Clinical and Biomedical Sciences

Exeter IBD and Pharmacogenetics Research Group

The Exeter IBD Research group was established in 2011. Since then  we have developed themes around early diagnosis, prediction of treatment-associated adverse drug reactions (ADRs), optimising and monitoring of treatment and interactions between IBD treatments and other therapeutic interventions including SARS-CoV-2 vaccination.

To deliver our NIHR portfolio-adopted studies we have created a network of 145 UK hospitals located in all 4 nations, with central laboratory facilities embedded in the RDUH NHS Blood sciences department. Our studies have employed innovative strategies to ensure efficient, patient-friendly trial delivery presented in multiple languages and formats, as reported by NIHR Stories: CLARITY IBD Changing the way we do research

Our research has been published in high impact journals (Nature Genetics, Nature Communications, JAMA, GUT, Gastroenterology, Lancet Gastro & Hepatol) and recognised by awards from the European Crohn’s and colitis organisation (ECCO) in 2018 and 2021 and the BSG/NIHR research team award for an outstanding contribution to the NIHR portfolio in 2021. Our SCImago rank placed us number 1 in the UK for gastroenterology in 2024 based on research performance, innovation outputs and societal impact. 

Tariq Ahmad

Professor of Gastroenterology, University of Exeter Medical School

Consultant Gastroenterologist, Royal Devon University Healthcare NHS Foundation trust

email: tariq.ahmad1@nhs.net
Nick Kennedy

Honorary Senior Clinical Lecturer, University of Exeter Medical School

Consultant Gastroenterologist, Royal Devon University Healthcare NHS Foundation trust

email: nick.kennedy1@nhs.net
James Goodhand

Honorary Senior Clinical Lecturer, University of Exeter Medical School

Consultant Gastroenterologist, Royal Devon University Healthcare NHS Foundation trust

james.goodhand@nhs.net
Claire Bewshea - Exeter IBD and Pharmacogenetics Research Group Members Claire Bewshea

Group Manager

email: claire.bewshea@nhs.net
Rebecca Smith - Exeter IBD and Pharmacogenetics Research Group Members Rebecca Smith 

IBD Research Fellow

Gastroenterology Specialist Registrar

email: rebecca.smith317@exeter.ac.uk
  Chris Roberts 

Academic Clinical Fellow in Gastroenterology

Internal Medicine Trainee

email: chris.roberts14@nhs.net
Rachel Nice - Exeter IBD and Pharmacogenetics Research Group Members Rachel Nice

PhD Student

Senior Biomedical Scientist

email: rachel.nice@nhs.net
  Phoebe Hodges

Clinical Fellow in Gastroenterology 

email: phoebe.hodges1@nhs.net
  Fakhirah Badrulhisham

IBD Clinical Research Fellow 

f.badrulhisham@nhs.net
Marian Parkinson - Exeter IBD and Pharmacogenetics Research Group Members Marian Parkinson

Project Co-ordinator 

email: marian.parkinson@nhs.net
  Helen Gardener-Thorpe

Group administrator 

email: h.gardner-thorpe@nhs.net
  Alumni

Maria Bishara

Neil Chanchlani

Simeng Lin

Benjamin Hamilton

Malik Janjua

Desmond Chee

Claire Gordan

Amanda Thomas

Gareth Walker

Neel Heerasing

Peter Hendy

Graham Heap

Abhey Singh

Kenji So

CLARITY IBD 

Read about the COVID-19 study and the impact it had on how research is conducted NIHR Stories

CLARITY IBD Results

PANTS

PANTS - Personalised Anti-TNF Therapy in Crohn's disease

PRED4

PRED4 - Predicting Serious Drug Side Effects in Gastroenterology

More information is available on our external site. 

