Gary Wild

Gary Wild
McGill University | McGill · Department of Medicine

MD.CM.PhD.FRCP(C)

About

247
Publications
19,279
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11,273
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Introduction
Gary Wild currently works at the Department of Medicine, McGill University.

Publications

Publications (247)
Article
Background Ustekinumab (UST) and vedolizumab (VED) have proven to be effective therapies for ulcerative colitis (UC), with similar safety profiles. There are limited real-world studies comparing the effectiveness between UST and VED in UC, especially after anti-TNF failure1–4. Our aim was to evaluate the real-world efficacy and safety of UST and VE...
Article
Background Ulcerative Colitis (UC) is a chronic inflammatory bowel disease characterized by relapsing inflammation of the colon. Current therapeutic goals emphasize clinical and endoscopic remission; however, histological remission has emerged as an important target due to its association with reduced relapse rates and improved long-term outcomes....
Article
Background Endoscopic healing in patients with ulcerative colitis predicted higher rates of clinical remission at 12 months follow-up. Meanwhile, active histologic disease did not affect time to clinical relapse in patients with UC who achieved endoscopic remission while the presence of basal plasmacytosis was associated with relapse. [1] We aim to...
Article
Background/Aims The role of ustekinumab therapeutic drug monitoring in patients with Crohn’s disease remains ambiguous. Examination of the association serum ustekinumab concentrations and endoscopic outcomes has yielded inconsistent results. Our study examined whether serum ustekinumab concentrations were associated with endoscopic healing in patie...
Article
Full-text available
Background Patients with IBD are at risk for metabolic dysfunction-associated steatotic liver disease (MASLD) due to chronic inflammation, hepatotoxic drugs, alteration of gut microbiota. MASLD, formerly known as non-alcoholic fatty liver disease, provides a positive rather than negative diagnosis, appropriately assigns a metabolic basis for hepati...
Article
Background Faecal calprotectin (FCP) is a reliable surrogate marker for disease activity in ulcerative colitis (UC). However, there are no consensus cut-off values for histoendoscopic remission. The aim of the study is to correlate FCP with Mayo Endoscopic Score (MES) and histological disease activity (Geboes score) of UC patients in clinical remis...
Article
Background Rectal bleeding and increased stool frequency are the most common symptoms patients with UC report, and they are key components in most of disease activity scores. It is unclear whether the severity of patient reported outcomes (rectal bleeding or diarrhea) correlate with endoscopic or histological disease activity. The aim of this prosp...
Article
Background Upadacitinib is a selective JAK1 inhibitor that has recently been approved for treatment of moderate-severe Crohn’s disease, with Phase III clinical trials showing positive efficacy and safety profiles. Our aim was to evaluate the real-world experience of upadacitinib in a refractory cohort of Canadian patients with Crohn’s disease. Met...
Preprint
Full-text available
Background Upadacitinib is a selective JAK1 inhibitor that has recently been approved for treatment of moderate-severe Crohn’s disease, with Phase III clinical trials showing positive efficacy and safety profiles. Aim Our aim was to evaluate the real-world experience of upadacitinib in a refractory cohort of Canadian patients with Crohn’s disease....
Article
Background: We aimed to evaluate clinical efficacy, biomarker activity, therapeutic drug monitoring (TDM), adverse events (AEs), and nocebo effect in inflammatory bowel disease (IBD) patients who underwent non-medical biosimilar switching. Methods: A prospective observational study of consecutive IBD patients who underwent biosimilar switch. Dis...
Article
Background: Endoscopic healing is a key treatment target in inflammatory bowel disease; few data are available on the clinical and endoscopic efficacy of biological therapy in upper gastrointestinal Crohn's disease. This study aimed to investigate small bowel mucosal healing and clinical efficacy of adalimumab therapy by video capsule endoscopy in...
Article
Full-text available
Background Non-alcoholic fatty liver disease (NAFLD) is strongly associated with cardiovascular disease in the general population. Both NAFLD and cardiovascular diseases seem more frequent in patients with inflammatory bowel disease (IBD). Purpose We aimed to assess the effect of NAFLD and associated liver fibrosis on the cardiovascular risk in pe...
Article
Full-text available
Background Non-alcoholic fatty liver disease (NAFLD) is strongly associated with cardiovascular disease in the general population. Both NAFLD and cardiovascular diseases seem more frequent in patients with inflammatory bowel disease (IBD). Purpose We aimed to assess the effect of NAFLD and associated liver fibrosis on the cardiovascular risk in pe...
Article
Full-text available
Background Nonalcoholic fatty liver disease (NAFLD) is strongly associated with cardiovascular disease in the general population. Both conditions seem more frequent in patients with inflammatory bowel disease (IBD). We aimed to assess the effect of NAFLD and liver fibrosis on intermediate–high cardiovascular risk in IBD. Methods We prospectively i...
Article
Full-text available
Background Current evidence suggests that biosimilar is safe and effective for patients with IBD. There is limited data on and nocebo effect after switching from originator to biosimilar. We aimed to report clinical efficacy, therapeutic drug monitoring, adverse events (AEs), and frequency of nocebo in IBD patients with biosimilar switches. Method...
Article
Full-text available
Background and aims: Objective monitoring and effective early treatment using a treat-to-target approach are key to improving therapeutic outcomes in IBD patients. This study aimed to assess adherence to objective monitoring (clinical, biomarkers, and endoscopy) and its impact on clinical outcomes. Methods: A prospective, multicenter study inclu...
Article
Full-text available
BACKGROUND Biologic therapy resulted in a significant positive impact on the management of inflammatory bowel disease (IBD) however data on the efficacy and side effects of these therapies in the elderly is scant. AIM To evaluate retrospectively the drug sustainability, effectiveness, and safety of the biologic therapies in the elderly IBD populat...
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
Full-text available
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 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
Full-text available
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
Full-text available
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
Full-text available
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
Full-text available
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
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
Full-text available
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...