the halls of Congress. To that end, Rep. Payne Jr. successfully lobbied the Obama administration in 2014 to designate March as National Colorectal Cancer Awareness Month – the first colorectal cancer presidential proclamation in over than a decade. The presidential proclamation was subsequently reissued in both 2015 and 2016 by the Obama administration and in 2018 and 2019 by the Trump administration. Additionally, Rep. Payne Jr. introduces a resolution in the House of Representatives every year to designate March as National Colorectal Cancer Awareness Month in an effort to further promote awareness and educational activities of colorectal cancer screening in the chamber.
Most importantly, Rep. Payne Jr. is the lead champion of legislative efforts in the House to increase access to colorectal cancer screenings. Specifically, Rep. Payne Jr. is the lead sponsor of H.R. 1570, the Removing Barriers to Colorectal Cancer Screening Act, legislation that has been one of AGA’s top policy priorities. The legislation, which enjoys broad bipartisan support with over 300 cosponsors in the House, would correct the Medicare beneficiary coinsurance issue when a screening colonoscopy becomes therapeutic. He also is a strong supporter of biomedical research funding, noting in an op-ed with former Rep. Charlie Dent, R-Pa., that “scientists need stable, consistent, and robust funding to ensure that we can continue ... breakthroughs for the colorectal cancer community and beyond.”
AGA looks forward to continuing to work with Rep. Payne Jr. and his office in the 116th Congress on these critical issues and on policies affecting our patients and the field of gastroenterology.
The importance of getting involved for gastroenterology
.
The evening before Advocacy Day, we discussed strategies for having a successful meeting on Capitol Hill with AGA staff (including Kathleen Teixeira, AGA vice president of government affairs, and Jonathan Sollish, AGA senior coordinator, public policy). We discussed having our “asks” supported with evidence, and “getting personal” about how these policy issues directly affect us and our patients. We also had the chance to hear from Rep. Jim McGovern (D-Mass.) and Sen. Roy Blunt (R-Mo.) , both of whom invited our questions. Both congressmen are friends of AGA, with McGovern serving as chair of the House Rules Committee, and Blunt serving as chair of the Senate Labor-HHS Subcommittee on Appropriations.
Advocacy Day began with a group breakfast during which we reviewed some of the policy issues of central importance to gastroenterology:
• Removing Barriers to the Colorectal Cancer Screening Act (HR1570/S668), which enjoys strong bipartisan support, would correct the “cost-sharing” problem of screening colonoscopies turning therapeutic (with polypectomy) for our Medicare patients, by waiving the coinsurance for screening colonoscopies – regardless of whether we remove polyps during these colonoscopies.
• Safe Step Act, HR2279, legislation introduced in the House, facilitates a common-sense and timely (72 hours or 24 hours if life-threatening) appeals process when our patients are subjected to step therapy (“fail first”) by insurers.
• Improving Seniors’ Timely Access to Care Act of 2019, HR3107, legislation in the House, eases onerous prior authorization burdens by promoting an electronic prior authorization process, ensuring requests are approved by qualified medical professionals who have specialty-specific experience, and mandating that plans report their rates of delays and denials.
• NIH research funding facilitates innovative research and supports young investigators in our field.
Full of enthusiasm, our six-strong North Carolina contingent (pictured, L-R, Ziad Gellad, MD, MPH, AGAF; David Leiman, MD, MSPH; Animesh Jain, MD; Anne Finefrock Peery, MD; Lisa Gangarosa, MD, AGAF, chair of the AGA Government Affairs Committee; and Amit Patel, MD) met with the offices of Rep. David Price (D-N.C.), and both North Carolina Senators, Richard Burr (R) and Thom Tillis (R) on Capitol Hill to convey our “asks.”
At Price’s office in the stately Rayburn House Office Building, we thanked his team for cosponsorship of H.R. 1570 and H.R. 2279. We also discussed the importance of increasing research funding by the AGA’s goal of $2.5 billion for NIH for fiscal year 2020, noting that a majority of our delegation has received NIH funding for our training and/or research activities. We also encouraged Price’s office to cosponsor H.R. 3107, sharing our personal experiences about the administrative toll of the prior authorization process for obtaining appropriate and recommended medications for our patients – in my case, swallowed topical corticosteroids for patients with eosinophilic esophagitis.