Email the Exeter IBD and Pharmacogenetics Group 

 

  1. Chanchlani et al. Mechanisms and management of loss of response to anti-TNF therapy for patients with Crohn's disease: 3-year data from the prospective, multicentre PANTS cohort study. Lancet Gastroenterol Hepatol. 2024 Apr 16:S2468-1253(24)00044-X. doi: 10.1016/S2468-1253(24)00044-X. PMID: 38640937
  1. Liu Z et al. Antibody Responses to Influenza Vaccination are Diminished in Patients With Inflammatory Bowel Disease on Infliximab or Tofacitinib. J Crohns Colitis. 2024 Apr 23;18(4):560-569. doi: 10.1093/ecco-jcc/jjad182. PMID: 37941436
  2. Liu Z et al. Neutralising antibody responses against SARS-CoV-2 Omicron BA.4/5 and wild-type virus in patients with inflammatory bowel disease following three doses of COVID-19 vaccine (VIP): a prospective, multicentre, cohort study. EClinicalMedicine. 2023 Oct 5;64:102249. doi: 10.1016/j.eclinm.2023.102249. eCollection 2023 Oct. PMID: 37842172

 

  1. Bai BYH et al. Baseline expression of immune gene modules in blood is associated with primary response to anti-TNF therapy in Crohn's disease patients. J Crohns Colitis. 2023 Sep 30:jjad166. doi: 10.1093/ecco-jcc/jjad166. Online ahead of print. PMID: 37776235

 

  1. Chapman T, Ahmad T, Satsangi J. Editorial: Use of immunomodulators in combination with infliximab in Crohn’s disease: time for a reappraisal? Lancet Gastroenterol Hepatol. 2024 (in press)

 

  1. Lin S et al. Whole blood DNA methylation changes are associated with anti-TNF drug concentration in patients with Crohn's disease. J Crohns Colitis. 2023 Aug 8:jjad133. doi: 10.1093/ecco-jcc/jjad133. Online ahead of print PMID: 37551994

 

  1. Yu N et al. Prevalence of NUDT15 genetic variants and incidence of thiopurine-induced leukopenia in Inflammatory Bowel Disease: A systematic review and meta-analysis. J Crohns Colitis. 2023 Jun 22:jjad107. doi: 10.1093/ecco-jcc/jjad107. Online ahead of print. PMID: 37346013

 

  1. Hanić M et al. Anti-TNF Biologicals Enhance the Anti-Inflammatory Properties of IgG N-Glycome in Crohn's Disease. 2023 Jun 7;13(6):954. doi: 10.3390/biom13060954.PMID: 37371534 

 

  1. Pretreatment Vitamin D Concentrations Do Not Predict Therapeutic Outcome to Anti-TNF Therapies in Biologic-Naïve Patients With Active Luminal Crohn's Disease. Chanchlani N et al. Crohns Colitis 360. 2023 May 15;5(3):otad026. doi: 10.1093/crocol/otad026. eCollection 2023 Jul.PMID: 37265586 

 

  1. Alexander JL et al. The gut microbiota and metabolome are associated with diminished COVID-19 vaccine-induced antibody responses in immunosuppressed inflammatory bowel disease patients. 2023 Feb;88:104430. doi: 10.1016/j.ebiom.2022.104430. Epub 2023 Jan 10.PMID: 36634565

 

  1. Liu Z et al. Neutralising antibody potency against SARS-CoV-2 wild-type and omicron BA.1 and BA.4/5 variants in patients with inflammatory bowel disease treated with infliximab and vedolizumab after three doses of COVID-19 vaccine (CLARITY IBD): an analysis of a prospective multicentre cohort study. Lancet Gastroenterol Hepatol. 2023 Feb;8(2):145-156.

 

  1. Liu Z et al. Infliximab and Tofacitinib Attenuate Neutralizing Antibody Responses Against SARS-CoV-2 Ancestral and Omicron Variants in Inflammatory Bowel Disease Patients After 3 Doses of COVID-19 Vaccine.  Gastroenterology. 2023 Feb;164(2):300-303.e3.

