Gary Wild

Gary Wild
McGill University | McGill · Department of Medicine

MD.CM.PhD.FRCP(C)

About

228
Publications
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Introduction
Gary Wild currently works at the Department of Medicine, McGill University.

Publications

Publications (228)
Article
Full-text available
Background and Aim: Newer biologics appeared safer in landmark clinical trials, but their safety is understudied in vulnerable populations. The aim of the present study was to perform a systematic review and meta-analysis to assess the safety of available biologicals in the elderly IBD population. Methods: We systematically searched PubMed/Medline...
Article
Objectives: Endoscopic healing is currently considered the main target in the management of ulcerative colitis (UC). There is conflicting data about the role of histology as a stricter treatment objective. We aim at evaluating the additional benefit of histologic remission over endoscopic remission. Methods: We performed a prospective observatio...
Article
Full-text available
Background Optimal management of patients with ulcerative colitis (UC) requires the accurate, objective assessment of disease activity. Aims We aimed to determine how strong patient-reported outcomes, clinical scores and symptoms correlate with endoscopy and biomarkers for assessment of disease activity in patients with UC. Methods Consecutive pa...
Article
Background Therapeutic drug monitoring, the measurement of serum biologic concentrations and immunogenicity, has become an important method in guiding the management of biologic therapy in patients with Crohn’s disease (CD). Ustekinumab, an inhibitor of the p40 subunit of interleukins 12 and 23, is an approved therapy for patients with CD. However,...
Article
Background There was a significant progress in the medical therapy of inflammatory bowel disease(IBD) with the advent of biological compounds, yet patients may experience adverse events(AE): infusion reactions, serious infections and malignancies, understudied in vulnerable patient populations (e.g. elderly). Aims Our aim was to perform a systemat...
Article
Background The impact of COVID-19 has been of great concern in patients with IBD worldwide, including an increased risk of severe outcomes and/or flare of IBD. Aims This study aims to evaluate prevalence, outcomes, the impact of COVID-19 in patients with IBD, and risk factors associated with severe COVID-19 or flare of IBD. Methods A consecutive...
Article
Full-text available
Background: Chronic inflammatory diseases are linked to an increased risk of atherothrombotic events, but the risk associated with inflammatory bowel disease (IBD) is controversial. We therefore examined the risk of and risk factors for myocardial infarction (MI) and stroke in IBD patients. Methods: We used the public health administrative datab...
Article
Background Despite the advancement in pharmacological management of Inflammatory Bowel Disease (IBD), the efficacy and the side effects of the biologics are rarely studied in the elderly population. Our aim was to evaluate retrospectively the drug sustainability, efficacy, and safety of the biologic therapies in the elderly IBD population. Methods...
Article
Background The impact of COVID-19 has been of great concern in patients with inflammatory bowel disease (IBD) worldwide, including an increased risk of severe outcomes and/or possible flare of IBD. This study aims to evaluate prevalence, outcomes, the impact of COVID-19 in patients with IBD, and risk factors associated with severe COVID-19 or flare...
Article
Background Endoscopic mucosal healing is a key treatment target in inflammatory bowel disease (IBD). The aim of this study was to investigate small bowel (SB) mucosal healing using video capsule endoscopy (VCE) in patients with Crohn’s disease (CD) following, 24 weeks of adalimumab therapy. Methods In this prospective study, moderate to severe SB...
Article
Background There was a significant progress in the medical therapy of inflammatory bowel diseases(IBD) with the advent of biological compounds, yet patients may experience adverse events(AE): infusion/injection reactions, infections and malignancies, understudied in vulnerable patient populations (e.g. elderly). Methods We systematically searched...
Article
Background Therapeutic drug monitoring, the measurement of serum biologic concentrations and immunogenicity, has become an important method in guiding the management of biologic therapy in patients with Crohn’s disease (CD). Ustekinumab, an inhibitor of the p40 subunit of interleukins 12 and 23, is an approved therapy for patients with CD. However,...
Article
Full-text available
Background and aims: The impact of COVID-19 has been of great concern in patients with inflammatory bowel disease (IBD) worldwide, including an increased risk of severe outcomes and/or possible flare of IBD. This study aims to evaluate prevalence, outcomes, the impact of COVID-19 in patients with IBD, and risk factors associated with severe COVID-...
Article
Background Data suggests that tight objective monitoring may improve clinical outcomes in IBD. Methods The aim of this study is to assess the adherence to serial tight objective monitoring(clinical and biomarkers) and its effect on clinical outcomes. We retrospectively reviewed the chart of 428 consecutive IBD patients started on adalimumab betwee...