We moved on to Sen. Tillis’s office, where we thanked his office for cosponsorship of S. 668 but encouraged his office to cosponsor upcoming companion Senate legislation for H.R. 2279 and H.R. 3107. Our colleague capably conveyed how an inflammatory bowel disease (IBD) patient he saw recently may require a colectomy due to delays in appropriate treatment stemming from these regulatory processes. We also showed Tillis’s office how NIH funding generates significant economic activity in North Carolina, supporting jobs in our state.
After a quick stop at the U.S. Senate gift shop in the basement to buy souvenirs for our kids, our last meeting was with Sen. Burr’s office. There, we also thanked his office for cosponsorship of S. 668 but encouraged him to sign the “Dear Colleague” letter that Sen. Sherrod Brown, D-OH, has circulated asking CMS to address the colonoscopy cost-sharing “loophole.” We discussed the importance of cosponsoring upcoming companion Senate legislation for H.R. 2279 and H.R. 3107, sharing stories from our clinical practices about how these regulatory burdens have delayed treatment for our patients.
You can get involved, too.
AGA Advocacy Day was a tremendous experience, but it is not the only way AGA members can get involved and take action. The AGA Advocacy website, gastro.org/advocacy, provides more information on multiple avenues for advocacy. These include an online advocacy tool for sending templated letters on these issues to your elected officials.
Perhaps now more than ever, it is crucial that we get involved to support gastroenterology and advocate for our patients.
Dr. Patel is assistant professor, division of gastroenterology, Duke University, Cary, N.C.; member, AGA Clinical Guidelines Committee.
.
The evening before Advocacy Day, we discussed strategies for having a successful meeting on Capitol Hill with AGA staff (including Kathleen Teixeira, AGA vice president of government affairs, and Jonathan Sollish, AGA senior coordinator, public policy). We discussed having our “asks” supported with evidence, and “getting personal” about how these policy issues directly affect us and our patients. We also had the chance to hear from Rep. Jim McGovern (D-Mass.) and Sen. Roy Blunt (R-Mo.) , both of whom invited our questions. Both congressmen are friends of AGA, with McGovern serving as chair of the House Rules Committee, and Blunt serving as chair of the Senate Labor-HHS Subcommittee on Appropriations.
Advocacy Day began with a group breakfast during which we reviewed some of the policy issues of central importance to gastroenterology:
• Removing Barriers to the Colorectal Cancer Screening Act (HR1570/S668), which enjoys strong bipartisan support, would correct the “cost-sharing” problem of screening colonoscopies turning therapeutic (with polypectomy) for our Medicare patients, by waiving the coinsurance for screening colonoscopies – regardless of whether we remove polyps during these colonoscopies.
• Safe Step Act, HR2279, legislation introduced in the House, facilitates a common-sense and timely (72 hours or 24 hours if life-threatening) appeals process when our patients are subjected to step therapy (“fail first”) by insurers.
• Improving Seniors’ Timely Access to Care Act of 2019, HR3107, legislation in the House, eases onerous prior authorization burdens by promoting an electronic prior authorization process, ensuring requests are approved by qualified medical professionals who have specialty-specific experience, and mandating that plans report their rates of delays and denials.
• NIH research funding facilitates innovative research and supports young investigators in our field.
Full of enthusiasm, our six-strong North Carolina contingent (pictured, L-R, Ziad Gellad, MD, MPH, AGAF; David Leiman, MD, MSPH; Animesh Jain, MD; Anne Finefrock Peery, MD; Lisa Gangarosa, MD, AGAF, chair of the AGA Government Affairs Committee; and Amit Patel, MD) met with the offices of Rep. David Price (D-N.C.), and both North Carolina Senators, Richard Burr (R) and Thom Tillis (R) on Capitol Hill to convey our “asks.”
At Price’s office in the stately Rayburn House Office Building, we thanked his team for cosponsorship of H.R. 1570 and H.R. 2279. We also discussed the importance of increasing research funding by the AGA’s goal of $2.5 billion for NIH for fiscal year 2020, noting that a majority of our delegation has received NIH funding for our training and/or research activities. We also encouraged Price’s office to cosponsor H.R. 3107, sharing our personal experiences about the administrative toll of the prior authorization process for obtaining appropriate and recommended medications for our patients – in my case, swallowed topical corticosteroids for patients with eosinophilic esophagitis.
