UCSF Colitis and Crohn’s Disease Center (Clinical) UCSF IBD

• Center launched November 2001

• 3000 patients seen per year

• Reach throughout the western United States, Alaska, Hawaii and Asia

• Interdisciplinary care Clinical/Translational Research Investigator Initiated Research Clinical Trials Uma Mahadevan MD

Interests • Pregnancy and Fertility in IBD • Nutrition as therapy for IBD • Education in IBD Key Publications • Pregnancy and Neonatal Outcomes after Fetal Exposure to Biologics and Thiopruines among Women with Inflammatory Bowel Disease. Mahadevan U, et al Gastroenterology. 2020 Nov 20:S0016- 5085(20)35441-X. doi: 10.1053/j.gastro.2020.11.038. • Inflammatory Bowel Disease (IBD) in Pregnancy Clinical Care Pathway – A Report from the American Gastroenterological Association IBD Parenthood Project Working Group. Mahadevan U, Gastroenterology. 2019 Apr;156(5):1508-1524 Awards and Honors • Member, International Organization for Inflammatory Bowel Disease • Crohn’s Colitis Foundation Catalyst for Mission Advancement, Bay Area Chapter 2020 • Advisory Committee, Vaccines and in Pregnancy Surveillance System (VAMPSS) PIANO: Pregnancy and Neonatal Outcomes after Fetal Exposure To Biologics and Thiopurines among Women with Inflammatory Bowel Disease

No increase in: n=379 Spontaneous • Congenital Abortion malformations n=242 • Spontaneous abortions n=642 • Preterm birth No negative 1490 1431 • Low Birth Weight impact of drug • Infections in year exposure n=227 + • But with preterm birth What we have shown: qBiologic therapies cross the placenta to the baby qBut this is not harmful qBiologic therapies cross into breastmilk qBut this is not harmful q Having a flare of disease is harmful to mom and baby! qIncreases Cesarean section, miscarriage, preterm birth qBabies have qExcellent Developmental Milestones qSafe and Effective response to vaccines qNo increase over expected infections in daycare SEAMUS: Strictly Eating And Mucosal healing in • Seamus Mullen: • Celebrity Chef, Rheumatoid Arthritis Sufferer • Weaned off biologic therapy AND had radiographic improvement with his personally developed anti-inflammatory diet • Collaborating with UCSF for a pilot study of his Real Food diet in patients with mild to moderate UC • Endoscopic and microbiome changes will be measured before, during and at conclusion of study • Promising data will prompt larger trial Jonathan Terdiman MD Publications • Allegretti JR, Siddique SM, Sing S, Terdiman JP. American Gastroenterological Association Technical Review on the Pharmacological Management of Moderate to Severe Ulcerative Colitis. Gastroenterol 2020;158:1465-1496. • Feuerstein JD, Ho E, Singh H, Falck-Yitter YT, Sultan S, Terdiman JP. American Gastroenterological Association Clinical Practice Guidelines on the Pharmacologic Management of Moderate- Severe Luminal and Perianal Crohn’s Disease. Gastroenterology 2021, in press. Interests • Guideline development • Clinical decision support Awards • UCSF Academy of Medical Educators, 2005 • Northern California Crohn's and Colitis Foundation, Champion of Hope, 2012 • UCSF Department of Medicine, Master Clinician, 2013 • San Francisco Magazine, Top Doctor, 2016-2020 Michael Kattah MD PhD Studies • Growing intestinal organoids (mini-guts) from patients • Studying how IBD-associated genes affect the cells that line the gut • Using”multi-omics” single-cell approaches to identify signatures associated with disease and treatment response in IBD patients

Publications • Kattah MG, Shao L, et al. A20 and ABIN-1 synergistically preserve intestinal epithelial cell survival. J Exp Med. 2018 • Kattah MG, Milush JM, et al, Mahadevan U. Anti-TNF and thiopurine therapy in pregnant IBD patients does not significantly alter a panel of B-cell and T-cell subsets in 1-year-old infants. Clin Transl Gastroenterol. 2018 • Kattah MG, Malynn BA, Ma A. Ubiquitin-Modifying Enzymes and Regulation of the Inflammasome. J Mol Biol. 2017

Interests • Single-cell analysis and “multi-omics” approaches • Precision medicine (identifying the best treatment for each patient) • Supporting the transition of young adults from pediatric to adult GI clinic • Colitis associated with cancer

Awards • Burroughs Wellcome Fund Career Award for Medical Scientists • ImmunoX CoProject Pilot Award • Recognition for Scientific Accomplishment as an Early-Stage Investigator DDW Kendall Beck MD

Studies • Evaluating the role of sarcopenia and frailty in treatment response in IBD patients • Evaluating risk factors for endoscopy cancellation in the COVID era Publications • Beck KR, Kim NJ, Khalili M. Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans. Ann Hepatol. 2018 Apr 09; 17(3):413418. PMID: 29735789 • Lewin SM, Wen KW, Velayos FS, Mahadevan U, Beck KR. How Dye May Prevent Dying from Cancer: Perceiving Imperceptible Dysplasia in Inflammatory Bowel Disease. Dig Dis Sci. 2019 01; 64(1):52-55. PMID: 30523483 • Beck KR, Shah ED, Hernandez-Barco YG. Understanding device development for GI clinical care. Am J Gastroenterol. 2021, in press. • Shah ED, Hernandez-Barco YG, Beck KR, Levy BH. Understanding Drug Development for Clinical Care. Am J Gastroenterol. 2020 09; 115(9):1351-1352. PMID: 32453059 Interests • Medical management of the elderly patient with IBD • Quality improvement in general GI and IBD • Regulatory science • Diversity, Equity, and Inclusion within the GI division Awards • ACG-FDA fellowship award (2016) Sara Lewin MD