Article
Background Optimal management of patients with ulcerative colitis (UC) requires the accurate assessment of disease activity. Endoscopic evaluation is considered the gold standard approach, but it is invasive. We aimed to determine the operating characteristics of the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), to quantify the cut off m...
Article
Background Optimal management of patients with ulcerative colitis (UC) requires the accurate assessment of disease activity. Endoscopic evaluation is considered the gold standard approach, but it is invasive. We aimed to determine how strong patient reported outcomes, clinical scores and symptoms correlate with endoscopy for assessment of disease a...
Article
Full-text available
Background Immunomodulator monotherapy is an important component in the treatment of inflammatory bowel disease (IBD). However, there is conflicting literature about thiopurines maintaining long-term remission in patients with active IBD.AimTo determine the durable clinical remission rate in adults with Crohn’s disease (CD) or ulcerative colitis (U...
Article
Full-text available
Background Data suggests that tight objective monitoring of inflammatory bowel diseases (IBD) may improve one-year clinical outcomes. Aims The goal of this study is to assess the adherence to serial tight objective monitoring, via clinical symptoms and biomarkers, and the effect of such tight monitoring on one year outcome in IBD patients at an ac...
Article
Background Data suggests that tight objective monitoring may improve clinical outcomes in IBD. Aim To assess the adherence to serial tight objective monitoring(clinical and biomarkers) and its effect on clinical outcomes. Methods We retrospectively reviewed the chart of 428 consecutive IBD patients started on adalimumab between January 1,2015–Jan...
Article
Background and aims: Anemia is a common complication of inflammatory bowel diseases (IBD), as well as a predictor of poor outcomes. The aim of this study was to determine the prevalence of anemia over time and the management of moderate to severe anemia at a tertiary referral IBD center. Methods: We retrospectively reviewed the occurrence of ane...
Article
Background Crohn disease (CD) and ulcerative colitis (UC) have high health care expenditures because of medications, hospitalizations, and surgeries. We evaluated disease outcomes and treatment algorithms of patients with inflammatory bowel disease (IBD) in Québec, comparing periods before and after 2010. Methods The province of Québec’s public he...
Article
Full-text available
Background Evaluating clinical data on the safety and efficacy of vedolizumab (VDZ) in ‘real-world’ setting is still desirable. Recent reports have raised concerns that arthralgia may be associated with VDZ. Aims The aim of this study is to present clinical experience with VDZ from a tertiary IBD center. Methods Retrospective chart reviews were p...
Article
Background: Emergency situations in inflammatory bowel diseases (IBD) put significant burden on both the patient and the healthcare system. Aim: To prospectively measure Quality-of-Care indicators and resource utilization after the implementation of the new rapid access clinic service (RAC) at a tertiary IBD center. Methods: Patient access, re...
Article
Background Non-alcoholic fatty liver disease (NAFLD) is the main cause of liver disease in Western countries and is a frequently reported comorbidity in inflammatory bowel disease (IBD). A complex interaction among polygenic predisposition, IBD-specific risk factors, microbiome, multiple environmental and patients’ factors could explain the develop...
Article
Background Chronic inflammatory diseases have been linked to increased risk of atherothrombotic events, but the risk associated with inflammatory bowel disease (IBD) is conflictive. We, therefore, examined the risk of and risk factors for myocardial infarction (MI) and stroke in patients with IBD in Quebec. Methods We used the public health admini...
Article
Background Optimal management of patients with ulcerative colitis (UC) requires the accurate assessment of disease activity. Endoscopic evaluation is considered the gold standard approach, but it is invasive. We aimed to determine the operating characteristics of the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), to quantify the cut off m...
Article
Background Optimal management of patients with ulcerative colitis (UC) requires the accurate assessment of disease activity. Endoscopic evaluation is considered the gold standard approach, but it is invasive. We aimed to determine how strong patient reported outcomes, clinical scores and symptoms correlate with endoscopy for assessment of disease a...
Article
Background Anaemia is an important complication and/or extra-intestinal manifestation of inflammatory bowel disease (IBD), as well as a predictor of poor outcomes. The aim of this study was to determine the occurrence of anaemia and the frequency of anaemia screening over time, at a tertiary referral IBD centre. Methods We retrospectively reviewed...
Article
Full-text available
Background/aims: Patient-reported outcomes (PRO) are key aspects in the management of inflammatory bowel disease (IBD). This study aims to evaluate factors associated with adverse PRO, including modifiable social constructs of maladaptive coping and self-efficacy as well as physician-patient concordance on PRO. Patients and methods: This cross-s...