We moved on to Sen. Tillis’s office, where we thanked his office for cosponsorship of S. 668 but encouraged his office to cosponsor upcoming companion Senate legislation for H.R. 2279 and H.R. 3107. Our colleague capably conveyed how an inflammatory bowel disease (IBD) patient he saw recently may require a colectomy due to delays in appropriate treatment stemming from these regulatory processes. We also showed Tillis’s office how NIH funding generates significant economic activity in North Carolina, supporting jobs in our state.
After a quick stop at the U.S. Senate gift shop in the basement to buy souvenirs for our kids, our last meeting was with Sen. Burr’s office. There, we also thanked his office for cosponsorship of S. 668 but encouraged him to sign the “Dear Colleague” letter that Sen. Sherrod Brown, D-OH, has circulated asking CMS to address the colonoscopy cost-sharing “loophole.” We discussed the importance of cosponsoring upcoming companion Senate legislation for H.R. 2279 and H.R. 3107, sharing stories from our clinical practices about how these regulatory burdens have delayed treatment for our patients.
You can get involved, too.
AGA Advocacy Day was a tremendous experience, but it is not the only way AGA members can get involved and take action. The AGA Advocacy website, gastro.org/advocacy, provides more information on multiple avenues for advocacy. These include an online advocacy tool for sending templated letters on these issues to your elected officials.
Perhaps now more than ever, it is crucial that we get involved to support gastroenterology and advocate for our patients.
Dr. Patel is assistant professor, division of gastroenterology, Duke University, Cary, N.C.; member, AGA Clinical Guidelines Committee.
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The evening before Advocacy Day, we discussed strategies for having a successful meeting on Capitol Hill with AGA staff (including Kathleen Teixeira, AGA vice president of government affairs, and Jonathan Sollish, AGA senior coordinator, public policy). We discussed having our “asks” supported with evidence, and “getting personal” about how these policy issues directly affect us and our patients. We also had the chance to hear from Rep. Jim McGovern (D-Mass.) and Sen. Roy Blunt (R-Mo.) , both of whom invited our questions. Both congressmen are friends of AGA, with McGovern serving as chair of the House Rules Committee, and Blunt serving as chair of the Senate Labor-HHS Subcommittee on Appropriations.
Advocacy Day began with a group breakfast during which we reviewed some of the policy issues of central importance to gastroenterology:
• Removing Barriers to the Colorectal Cancer Screening Act (HR1570/S668), which enjoys strong bipartisan support, would correct the “cost-sharing” problem of screening colonoscopies turning therapeutic (with polypectomy) for our Medicare patients, by waiving the coinsurance for screening colonoscopies – regardless of whether we remove polyps during these colonoscopies.
• Safe Step Act, HR2279, legislation introduced in the House, facilitates a common-sense and timely (72 hours or 24 hours if life-threatening) appeals process when our patients are subjected to step therapy (“fail first”) by insurers.
• Improving Seniors’ Timely Access to Care Act of 2019, HR3107, legislation in the House, eases onerous prior authorization burdens by promoting an electronic prior authorization process, ensuring requests are approved by qualified medical professionals who have specialty-specific experience, and mandating that plans report their rates of delays and denials.
• NIH research funding facilitates innovative research and supports young investigators in our field.
Full of enthusiasm, our six-strong North Carolina contingent (pictured, L-R, Ziad Gellad, MD, MPH, AGAF; David Leiman, MD, MSPH; Animesh Jain, MD; Anne Finefrock Peery, MD; Lisa Gangarosa, MD, AGAF, chair of the AGA Government Affairs Committee; and Amit Patel, MD) met with the offices of Rep. David Price (D-N.C.), and both North Carolina Senators, Richard Burr (R) and Thom Tillis (R) on Capitol Hill to convey our “asks.”
At Price’s office in the stately Rayburn House Office Building, we thanked his team for cosponsorship of H.R. 1570 and H.R. 2279. We also discussed the importance of increasing research funding by the AGA’s goal of $2.5 billion for NIH for fiscal year 2020, noting that a majority of our delegation has received NIH funding for our training and/or research activities. We also encouraged Price’s office to cosponsor H.R. 3107, sharing our personal experiences about the administrative toll of the prior authorization process for obtaining appropriate and recommended medications for our patients – in my case, swallowed topical corticosteroids for patients with eosinophilic esophagitis.
