Rupert W Leong

Rupert W Leong
Sydney Local Health District | SLHD · Concord Hospital Department of Gastroenterology and Hepatology

MBBS, FRACP, MD, AGAF
Director of Endoscopy, Head of IBD Services, Concord Hospital Professor of Medicine, University of Sydney, Macquarie Uni

About

687
Publications
87,136
Reads
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17,356
Citations
Citations since 2016
311 Research Items
11684 Citations
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Introduction
Professor Rupert Leong is a Senior Staff Specialist gastroenterologist, Director of Endoscopy and Conjoint Professor of Medicine at UNSW, University of Sydney, Macquarie University and at Concord Hospital in Sydney, Australia. He is also the clinical lead of gastroenterology at Macquarie University Hospital. He performs endoscopy (gastroscopy and colonoscopy), EUS, and manages inflammatory bowel diseases (IBD, Crohn's, colitis). Dr Leong runs busy IBD Clinics at Concord Hospital - (+612 9767 6111) and private gastroenterology clinics at Macquarie University Hospital suite 404, 2 Technology Place (+612 98123880). His CBD rooms on level 11, 501 George St, Sydney (+612 83781721). www.rupertleong.com
Additional affiliations
November 2018 - present
Macquarie University Hospital
Position
  • Head of Department
January 2010 - December 2012
Concord Repatriation General Hospital
January 2009 - present
Education
January 2001 - December 2002
The Chinese University of Hong Kong
Field of study
  • Doctor of Medicine MD
January 1988 - December 1993
University of Western Australia
Field of study
  • Medicine

Publications

Publications (687)
Article
Smoking is the best-characterised environmental association of ulcerative colitis (UC). Smoking has been observed to exert protective effects on both the development and progression of UC. To examine the association between UC and smoking, possible pathogenic mechanisms and the potential of nicotine as a therapeutic agent in the treatment of UC. A...
Article
Inflammatory bowel diseases (IBD) may result in disability. We aim to validate a novel scoring system for the IBD disability index (IBD-DI), and identify predictors of disability and its correlation with work absenteeism. This prospective IBD ambulatory clinic cohort study measured IBD-DI, Crohn's Disease Activity Index (CDAI) for Crohn's disease (...
Article
Full-text available
Helicobacter pylori infects up to half of the world's population. It remains the major cause of peptic ulcer disease and is recognised as a carcinogen for its role in gastric carcinogenesis. Successful eradication of the bacteria is associated with improved health outcomes including fewer dyspeptic symptoms, reduced peptic ulcer recurrence and rebl...
Article
Poor adherence frequently impaired the efficacy of therapy to maintain remission from inflammatory bowel diseases (IBD). There is a lack of practical and effective interventions to improve adherence. This study aimed to identify modifiable risk factors, which may yield targets for new interventions. Participants with IBD were recruited from hospita...
Article
Full-text available
Immunomodulator therapy with the thiopurine analogues azathioprine or 6-mercaptopurine is commonly prescribed for the treatment of inflammatory bowel disease (IBD). Drug adverse effects and the lack of efficacy, however, commonly require withdrawal of therapy. Allopurinol, a xanthine oxidase inhibitor, was recently evaluated in its role in modifyin...
Article
Full-text available
The epithelial barrier’s primary role is to protect against entry of foreign and pathogenic elements. Both COVID-19 and Inflammatory Bowel Disease (IBD) show commonalities in symptoms and treatment with sensitization of the epithelial barrier inviting an immune response. In this study we use a multi-omics strategy to identify a common signature of...
Article
Background/aims: Biofeedback therapy is widely used to treat patients with chronic constipation, especially those with dyssynergic defecation. Yet, the utility of high-resolution manometry with novel parameters in the prediction of biofeedback response has not been reported. Thus, we constructed a model for predicting biofeedback therapy responder...
Conference Paper
Full-text available
Background and Aim: Ustekinumab (UST) is a monoclonal antibody targeting IL-12 and IL-23 through their shared p40 subunit. Although UST was approved for the treatment of moderate to severe Crohn's disease (CD) in Australia in September 2017, there are limited data investigating its utility in real-world clinical practice. Further, there are no pros...