Article
Background Patients with Crohn’s disease (CD) and ulcerative colitis (UC) are at increased risk for colorectal dysplasia (CRD) and cancer (CRC). Adherence to CRC surveillance guidelines is reportedly low internationally. Aim To evaluate surveillance practices at the tertiary IBD Center of the McGill University Health Center (MUHC) and to determine...
Article
Full-text available
Background Patients with Crohn’s disease (CD) and ulcerative colitis (UC) are at increased risk for colorectal dysplasia (CRD) and cancer (CRC). Adherence to CRC surveillance guidelines is reportedly low internationally. Aims To evaluate surveillance practices at the tertiary IBD Center of the McGill University Health Center (MUHC) and to determin...
Article
Full-text available
Background Background: Patients with Crohn’s disease (CD) and ulcerative colitis (UC) are at increased risk for colorectal dysplasia (CRD) and cancer (CRC). Adherence to CRC surveillance guidelines is reportedly low internationally. Aims Aims: To evaluate surveillance practices at the tertiary IBD Center of the McGill University Health Center (MUH...
Article
Background Emergency situations in inflammatory bowel diseases (IBD) put significant burden on the patient and healthcare system as well. Aims We aimed to prospectively measure indicators of quality-of-care, after implementation of a new rapid access clinic (RAC) at the McGill University Health Centre (MUHC) tertiary care IBD center. Methods The...
Article
Full-text available
Background Patients with Crohn’s disease(CD) and ulcerative colitis(UC) are at increased risk for colorectal dysplasia(CRD) and cancer(CRC). Adherence to CRC surveillance guidelines is reported to be low internationally. Aims Our aim was to evaluate surveillance practices at the tertiary IBD Center of the McGill University Health Center(MUHC) and...
Article
Background Optimal management of inflammatory bowel disease (IBD) requires harmonized monitoring strategy and treatment pathways. Comprehensive evaluation of the quality of care provided by IBD centers is still scarce. Aims We aimed to evaluate the quality of care at the McGill University Health Center (MUHC) IBD Center using quality of care indic...
Article
Background and aims: Measuring quality of care (QoC) in inflammatory bowel diseases (IBD) has become increasingly important, yet complex assessment of QoC from the patients' perspective is rare. We evaluated perceived QoC using the Quality of Care Through the Patient's Eyes - IBD (QUOTE-IBD) questionnaire, and investigated associations between QoC...
Article
Full-text available
Background Patients with Crohn’s disease(CD) and ulcerative colitis(UC) are at increased risk for colorectal dysplasia (CRD) and cancer (CRC). Adherence to CRC surveillance guidelines is reported to be low internationally. Our aim was to evaluate surveillance practices at the tertiary IBD Center of the McGill University Health Center (MUHC) and to...
Article
Background Optimal management of IBD requires harmonised monitoring and treatment pathways. We aimed to evaluate the quality of care at the McGill University Health Center (MUHC) IBD Center using quality of care indicators (QIs) including patient assessment strategy, monitoring, treatment decisions, and outcomes. Methods The MUHC IBD centre was of...
Article
Full-text available
Background Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are associated with high healthcare expenditures related to medications, hospitalisations, and surgeries. Our aim was to analyse disease outcomes and treatment algorithms in newly diagnosed IBD patients in Québec over the past 2 decades, compar...
Article
Background Emergency situations in inflammatory bowel diseases (IBD) put significant burden on the patient and healthcare system as well. We aimed to prospectively measure indicators of quality-of-care, after implementation of a new rapid access clinic (RAC) at the McGill University Health Centre (MUHC) tertiary care IBD centre. Methods The RAC pr...
Article
Background Measuring the quality of care (QoC) in IBD has become increasingly important, yet complex assessment of quality indicators and perceived quality of care is rare. In this prospective study, we evaluated patients’ satisfaction on the QoC using the QUOTE-IBD questionnaire in the context of health related quality of life (HRQoL) and work pro...
Article
Background and aims: We aimed to evaluate the quality of care at a tertiary inflammatory bowel disease (IBD) center using quality of care indicators (QIs) including patient assessment strategy, monitoring, treatment decisions and outcomes. Methods: We retrospectively reviewed the quality of care pre- and post-referral and during follow-up at the...
Article
Background Inflammatory bowel disease (IBD) patients may be at risk for nonalcoholic fatty liver disease (NAFLD) due to chronic inflammation, hepatotoxic drugs, and alteration of the gut microbiota. Prospective data using accurate diagnostic methods are lacking. Methods We prospectively investigated prevalence and predictors of NAFLD and liver fib...