We moved on to Sen. Tillis’s office, where we thanked his office for cosponsorship of S. 668 but encouraged his office to cosponsor upcoming companion Senate legislation for H.R. 2279 and H.R. 3107. Our colleague capably conveyed how an inflammatory bowel disease (IBD) patient he saw recently may require a colectomy due to delays in appropriate treatment stemming from these regulatory processes. We also showed Tillis’s office how NIH funding generates significant economic activity in North Carolina, supporting jobs in our state.
After a quick stop at the U.S. Senate gift shop in the basement to buy souvenirs for our kids, our last meeting was with Sen. Burr’s office. There, we also thanked his office for cosponsorship of S. 668 but encouraged him to sign the “Dear Colleague” letter that Sen. Sherrod Brown, D-OH, has circulated asking CMS to address the colonoscopy cost-sharing “loophole.” We discussed the importance of cosponsoring upcoming companion Senate legislation for H.R. 2279 and H.R. 3107, sharing stories from our clinical practices about how these regulatory burdens have delayed treatment for our patients.
You can get involved, too.
AGA Advocacy Day was a tremendous experience, but it is not the only way AGA members can get involved and take action. The AGA Advocacy website, gastro.org/advocacy, provides more information on multiple avenues for advocacy. These include an online advocacy tool for sending templated letters on these issues to your elected officials.
Perhaps now more than ever, it is crucial that we get involved to support gastroenterology and advocate for our patients.
Dr. Patel is assistant professor, division of gastroenterology, Duke University, Cary, N.C.; member, AGA Clinical Guidelines Committee.
A letter from Dr. Robert S. Sandler, MPH, AGAF, Chair of the AGA Research Foundation
Dear Colleagues,
Join me in supporting talented investigators through a personal gift to the AGA Research Foundation.
As a member of the GI community, you understand the physical, emotional and financial costs of digestive diseases. And you understand the value of research to advance patient care. The gap in federal funding for research continues to grow. Many well-qualified young investigators cannot get government funding. Gifts to the AGA Research Foundation this year directly supported 52 talented investigators. Despite this success, over 200 other innovative and promising research ideas went unfunded.
That’s why I’m asking for your help.
Securing the future of the field is no small task. Every dollar is a step forward in helping to spark the scientific breakthroughs of today so clinicians will have the tools to improve care tomorrow.
Everyone benefits from GI research developed by dedicated investigators.
I invite you to help the AGA Research Foundation continue our efforts to fund and retain talented GI scientists whose research will impact the future care of patients. Donate today at www.gastro.org/donate.
Thank you for your generosity. Best wishes for a happy, healthy holiday season and successful New Year.
Dear Colleagues,
Join me in supporting talented investigators through a personal gift to the AGA Research Foundation.
As a member of the GI community, you understand the physical, emotional and financial costs of digestive diseases. And you understand the value of research to advance patient care. The gap in federal funding for research continues to grow. Many well-qualified young investigators cannot get government funding. Gifts to the AGA Research Foundation this year directly supported 52 talented investigators. Despite this success, over 200 other innovative and promising research ideas went unfunded.
That’s why I’m asking for your help.
Securing the future of the field is no small task. Every dollar is a step forward in helping to spark the scientific breakthroughs of today so clinicians will have the tools to improve care tomorrow.
Everyone benefits from GI research developed by dedicated investigators.
I invite you to help the AGA Research Foundation continue our efforts to fund and retain talented GI scientists whose research will impact the future care of patients. Donate today at www.gastro.org/donate.
Thank you for your generosity. Best wishes for a happy, healthy holiday season and successful New Year.
Dear Colleagues,
Join me in supporting talented investigators through a personal gift to the AGA Research Foundation.
As a member of the GI community, you understand the physical, emotional and financial costs of digestive diseases. And you understand the value of research to advance patient care. The gap in federal funding for research continues to grow. Many well-qualified young investigators cannot get government funding. Gifts to the AGA Research Foundation this year directly supported 52 talented investigators. Despite this success, over 200 other innovative and promising research ideas went unfunded.
That’s why I’m asking for your help.
Securing the future of the field is no small task. Every dollar is a step forward in helping to spark the scientific breakthroughs of today so clinicians will have the tools to improve care tomorrow.
Everyone benefits from GI research developed by dedicated investigators.
I invite you to help the AGA Research Foundation continue our efforts to fund and retain talented GI scientists whose research will impact the future care of patients. Donate today at www.gastro.org/donate.
Thank you for your generosity. Best wishes for a happy, healthy holiday season and successful New Year.