Studies • Efficacy, safety, and patient satisfaction of intensive outpatient therapy for moderate to severe ulcerative colitis • Improving quality of care for hospitalized IBD patients through the use of standard care protocols Clinical Trials • Darvadstrocel for the treatment of complex perianal fistulas Publications • Lewin SM & McConnell RA, et al Improving the Quality of Inpatient Ulcerative Colitis Management: Promoting Evidence-Based Practice and Reducing Care Variation With an Inpatient Protocol. Inflammatory Bowel Diseases. 2019;25(11):1822-1827. • Kotwani P, Terdiman J, Lewin S. Tofacitinib for rescue therapy in acute severe ulcerative colitis: a real-world experience. J Crohns Colitis. 2020 Jul 30; 14(7):1026- 1028 Interests • Management of hospitalized IBD patients • Use of novel and adjunct treatments for refractory IBD Awards • Haile T. Debas Academy of Medical Educators Excellence in Teaching Award, 2020 • American College of Gastroenterology Young Leaders Physician Scholar, 2018 Vivek Rudrapatna MD

Studies • Comparative effectiveness of IBD therapies in disease subgroups • Using electronic health records data to assess treatment effects in IBD patients at UCSF Health • Automated adverse event detection in patients on long-term immunosuppression Publications • Rudrapatna VA, Butte AJ. Opportunities and challenges in using real- world data for health care. J Clin Invest 2020;130:565–574. • Ko MS, Rudrapatna VA, Avila P, et al. Safety of Flexible Sigmoidoscopy in Pregnant Patients with Known or Suspected Inflammatory Bowel Disease. Dig Dis Sci 2020;65:2979–2985. • Rudrapatna VA, Butte AJ. Open data informatics and data repurposing for IBD. Nat Rev Gastroenterol Hepatol 2020; 15: 715-716. Interests • Machine learning • Clinical decision support • Precision medicine Awards • Vivli Pioneer award (2020) Najwa El-Nachef MD Studies • Optimizing Fecal Microbiota Transplant in mild to moderate Ulcerative Colitis • Fecal Microbiota Transplant in Pouchitis • ABI-M201 (microbial cocktail) in mild to moderate Ulcerative Colitis Key Publications • Fecal microbiota transplant for Crohn’s disease: A study evaluating safety, efficacy and microbiome profile. United European Gastroenterol J. 2019;7(6):807-814. • Capsule-Delivered Fecal Microbiota Transplant is safe and well tolerated in patients with Ulcerative Colitis. Dig Dis Sci 2019;64(9):2452-2454. • Fecal Microbiota Transplantation in Pouchitis: Clinical, Endoscopic, Histologic and Microbiota Results from a Pilot Study. Dig Dis Sci. 2020;65(4):1099-1106. Interests • Microbial Restoration Therapy in Inflammatory Bowel Disease • Deep enteroscopy • Fellow Education Awards • UEG Journal Best Paper Award 2019 • Marin Magazine Top Doctors 2020 Current Clinical Trials

• 3 full time study coordinators Current Trials Ulcerative Colitis Crohns Disease

IV steroids Upadactinib outpatient Tigenix (stem cell fistula) Ozanimod PAST TRIALS: Both Ulcerative Colitis Crohns Disease Lactoferrin Mongersen Trichuris Suis Ova ABT-874 (anti-il12/23) Budesonide Adacolumn Apheresis Celecoxib Sargramostim/Leukine Abatacept Rhumab β7 CDP870 Rituximab CCX82-B CNI-1493 PF-05285401 (multistem) Metronidzole ointment Etrolizumab firategrast (α4 integrin) tofacitinib Certolizumab Prochymal PF-04236921 (anti-IL6) Daikenchuto Education Graduate and Post-Graduate Education

• Monthly multidisciplinary case conference • Colorectal surgery, pathology, dermatology, rheumatology, infectious disease

• Annual UCSF IBD course (17th year) • 250 attendees from around the United States and Canada

• Advanced IBD Fellowship

• UCSF GI Fellows EPA Cases website – Colin Feuille, Cary Kraft IBD Fellowship: Training Future Leaders

• Brinda Truta: Johns Hopkins (2010-11) • Caroline Hwang: USC (2012) • Sarah Sheibani: USC (2013) • Kirk Lin: PAMF (2014) • Rebecca Matro: OHSU (2015) • Ryan Mcconnell: PAMF (2017) • Abhik Roy: Kaiser SL (2017) • Eric Mao: UC Davis (2018) • Sara Lewin UCSF (2018) • Bader Hammami UC Riverside, Loma Linda(2019) • Florence Odufalu USC (2020) • Colin Feuille (2020) • Rishika Chaugh (2021) Team IBD