Objective: Although in recent years the world has witnessed great advances in the medical field, much ambiguity still surrounds the issue of euthanasia and physician-assisted suicide, with increasingly favorable attitudes among physicians around the world. In our study, we aimed to assess the attitudes of physicians in Kuwait towards different types of euthanasia and examine whether physicians’ frequent encounters with terminally ill patients were associated with their approval. Subjects and Methods: We conducted a cross- sectional study on 464 physicians employed in government hospitals (6 general and 3 specialty hospitals). A self-administered questionnaire adapted from previous studies was used. Results: Of the physicians in our study, 43.9% reported that the Ministry of Health should legalize euthanasia under certain restricted conditions. In addition, 29.1% of our population was willing to perform euthanasia. After controlling for several characteristics in logistic regression analysis, approval of passive euthanasia was significantly associated with the following 2 factors: frequent exposure to terminally ill patients (AOR = 2.45) and obtention of the basic medical degree from Asia (AOR = 4.36) or North America/Europe (AOR = 3.24) compared to Kuwait. Male gender was significantly associated with willingness to perform euthanasia. Religion was the major reason for opposing euthanasia. Conclusion: The attitudes of physicians towards euthanasia are diverse, and therefore the Ministry of Health should provide guidelines for physicians dealing with situations where patients or their families request euthanasia.

Crohn’s disease (CD) and ulcerative colitis (UC), known as inflammatory bowel diseases (IBD), are characterized by chronic inflammation of the gastrointestinal tract. Over the last two decades, numerous medications have been developed and repurposed to induce and maintain remission in IBD patients. Despite the approval of multiple drugs, the major recurring issues continue to be primary non-response and secondary loss of response, as well as short- and long-term adverse events. Most clinical trials show percentages of response under 60%, possibly as a consequence of strict inclusion criteria and definitions of response. That is why these percentages appear to be more optimistic in real-life studies. A therapeutic ceiling has been used as a term to define this invisible bar that has not been crossed by any drug yet. This review highlights novel therapeutic target agents in phases II and III of development, such as sphingosine-1-phosphate receptor modulators, selective Janus kinase inhibitors, anti-interleukins, and other small molecules that are currently under research until 1 January 2023. Emerging treatments for CD and UC that have just received approval or are undergoing phase III clinical trials are also discussed in this review.

Background: COVID-19 vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They have also been shown to be safe and effective in patients with inflammatory bowel disease (IBD) who are receiving biologic therapies. In this study, we aimed to evaluate the prevalence of vaccination among patients receiving biologic therapies for IBD. Methods: A single-center prospective cross-sectional study conducted at a tertiary care inflammatory bowel disease center in Kuwait. Data from patients with inflammatory bowel disease (IBD) who attended the gastroenterology infusion clinic from 1 June 2021 until 31 October 2021 were retrieved. Patients who received infliximab or vedolizumab at least six weeks before recruitment were included. The primary outcome was prevalence of COVID-19 vaccination. The secondary outcome was to assess whether prevalence of COVID-19 vaccination differed based on sex, age, type of biologic therapy and nationality. Results: The total number of inflammatory bowel disease (IBD) patients enrolled in the study was 280 (56.0% male and 44.0% female). Of the total, 112 (40.0%) patients were diagnosed with ulcerative colitis and 168 (60.0%) with Crohn’s disease. The number of ulcerative colitis patients who were vaccinated was 49 (43.8%) and the number of Crohn’s disease patients who were vaccinated was 68 (40.5%). The median age was 33.2 years and BMI was 24.8 kg/m2. With respect to the total number of patients, 117 (41.8%) were vaccinated with either BNT162b2 or ChAdOx1 nCoV-19 and 163 (58.2%) were not vaccinated. Female patients were more likely to receive the vaccine compared to male patients (83.0% vs. 63.8%, p < 0.001). In addition, patients above the age 50 were more likely to receive the vaccine than patients below the age of 50 (95.6% vs. 31.2% p < 0.001). Expatriates were more likely to receive the vaccine than citizens (84.8% vs. 25.0%, p < 0.001). There was no statistical difference between patients on infliximab and vedolizumab with regard to prevalence of vaccination (40.0% vs 48.0%, p = 0.34). Conclusion: The overall prevalence of COVID-19 vaccination among patients with inflammatory bowel disease (IBD) on biologic therapies was lower than that of the general population and world health organization (WHO) recom-mendation. Female patients, patients above the age of 50, and expatriates were more likely to receive the vaccine. Physicians should reinforce the safety and efficacy of COVID-19 vaccines among patients, especially IBD patients on biologic therapies, who express hesitancy towards them.

BackgroundCOVID-19 Vaccinations have been shown to be effective in reducing risk of severe infection, hospitalization, and death. They also have been shown to be safe and effective in patients with inflammatory bowel disease (IBD) on biologic therapies. In this study, we aimed to evaluate the prevalence of vaccination among patients with IBD on biologic therapies.MethodsA single-center prospective cross-sectional study conducted at a tertiary care inflammatory bowel disease center. Data from patients with inflammatory bowel disease (IBD) who attended the gastroenterology infusion clinic from June 1st, 2021 until October 31st, 2021 were retrieved. Patients received infliximab or vedolizumab at least 6 weeks before recruitment were included. The primary outcome was prevalence of COVID-19 vaccination. The secondary outcome was to assess whether prevalence of COVID-19 vaccination differed based sex, age, type of biologic therapy and citizenship status.ResultsThe total number of inflammatory bowel disease (IBD) patients enrolled in the study was 280 (56.0% male and 44.0% female). The median age was 33.2 years and BMI was 24.8 kg/m2. 112 patients with ulcerative colitis (40.0%) and 168 (60.0%) with Crohn’s disease. 117 (41.8%) were vaccinated with either BNT162b2 or ChAdOx1 nCoV-19 and 163 (58.2%) were not vaccinated. Female patients were more likely to receive the vaccine compared to male patients (83.0% vs. 63.8%, p < 0.001). In addition, older patients (above the age 50) were also more likely to receive the vaccine than younger patients, below the age of 50 (95.6% vs 31.2% p< 0.001). Expatriates were more likely to receive the vaccine than citizens (84.8% vs 25.0%, p < 0.001). There was no statistical difference between patients on Infliximab and vedolizumab in terms of prevalence of vaccination (40.0% vs 48.0%, p= 0.34).ConclusionThe overall prevalence of COVID-19 vaccination among patients with inflammatory bowel disease (IBD) on biologic therapies was lower than the general population and world health organization (WHO) recommendation. Female patients, patients above the age of 50, and expatriates were more likely to be vaccinated. On the other hand, male patients, patients below the age of 50, and citizens were less likely to be vaccinated.