Top AGA Community patient cases
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe ulcerative colitis # IBD – A 41-year-old female patient with ulcerative colitis had a flare that didn’t improve with adalimumab and prednisone, and was admitted to the hospital with bloody stools and abdominal pain. The GI community discussed considerations for next steps and other tests to consider.
2. Unexplained diarrhea – Following the eQ&A with an AGA guideline coauthor on chronic diarrhea, this popular case follows a celiac disease patient on a gluten-free diet who continues to have significant diarrhea and fatigue.
3. Difficult ERCP – How would you handle an ERCP where the papilla is small and in a tricky location? View photos from your colleague’s scope and share your advice with the GI community.
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe ulcerative colitis # IBD – A 41-year-old female patient with ulcerative colitis had a flare that didn’t improve with adalimumab and prednisone, and was admitted to the hospital with bloody stools and abdominal pain. The GI community discussed considerations for next steps and other tests to consider.
2. Unexplained diarrhea – Following the eQ&A with an AGA guideline coauthor on chronic diarrhea, this popular case follows a celiac disease patient on a gluten-free diet who continues to have significant diarrhea and fatigue.
3. Difficult ERCP – How would you handle an ERCP where the papilla is small and in a tricky location? View photos from your colleague’s scope and share your advice with the GI community.
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe ulcerative colitis # IBD – A 41-year-old female patient with ulcerative colitis had a flare that didn’t improve with adalimumab and prednisone, and was admitted to the hospital with bloody stools and abdominal pain. The GI community discussed considerations for next steps and other tests to consider.
2. Unexplained diarrhea – Following the eQ&A with an AGA guideline coauthor on chronic diarrhea, this popular case follows a celiac disease patient on a gluten-free diet who continues to have significant diarrhea and fatigue.
3. Difficult ERCP – How would you handle an ERCP where the papilla is small and in a tricky location? View photos from your colleague’s scope and share your advice with the GI community.
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
FDA transition to disposable component duodenoscopes — talking points for your patients
The U.S. Food and Drug Administration (FDA) recently released a safety communication recommending duodenoscope manufacturers and health care facilities move away from using duodenoscopes with fixed endcaps to those with disposable components that include disposable endcaps – or to fully disposable duodenoscopes when they become available. This announcement may have already produced some questions among your patients when it comes to their procedures that use a duodenoscope, such as endoscopic retrograde cholangiopancreatography (ERCP).
Talking points:
• Duodenoscopes are an important tool used during an ERCP to help localize and treat abnormal issues in your bile duct system and pancreas, and possibly help you avoid surgery.
• The complex design of duodenoscopes can sometimes result in bacteria remaining in a small portion of the duodenoscope (the “elevator channel”) even after careful cleaning according to approved instructions. However, the chance of getting an identified “superbug infection” with a duodenoscope is very low, currently estimated at 1 per 20,000 ERCPs performed in more than 650,000 ERCP procedures each year in the U.S. FDA continues to work with duodenoscope manufacturers to provide strict guidelines for cleaning and disinfection of these tools.
• The switch to new duodenoscopes with disposable components will be slow and orderly to make sure that there are enough duodenoscopes to perform ERCPs so that patients who need this often life-saving procedure will still have access.
• Do not cancel or delay any planned procedure without first discussing the benefits and risks with me or another health care provider, as delaying the procedure and alternatives like surgery or radiologic intervention may be riskier than a timely ERCP.
• The esophagogastroduodenoscopy (EGD) procedure does not use the same tool that is used for ERCP. EGD uses a different endoscope than ERCP and has not been shown to have the same risk of infection because there is no “elevator channel.”
The U.S. Food and Drug Administration (FDA) recently released a safety communication recommending duodenoscope manufacturers and health care facilities move away from using duodenoscopes with fixed endcaps to those with disposable components that include disposable endcaps – or to fully disposable duodenoscopes when they become available. This announcement may have already produced some questions among your patients when it comes to their procedures that use a duodenoscope, such as endoscopic retrograde cholangiopancreatography (ERCP).
Talking points:
• Duodenoscopes are an important tool used during an ERCP to help localize and treat abnormal issues in your bile duct system and pancreas, and possibly help you avoid surgery.
