The work of Dr. Sidney Truelove in the 1960s radically changed our vision of ulcerative colitis and what later was to be called “Inflammatory Bowel Disease”.
We must also remember that it was Dr. Truelove’s meticulous and well-designed clinical studies that showed, among other things, the utility of glucocorticoids in those suffering from acute ulcerative colitis — a treatment plan that has been unaltered since then.
IOIBD – a brief history
The International Organisation for the Study of Inflammatory Bowel Disease (IOIBD) was formally constituted at a meeting held in Lyon in April 1981 which was hosted by Professor Louis Descos and Dr Claude Andre. A number of events had led up to this occasion. There had been an international IBD Workshop held in Cape Town in 1979, hosted by Professor Solly Marks and Dr John Wright, and then in June 1980 Professor Salvador Pena together with Professor Sir Christopher Booth and Dr Warren Strober organised another meeting near Leiden in Holland. One of the topical points for discussion was how to assess disease activity in patients with Crohn’s disease. This interest had been generated by the development and validation of the Crohn’s Disease Activity Index by the National Cooperative Crohn’s Disease Study Group in North America led by Dr John Singleton and Dr Bill Best. For the first time, this tool allowed a reliable way of providing a standardised way of assessing disease activity and made possible multicentre therapeutic trials in Crohn’s disease. However, soon after the NCCDS published the CDAI in 1976, another Activity Index was published from Holland by Dr Peter van Hees and Professor van Tongeren. During the Leiden meeting in 1980 data were presented demonstrating that there was a poor correlation between these two indices, largely due to the fact that the Dutch Index was based on parameters of inflammation. During the final discussion period, Dr Sidney Truelove and Mr Emanoel Lee proposed that a further meeting was held to allow more discussion of disease activity and to develop plans for future research. They offered to host the meeting in Oxford.
Accordingly, a small meeting was held in September 1980 in order to plan a formal meeting in November. That took place in Oxford on Nov 7tth and 8th ( a list of those attending is added as an Appendix ). Dr Truelove opened the meeting and stated very clearly that the aim was to lead towards obtaining agreement on an international index of Crohn’s disease activity. It was rapidly agreed that if an index was to be used, and there was some dissension on the utility of using an index, then it would be difficult to devise a single index that would collate all aspects of the disease. It was suggested that 4 separate indices could be developed and the meeting split into 4 groups to discuss this: clinical features of severity (led by Mr Tim de Dombal ), a morphological index based on radiological/endoscopic features ( led by Professor John Lennard-Jones ), an index based on laboratory parameters of inflammation (led by Dr Derek Jewell ) and a nutritional index (led by Dr Robert Allan ). A sub-group consisting of Tim de Dombal, Peter van Hees and Bill Best was formed to oversee and refine the outcome of these 4 groups and then develop means of testing the validity of the new indices in terms of overall clinical assessment and subsequent clinical course. Louis Descos and Claude Andre invited everyone to attend a further meeting in Lyon in April 1981 in order to present the deliberations of the four groups and to continue the discussion.
It was about 3 weeks prior to the Lyon meeting that Dr Truelove began to develop the idea that the group needed to have a formal identity and that an informal workshop would not provide for an ongoing discussion group that would have scientific outcome. After lively discussion in Lyon, the decision was made to draw up a constitution and by-laws for an International Organisation for the Study of Inflammatory Bowel Disease. It was agreed that the group would stay small (membership was limited to 50 until very recently and is now only slightly larger) and that the group would meet annually. This has remained the pattern but several other developments have taken place which have extended the activity of the Organisation.
- The 1987 meeting was held at the Cleveland Clinic, hosted by Dr Richard Farmer, and it was at that meeting that it was agreed that industry could send representatives to attend the scientific sessions of the annual general meeting This facilitated sharing preliminary data and establishing networks for clinical studies.
- In 1997, the financial health of the Organisation was such that it was possible to set up a Foundation for Research and Education. At the time, Dr Robert Lofberg was the Treasurer and thus the Foundation is based in Sweden. It has allowed research grants to be awarded on an annual basis which has greatly improved the scientific output from the Organisation. These grants are awarded in open competition amongst Members following external reviews.
- The initial aims of the Organisation were focussed very much on clinical research, epidemiology and clinical trials and this has continued to be the case. However, it was considered important to be kept aware of developments in basic science. Thus, in 1997 the Truelove Lecture was introduced to allow the Organisation to invite a leading scientist interested in IBD to provide an overview of his work. The first Truelove Lecturer was Dr Warren Strober (Assissi, 1997).
- There has always been a vigorous self-criticism about the Organisation being just a talking shop rather than producing an ongoing scientific outcome. To encourage the latter, Members were assigned to different task forces ( eg epidemiology, clinical trials, pathobiology, surgery ) in order to formulate specific research plans. This developed in around 1993 and has allowed the Organisation to remain as a forum for new ideas and facilitator for a steady stream of scientific publications.
- To keep an active membership, there are attendance rules which currently demand attendance twice every four years.
- If vacancies occur within the membership, either due to failing to meet attendance rules or because a member reaches the age of 65 and transfers to senior member status or because of resignation, nominations for new members will be sought from the membership. The Executive Committee then makes recommendations for election at the next Annual Business Meeting.
At the onset IOIBD included members from Europe, USA, Canada and South Africa. Subsequently it has continued to live up to its “international” intent and now includes members from Australia and Japan. Meetings are held in locations which are proposed by members willing to host the meeting and are truly global i.e. 2008 (Kyoto), 2009 (Phoenix), 2010 (Crete), 2011 (Bruges), 2012 (Melbourne), 2013 (New York), 2014 (Amsterdam), 2015 (Montreal), Tel Aviv (2016), Stresa-Lago Maggiore (2017), Rio de Janeiro (2018).
Compiled and submitted by Derek Jewell
Those attending the 1980 Oxford meeting:
- Dr S C Truelove UK
- Mr E Lee UK
- Mr F T de Dombal UK
- Dr C Andre France
- Dr R Allan UK
- Dr W R Best USA
- Dr I Biemond Netherlands
- Professor L Descos France
- Dr R G Farmer USA
- Dr P A M van Hees Netherlands
- Dr G Hellers Sweden
- Dr H G F Hodgson UK
- Dr D P Jewell UK
- Professor J Lennard-Jones UK
- Dr H Malchow Germany
- Professor S Marks South Africa
- Dr J Singleton USA
- Dr J H M van Tongeren Netherlands
- Dr I Weterman Netherlands
- Dr J Wright South Africa