Conference Paper
Background The use of immunomodulator (IMM) co-therapy with first-line and second-line anti-tumour necrosis factor agents (anti-TNF) varies worldwide. We aimed to examine the utilisation and impact of IMM co-therapy on real-world treatment persistence of first-line and second-line anti-TNF agents in Crohn’s disease (CD) and ulcerative colitis (UC)....
Conference Paper
Background Histological remission is increasingly accepted as a treatment endpoint in the management of ulcerative colitis (UC). However, the knowledge of histology guidelines and the attitudes towards their use in clinical practice by gastroenterologists and pathologists is unknown. We aimed to evaluate gastroenterologists’ and histopathologists’...
Conference Paper
Background Current treatment guidelines recommend achieving clinical and endoscopic remission for patients with ulcerative colitis (UC). However, histological remission is evolving as an important treatment target in UC. We aimed to evaluate histological activity as a predictor for clinical relapse in vedolizumab-treated patients in both clinical a...
Article
Objective Faecal microbiota transplantation (FMT) has variable efficacy in treating UC. Recently, oral lyophilised FMT was found to induce remission in patients with UC, with one donor having 100% efficacy compared with a second donor (36% efficacy). We characterised differences in the gut microbiota of these two donors with the aim of improving FM...
Article
Full-text available
Background and AimsThe value of ustekinumab (UST) therapeutic drug monitoring (TDM) in clinical practice remains unclear. This study examined the impact of UST TDM on clinical decision making in patients with Crohn’s disease (CD).MethodsA total of 110 consecutive UST-treated CD patients were enrolled in this multicenter, single-arm cross-sectional...
Article
Background/aims: We aimed to investigate the oral beclomethasone dipropionate's (BDP) efficacy as an add-on therapy and to clarify the predictive factor for response to oral BDP in Korean ulcerative colitis (UC) patients. Methods: Patients with a stable concomitant drug regimen with exposure to oral BDP (5 mg/day) within 30 days before BDP initi...
Article
Background The management of pregnant women with inflammatory bowel disease (IBD) is complex. We aimed to assess health care professionals’ (HCPs) theoretical and applied knowledge of pregnancy-related IBD issues. Methods A cross-sectional international survey was distributed to HCPs providing IBD care between October 2020 and March 2021. Knowledg...
Article
Background Active-comparator trials are important to inform patient and physician choice. We aimed to evaluate the efficacy and safety of monotherapy with either ustekinumab or adalimumab in biologic-naive patients with moderately to severely active Crohn's disease. Methods We conducted a randomised, double-blind, parallel-group, active-comparator...
Conference Paper
Introduction The management of pregnant women with inflammatory bowel disease (IBD) is complex. We aimed to assess healthcare professionals’ (HCP) theoretical and applied knowledge of pregnancy-related IBD issues. Methods A cross-sectional international survey was distributed to HCPs providing IBD care between October 2020 and March 2021. Knowledg...
Conference Paper
Introduction Fecundity may be reduced in women with active inflammatory bowel disease (IBD) or prior IBD-related surgery, and these women may require assisted reproductive technology (ART). There are no guidelines for women with IBD to outline referral criteria for ART. Methods We performed a prospective, multicentre, international questionnaire o...
Preprint
Indocyanine green (ICG) has been used in clinical practice for more than 40 years and its safety and preferential accumulation of ICG in tumors has been reported for various tumor types, including colon cancer. However, reports on the clinical assessments of ICG-based molecular endoscopy imaging for pre-cancerous lesions are scarce. Therefore, we d...
Article
Background/aims: Fecal S100A12 (FS) and serum S100A12 (SS) have been reported as novel biomarkers that accurately reflect intestinal inflammation. We evaluated if FS and SS in comparison to fecal calprotectin (FC) are associated with poor future outcomes in clinically quiescent Crohn's disease (CD) patients. Methods: We prospectively enrolled 49...
Article
Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guid...
Article
Full-text available
Background Owing to an increased number of colonoscopy screenings, the incidence of diagnosed rectal neuroendocrine tumors (NETs) has also increased. Tumor size is one of the most frequently regarded factors when selecting treatment; however, it may not be the determinant prognostic variable. We aimed to evaluate oncological outcomes according to t...