Article
Background Managing loss of response (LOR) in Crohn’s disase (CD) patients remains challenging. Compelling evidence supports therapeutic drug monitoring (TDM) to guide management in patients on infliximab, but data for other biologics are less robust. We aimed to asses if empiric dose escalation led to improved clinical outcome in addition to TDM-g...
Article
Full-text available
Background IBD impacts on patient’s physical health, social functioning and quality of life, contributing to the health-economic burden associated with the disease, especially in emergency situations. Aims We aimed to prospectively measure indicators of quality-of-care, after implementation of a new rapid access clinic (RAC) at a tertiatry care IB...
Article
Full-text available
Background IBD impacts substantially on patient’s physical health, social functioning and quality of life. Aims We aimed to analyze quality of care indicators (QIs) including structural and process QIs at referral in the McGill University Health Center (MUHC) IBD Center that includes 6 IBD specialists, 2 IBD nurses, 2 research nurses, and 2 IBD fe...
Article
Full-text available
Background Optimal management of IBD requires harmonized monitoring processes and treatment pathways. Aims We aimed to retrospectively analyze quality of care indicators (QIs) during follow-up including patient monitoring, treatment decisions and outcomes in the McGill University Health Center (MUHC) IBD Center. Methods We retrospectively analyze...
Article
Full-text available
Background Therapeutic drug monitoring (TDM) and faecal calprotectin (FCP) testing in IBD patients with secondary loss of response (LOR) to infliximab (IFX), help guide clinicians to the most appropriate intervention to recapture response. However, TDM and FCP result reporting can be delayed, hampering immediate treatment optimisation. We investiga...
Article
Full-text available
Background Optimal management of patients with ulcerative colitis (UC) requires the assessment of disease severity. Endoscopic evaluation is considered the gold standard approach but it is invasive and caries potential harmful consequences. We aimed to determine whether clinical symptoms correlate endoscopy for assessment of disease activity in UC...
Article
Full-text available
Background IBD impacts on patient’s physical health, social functioning and quality of life, contributing to the health-economic burden associated with the disease, especially in emergency situations. We aimed to prospectively measure indicators of quality-of-care, after implementation of a new rapid access clinic (RAC) at a tertiary care IBD centr...
Article
Full-text available
Background Vedolizumab (VDZ) is an effective therapy for Crohn’s disease (CD) and ulcerative colitis (UC). Therapeutic drug monitoring may guide the use of VDZ to improve outcomes. We aim to investigate the association between VDZ trough level (TL) and clinical, biochemical and endoscopic outcomes. Methods We recruited patients on VDZ for treatmen...
Article
Full-text available
Background Optimal management of IBD requires harmonised monitoring processes and treatment pathways. We aimed to retrospectively analyse quality of care indicators (QIs) during follow-up including patient monitoring, treatment decisions and outcomes in the McGill University Health Center (MUHC) IBD Center. Methods We retrospectively analysed out-...
Article
Full-text available
Background Ustekinumab (UST), an inhibitor of IL-12 and IL-23, has been shown to effectively induce and maintain remission in patients with Crohn’s disease. However, a significant number of patients do not respond or experience a secondary loss of response to UST. This study aims to assess the role of UST reinduction to achieve clinical and endosco...
Article
Full-text available
Background: Patient reported outcomes (PRO), key aspects in the management of inflammatory bowel disease (IBD), are strongly influenced by biopsychosocial factors. Whereas self-efficacy and coping strategies are modifiable social constructs that may improve health outcomes following dedicated intervention. This study aims to evaluate the relationsh...
Article
Full-text available
Background: Medication adherence is pivotal to the optimal management of inflammatory bowel disease (IBD) patients and this could be influenced by various patient related factors independent of disease course. This study aims to evaluate the impact of patient reported outcomes, coping strategies and psychosocial factors on adherence. Methods: We co...
Article
Multiple studies have established the superior diagnostic accuracy of video capsule endoscopy (VCE) for the diagnosis of small bowel (SB) Crohn's disease (CD). However, data on the clinical impact of VCE in patients with established CD are scarce. The aim of this study was to examine the impact and safety of VCE on the clinical management of patien...
Article
Background: Ustekinumab is a fully human IgG1κ monoclonal antibody that blocks the biologic activity of interleukin-12/23. Ustekinumab is approved for treatment of plaque psoriasis and has been shown to be effective for induction and maintenance of clinical response in anti-TNF resistant Crohn's disease (CD). The aim of the study was to describe t...