 

  1. Kennedy NA et al. Vaccine escape, increased breakthrough and reinfection in infliximab-treated patients with IBD during the Omicron wave of the SARS-CoV-2 pandemic. Gut. 2023 Feb;72(2):295-305.

 

  1. Alexander JL et al.  COVID-19 vaccine-induced antibody and T-cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose (VIP): a multicentre, prospective, case-control study. Lancet Gastroenterol Hepatol. 2022 Nov;7(11):1005-1015.

 

  1. Chanchlani N et al.  Implications for sequencing of biologic therapy and choice of second anti-TNF in patients with inflammatory bowel disease: results from the IMmunogenicity to Second Anti-TNF therapy (IMSAT) therapeutic drug monitoring study. Aliment Pharmacol Ther. 2022 Oct;56(8):1250-1263.

 

  1. Lin S et al. Understanding anti-TNF treatment failure: does serum triiodothyronine-to-thyroxine (T3/T4) ratio predict therapeutic outcome to anti-TNF therapies in biologic-naïve patients with active luminal Crohn's disease? Aliment Pharmacol Ther. 2022 Sep;56(5):783-793.

 

  1. Lin S et al. Antibody decay, T cell immunity and breakthrough infections following two SARS-CoV-2 vaccine doses in inflammatory bowel disease patients treated with infliximab and vedolizumab. Nat Commun 2022 Mar 16;13(1):1379. doi: 10.1038/s41467-022-28517-z.

 

  1. Alexander JL et al. COVID-19 vaccine-induced antibody responses in immunosuppressed patients with inflammatory bowel disease (VIP): a multicentre, prospective, case-control study. Lancet Gastroenterol Hepatol. 2022 Feb 3:S2468-1253(22)00005-X.

 

  1. Chanchlani N et al. Adalimumab and infliximab impair SARS-CoV-2 antibody responses: results from a therapeutic drug monitoring study in 11422 biologic-treated patients. J Crohns Colitis. 2021 Sep 2:jjab153.

 

  1. Chee D et al.  Patient-led Remote IntraCapillary pharmacoKinetic Sampling (fingerPRICKS) for therapeutic drug monitoring in patients with inflammatory bowel disease. J Crohns Colitis. 2021 Jul 21:jjab128.

 

  1. Kennedy NA et al. Anti-SARS-CoV-2 antibody responses are attenuated in patients with IBD treated with infliximab. Gut. 2021 May;70(5):865-875.

 

  1. Kennedy NA et al. Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD. Gut. 2021 Apr 26:gutjnl-2021-324789.

 

  1. Nice R et al. Validating the positivity thresholds of anti-infliximab and anti-adalimumab drug-tolerant assays. Aliment Pharmacol Ther. 2021 Jan;53(1):128-137.

 

  1. Gordon C et al. Root-cause analyses of missed opportunities for the diagnosis of colorectal cancer in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2021 Jan;53(2):291-301.

 

  1. Honap S et al.  Real-World Effectiveness of Tofacitinib for Moderate to Severe Ulcerative Colitis: A Multi-Centre UK Experience. J Crohns Colitis. 2020 Oct 5;14(10):1385-1393. 

 

  1. Walker GJ et al. Primary care faecal calprotectin testing in children with suspected inflammatory bowel disease: a diagnostic accuracy study. Arch Dis Child. 2020 Oct;105(10):957-963. 

 

  1. Chee D et al. Editorial: is pharmacogenetic testing for adverse effects to IBD treatments ready for roll-out? Aliment Pharmacol Ther. 2020 Sep;52(6):1076-1077. 

 

  1. Walker GJ et al. Quality improvement project identifies factors associated with delay in IBD diagnosis. Aliment Pharmacol Ther. 2020 Aug;52(3):471-480. 