• The complex design of duodenoscopes can sometimes result in bacteria remaining in a small portion of the duodenoscope (the “elevator channel”) even after careful cleaning according to approved instructions. However, the chance of getting an identified “superbug infection” with a duodenoscope is very low, currently estimated at 1 per 20,000 ERCPs performed in more than 650,000 ERCP procedures each year in the U.S. FDA continues to work with duodenoscope manufacturers to provide strict guidelines for cleaning and disinfection of these tools.
• The switch to new duodenoscopes with disposable components will be slow and orderly to make sure that there are enough duodenoscopes to perform ERCPs so that patients who need this often life-saving procedure will still have access.
• Do not cancel or delay any planned procedure without first discussing the benefits and risks with me or another health care provider, as delaying the procedure and alternatives like surgery or radiologic intervention may be riskier than a timely ERCP.
• The esophagogastroduodenoscopy (EGD) procedure does not use the same tool that is used for ERCP. EGD uses a different endoscope than ERCP and has not been shown to have the same risk of infection because there is no “elevator channel.”
The U.S. Food and Drug Administration (FDA) recently released a safety communication recommending duodenoscope manufacturers and health care facilities move away from using duodenoscopes with fixed endcaps to those with disposable components that include disposable endcaps – or to fully disposable duodenoscopes when they become available. This announcement may have already produced some questions among your patients when it comes to their procedures that use a duodenoscope, such as endoscopic retrograde cholangiopancreatography (ERCP).
Talking points:
• Duodenoscopes are an important tool used during an ERCP to help localize and treat abnormal issues in your bile duct system and pancreas, and possibly help you avoid surgery.
• The complex design of duodenoscopes can sometimes result in bacteria remaining in a small portion of the duodenoscope (the “elevator channel”) even after careful cleaning according to approved instructions. However, the chance of getting an identified “superbug infection” with a duodenoscope is very low, currently estimated at 1 per 20,000 ERCPs performed in more than 650,000 ERCP procedures each year in the U.S. FDA continues to work with duodenoscope manufacturers to provide strict guidelines for cleaning and disinfection of these tools.
• The switch to new duodenoscopes with disposable components will be slow and orderly to make sure that there are enough duodenoscopes to perform ERCPs so that patients who need this often life-saving procedure will still have access.
• Do not cancel or delay any planned procedure without first discussing the benefits and risks with me or another health care provider, as delaying the procedure and alternatives like surgery or radiologic intervention may be riskier than a timely ERCP.
• The esophagogastroduodenoscopy (EGD) procedure does not use the same tool that is used for ERCP. EGD uses a different endoscope than ERCP and has not been shown to have the same risk of infection because there is no “elevator channel.”
Talking to your patients about ranitidine
The FDA recently released several safety alerts on ranitidine formulations, including the brand-name drug Zantac, which were found to contain a nitrosamine impurity called N-nitrosodimethylamine (NDMA) at low levels. NDMA is classified as a probable human carcinogen (a substance that could cause cancer) based on results from laboratory tests and animal studies. NDMA is a known environmental contaminant and found in water and foods, including meats, dairy products, and vegetables. This contaminant is similar to what was recently found in losartan, an angiotensin II receptor blocker used to treat hypertension, that was recalled by the FDA.
The FDA is continuing to test ranitidine products from multiple manufacturers and is assessing the potential effect on patients who have been taking ranitidine.
With the voluntary recall of 14 lots of prescription ranitidine capsules distributed by Sandoz Inc., as well as the voluntary recall of over-the-counter (OTC) ranitidine tablets (75 mg and 150 mg), labeled by Walgreens, Walmart, and Rite-Aid and manufactured by Apotex Corp, your patients might be asking a lot of questions about whether to continue to using their medicines and what alternatives are available.
Talking to your patients
The FDA safety alerts have been covered by various media outlets since early September. This may cause your patients to question whether they should stay on or start using ranitidine products. When discussing the recall with your patients, let them know that:
• Ranitidine is an H2 blocker (antihistamine) – available OTC and in prescription strength – used to prevent and relieve heartburn associated with acid indigestion and sour stomach. It reduces stomach acid and works longer but not as quickly as antacids.
• Not all ranitidine medicines marketed in the United States are being recalled and the FDA is not recommending individuals stop taking all ranitidine medicines at this time.
• It might be prudent to hold off taking Zantac until a final FDA conclusion is released.
• Multiple drugs are approved for the same or similar uses as ranitidine. Other treatment options are available, both prescription and OTC, for patients who are concerned about ranitidine.