Article
Background and aims WingCap is a novel distal attachment device for colonoscopy that combines a cap and an existing mucosal exposure device, such as Endocuff or AmplifEye. We aimed to investigate whether WingCap-assisted colonoscopy can improve the adenoma detection rate (ADR) and adenoma per colonoscopy (APC) and simultaneously shorten caecal intu...
Article
Full-text available
Introduction Fecundity may be reduced in women with active inflammatory bowel disease (IBD) or prior IBD-related surgery, and these women may require assisted reproductive technology (ART). There are no guidelines for women with IBD to outline referral criteria for ART. Methods We performed a prospective, multicentre, international questionnaire o...
Article
Full-text available
Background and aims: The UNIFI long-term extension (LTE) study reports the efficacy and safety of subcutaneous 90 mg ustekinumab through three years of maintenance therapy. Methods: Patients randomized to ustekinumab q12w or q8w at maintenance baseline (N=348) and randomized ustekinumab-treated patients in the LTE (N=284) were evaluated. Symptom...
Article
Background In the UNIFI study of ustekinumab (UST) in ulcerative colitis (UC), patients who achieved histo-endoscopic mucosal healing (HEMH; ie, both histologic and endoscopic improvement of mucosa) after induction had higher clinical remission and corticosteroid-free clinical remission rates through 1 year than those who achieved either histologic...
Article
Introduction: Although endoscopic healing (EH) is recommended as the therapeutic goal in patients with Crohn's disease (CD), combined EH and radiologic healing (RH) could be a more ideal therapeutic goal considering the transmural nature of CD. We compared the prognosis of patients with CD who achieved EH, RH, both EH and RH (deep healing; DH), or...
Article
Background and Aim Evidence has emerged that a pretreatment immune profile in rectal cancer is associated with response to chemoradiotherapy (CRT) and recurrence after CRT. However, few studies have evaluated the immune profile differences after CRT regarding recurrence and nonrecurrence. Methods We included patients with advanced rectal cancer tr...
Article
In 2020, the novel coronavirus disease 2019 (COVID-19) began to spread worldwide and remains an ongoing medical challenge. This case series reports on the clinical features and characteristics of patients with inflammatory bowel disease (IBD) and confirmed COVID-19 infection. From February 2020 to March 2021, nine patients with IBD had confirmed CO...
Article
Background Faecal microbiota transplantation (FMT) delivered via colonoscopic infusion or enemas have been shown to induce remission in a proportion of patients with active ulcerative colitis. Whether orally administered FMT is effective in ulcerative colitis is unknown. We aimed to assess the efficacy of oral lyophilised FMT for the treatment of a...
Article
Background/aims: Polyethylene glycol (PEG)-based bowel preparations are effective cleansing agents for colonoscopy. However, they require relatively large volumes to be used even with agents such as 2 L PEG with ascorbate (2LPEG). This phase 3, randomized, single-blinded, multicenter, parallel-group study compared the efficacy of 1 L PEG with high...
Article
Full-text available
Despite recent developments in therapy for inflammatory bowel diseases (IBDs), there have been limited advances in diagnostic tools available to aid in disease management. A growing body of evidence suggests that there are important host-microbe interactions at the mucosal interface that modulate the inflammatory response in patients with IBD. Addi...
Article
Full-text available
Background Chronic viral hepatitis is associated with a wide range of extrahepatic diseases; however, evidence on a link between chronic viral hepatitis and colorectal neoplasia is still lacking. Aims To analyze the association between chronic viral hepatitis and prevalence of colorectal neoplasia. Methods A systematic review of articles publishe...
Article
Introduction: Infertility may occur in women with Crohn's disease (CD) and ulcerative colitis (UC), especially after surgery such as ileal pouch-anal anastomosis (IPAA). Assisted reproductive technology (ART) may be an option, but the safety and efficacy in this setting has been based on small cohorts to date. We performed a systematic review and...
Article
Full-text available
Background Anti-tumor necrosis factor (TNF) treatment for inflammatory bowel disease (IBD) increases the risk of tuberculosis (TB) infection. In the present study, we analyzed the clinical characteristics and risks of TB in Korean patients with IBD who received anti-TNF treatment. Methods The study included patients with IBD who were treated using...