 

  1. Green HD et al. Genetic evidence that higher central adiposity causes gastro-oesophageal reflux disease: a Mendelian randomization study. Int J Epidemiol. 2020 Aug 1;49(4):1270-1281. 

 

  1. Kennedy NA et al. British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic. Gut. 2020 Jun;69(6):984-990. 

 

  1. Hamilton B et al. Incidence and prevalence of inflammatory bowel disease in Devon, UK. Frontline Gastroenterol. 2020 Jun 24;12(6):461-470. 

 

  1. Lin S et al. Clinical features and genetic risk of demyelination following anti-TNF treatment. J Crohns Colitis. 2020 Jun 4:jjaa104. 

 

  1. Sazonovs A et al. HLA-DQA1 05 Carriage Associated With Development of Anti-Drug Antibodies to Infliximab and Adalimumab in Patients With Crohn’s Disease. Gastroenterology. 2020 Jan;158(1):189-199.

 

  1. Green HD et al.  Genome-Wide Association Study of Microscopic Colitis in the UK Biobank Confirms Immune-Related Pathogenesis. J Crohns Colitis. 2019 Dec 10;13(12):1578-1582. 

 

  1. Wilkinson B et al. Factors associated with depression in people with inflammatory bowel disease: The relationship between active disease and biases in neurocognitive processing. Neurogastroenterol Motil. 2019 Aug;31(8):e13647.

 

  1. Walker GJ et al. Association of Genetic Variants in NUDT15 With Thiopurine-Induced Myelosuppression in Patients With Inflammatory Bowel Disease. JAMA. 2019 Feb 26;321(8):773-785. 

 

  1. Kennedy NA et al.  Predictors of anti-TNF treatment failure in anti-TNF-naive patients with active luminal Crohn's disease: a prospective, multicentre, cohort study. Lancet Gastroenterol Hepatol. 2019 Feb 26. pii: S2468-1253(19)30012-3. 

 

  1. Walker GJ, Ahmad T. Drug toxicity: personalising IBD therapeutics–the use of genetic biomarkers to reduce drug toxicity. Biomarkers in Inflammatory Bowel Diseases. 257-269. Springer, Cham. 2019.

 

  1. Walker GJ et al. Faecal calprotectin effectively excludes inflammatory bowel disease in 789 symptomatic young adults with/without alarm symptoms: a prospective UK primary care cohort study. Aliment Pharmacol Ther. 2018 Apr;47(8):1103-1116. 

 

  1. Heerasing N et al. Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn's disease. Aliment Pharmacol Ther. 2017 Mar;45(5):660-669. 

 

  1. Carrieri D et al. Ethical issues and best practice in clinically based genomic research: Exeter Stakeholders Meeting Report. J Med Ethics. 2016 Sep 27. pii: medethics-2016-103530. doi: 10.1136/medethics-2016-103530. [Epub ahead of print] PubMed PMID: 27677925; PubMed Central PMCID: PMC5136727. 

 

  1. Heap GA et al. Clinical Features and HLA Association of 5-Aminosalicylate (5-ASA)-induced Nephrotoxicity in Inflammatory Bowel Disease. J Crohns Colitis. 2016 Feb;10(2):149-58. doi: 10.1093/ecco-jcc/jjv219. Epub 2015 Nov 29. PubMed PMID: 26619893. 

 

  1. Perry M et al. Infliximab and adalimumab are stable in whole blood clotted samples for seven days at room temperature. Ann Clin Biochem. 2015 Nov;52(Pt 6):672-4. doi: 10.1177/0004563215580001. Epub 2015 Mar 16. PubMed PMID: 25780249. 

 

  1. Heap GA et al. HLA-DQA1-HLA-DRB1 variants confer susceptibility to pancreatitis induced by thiopurine immunosuppressants. Nat Genet. 2014 Oct;46(10):1131-4. doi: 10.1038/ng.3093. Epub 2014 Sep 14. PubMed PMID: 25217962.