• Life-style modifications may reduce or eliminate the need for heartburn drugs for long-term use. These may include weight loss, avoiding tobacco, or a change in eating patterns. Share AGA’s patient education content on gastroesophageal reflux disease (GERD) for more tips for your patients.
The FDA recently released several safety alerts on ranitidine formulations, including the brand-name drug Zantac, which were found to contain a nitrosamine impurity called N-nitrosodimethylamine (NDMA) at low levels. NDMA is classified as a probable human carcinogen (a substance that could cause cancer) based on results from laboratory tests and animal studies. NDMA is a known environmental contaminant and found in water and foods, including meats, dairy products, and vegetables. This contaminant is similar to what was recently found in losartan, an angiotensin II receptor blocker used to treat hypertension, that was recalled by the FDA.
The FDA is continuing to test ranitidine products from multiple manufacturers and is assessing the potential effect on patients who have been taking ranitidine.
With the voluntary recall of 14 lots of prescription ranitidine capsules distributed by Sandoz Inc., as well as the voluntary recall of over-the-counter (OTC) ranitidine tablets (75 mg and 150 mg), labeled by Walgreens, Walmart, and Rite-Aid and manufactured by Apotex Corp, your patients might be asking a lot of questions about whether to continue to using their medicines and what alternatives are available.
Talking to your patients
The FDA safety alerts have been covered by various media outlets since early September. This may cause your patients to question whether they should stay on or start using ranitidine products. When discussing the recall with your patients, let them know that:
• Ranitidine is an H2 blocker (antihistamine) – available OTC and in prescription strength – used to prevent and relieve heartburn associated with acid indigestion and sour stomach. It reduces stomach acid and works longer but not as quickly as antacids.
• Not all ranitidine medicines marketed in the United States are being recalled and the FDA is not recommending individuals stop taking all ranitidine medicines at this time.
• It might be prudent to hold off taking Zantac until a final FDA conclusion is released.
• Multiple drugs are approved for the same or similar uses as ranitidine. Other treatment options are available, both prescription and OTC, for patients who are concerned about ranitidine.
• Life-style modifications may reduce or eliminate the need for heartburn drugs for long-term use. These may include weight loss, avoiding tobacco, or a change in eating patterns. Share AGA’s patient education content on gastroesophageal reflux disease (GERD) for more tips for your patients.
The FDA recently released several safety alerts on ranitidine formulations, including the brand-name drug Zantac, which were found to contain a nitrosamine impurity called N-nitrosodimethylamine (NDMA) at low levels. NDMA is classified as a probable human carcinogen (a substance that could cause cancer) based on results from laboratory tests and animal studies. NDMA is a known environmental contaminant and found in water and foods, including meats, dairy products, and vegetables. This contaminant is similar to what was recently found in losartan, an angiotensin II receptor blocker used to treat hypertension, that was recalled by the FDA.
The FDA is continuing to test ranitidine products from multiple manufacturers and is assessing the potential effect on patients who have been taking ranitidine.
With the voluntary recall of 14 lots of prescription ranitidine capsules distributed by Sandoz Inc., as well as the voluntary recall of over-the-counter (OTC) ranitidine tablets (75 mg and 150 mg), labeled by Walgreens, Walmart, and Rite-Aid and manufactured by Apotex Corp, your patients might be asking a lot of questions about whether to continue to using their medicines and what alternatives are available.
Talking to your patients
The FDA safety alerts have been covered by various media outlets since early September. This may cause your patients to question whether they should stay on or start using ranitidine products. When discussing the recall with your patients, let them know that:
• Ranitidine is an H2 blocker (antihistamine) – available OTC and in prescription strength – used to prevent and relieve heartburn associated with acid indigestion and sour stomach. It reduces stomach acid and works longer but not as quickly as antacids.
• Not all ranitidine medicines marketed in the United States are being recalled and the FDA is not recommending individuals stop taking all ranitidine medicines at this time.
• It might be prudent to hold off taking Zantac until a final FDA conclusion is released.
• Multiple drugs are approved for the same or similar uses as ranitidine. Other treatment options are available, both prescription and OTC, for patients who are concerned about ranitidine.
• Life-style modifications may reduce or eliminate the need for heartburn drugs for long-term use. These may include weight loss, avoiding tobacco, or a change in eating patterns. Share AGA’s patient education content on gastroesophageal reflux disease (GERD) for more tips for your patients.