Article
Objectives: Post-polypectomy surveillance intervals should be determined based on index colonoscopy findings. However, the risk of metachronous lesions, resulting from the coexistence of adenoma and sessile serrated lesions (SSLs), has rarely been addressed. We evaluated the impact of synchronous SSL on the risk of metachronous lesions within simi...
Article
Full-text available
Backgrounds: It is not clear when and how frequently surveillance endoscopy should be performed after colorectal endoscopic submucosal dissection (ESD). We aimed to suggest a surveillance endoscopy strategy by investigating the cumulative local recurrence rates and identifying risk factors for local recurrence after colorectal ESD. Methods: We r...
Article
Background and Aims The 1-L PEG-based bowel preparation agent NER1006 (Plenvu) has shown high cleansing efficacy and tolerability in clinical trials in Europe and North America. However, no clinical trials have been reported yet in Asia. Therefore, the aim of this study was to evaluate the efficacy and safety of 1L PEG-based bowel preparation with...
Article
Full-text available
This study aimed to evaluate self-reported vaccination rates, immunity, knowledge of and attitudes toward vaccination among Korean patients with inflammatory bowel disease (IBD) as well as to identify factors associated with proper vaccination. Between November 2013 and February 2015, consecutive patients with IBD were invited to complete a standar...
Article
Full-text available
Background: The Rutgeerts score is used to predict postoperative recurrence in CD patients after ileocolic resection and is primarily based on endoscopic findings at the neoterminal ileum. However, the optimal assessment of anastomotic ulcers (AUs) remains subject to debate. Aims: We aimed to investigate the association between anastomotic ulcer...
Article
Full-text available
Introduction Immunomodulators remain fundamental for the medical treatment of Crohn’s disease (CD). Methotrexate (MTX) is widely used as a second-line immunomodulator; however, there is a lack of recent data on MTX monotherapy among the Asian population with CD. Therefore, in this study, we aimed to investigate the tolerability and clinical outcome...
Article
Full-text available
For the sensitive diagnosis of colorectal cancer lesions, advanced molecular imaging techniques using cancer-specific targets have emerged. However, issues regarding the clearance of unbound probes and immunogenicity remain unresolved. To overcome these limitations, we developed a small-sized scFv antibody fragment conjugated with FITC for the real...
Article
Background/aims: The worldwide coronavirus disease 2019 pandemic has led endoscopists to use personal protective equipment (PPE) for infection prevention. This study aimed to investigate whether wearing a face shield as PPE affects the quality of colonoscopy. Methods: We reviewed the medical records and colonoscopy findings of patients who under...
Article
Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy appointed a Task Force to draft clinical practice guidelines for EUS-guided tissue acquisition...
Article
Full-text available
Methods: We retrospectively reviewed the medical records of IBD patients who visited Asan Medical center. We used a large, well-characterized referral center-based cohort. The clinical features of IBD patients with body mass index (BMI) over 30 and matched controls with BMI under 30 were compared. Results: Among the 6,803 IBD patients enrolled i...
Article
Full-text available
Background Medication persistence contributes real-world evidence about treatment effectiveness, tolerability and prescriber and patient acceptability. Aims To evaluate persistence of biological agents in Crohn's disease (CD) and ulcerative colitis (UC) and the effects of immunomodulator use and treatment lines. Methods Retrospective national pop...
Article
Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy appointed a Task Force to draft clinical practice guidelines for EUS-guided tissue acquisition...
Article
The Korean Society of Gastrointestinal Endoscopy developed medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidencebased Healthcare Collaborating Agency. Previous studies on peripancreatic fluid collections (PFCs) were searched, and certain studies were selected with the help of ex...
Article
Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guid...
Article
The phosphorous balance is clinically important in increasing the long-term outcomes and preventing complications of end-stage renal disease. Sevelamer is a phosphate binder used widely to regulate hyperphosphatemia. On the other hand, gastrointestinal side effects increase with increasing sevelamer intake. A 29-year-old male with end-stage renal d...
Article
Full-text available
Small rectal neuroendocrine tumors (NETs) can be treated using cap-assisted endoscopic mucosal resection (EMR-C), which requires additional effort to apply a dedicated cap and snare. We aimed to evaluate the feasibility of a simpler modified endoscopic mucosal resection (EMR) technique, so-called anchored snare-tip EMR (ASEMR), for the treatment of...