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Alimentary Pharmacology & Therapeutics

Grace Lai-Hung Wong, Andy Jinhua Ma, Huiqi Deng, Jessica Yuet-Ling Ching, Vincent Wai-Sun Wong, Yee-Kit Tse, Terry Cheuk-Fung Yip, Louis Ho-Shing Lau, Henry Hin-Wai Liu, Chi-Man Leung, Steven Woon-Choy Tsang, Chun-Wing Chan, James Yun-Wong Lau, Pong-Chi Yuen, Francis Ka-Leung Chan
BACKGROUND: Patients with a history of Helicobacter pylori-negative idiopathic bleeding ulcers have an increased risk of recurring ulcer complications. AIM: To build a machine learning model to identify patients at high risk for recurrent ulcer bleeding. METHODS: Data from a retrospective cohort of 22 854 patients (training cohort) diagnosed with peptic ulcer disease in 2007-2016 were analysed to build a model (IPU-ML) to predict recurrent ulcer bleeding...
February 13, 2019: Alimentary Pharmacology & Therapeutics
Bridget Bishop, Nicholas Hannah, Adam Doyle, Francesco Amico, Brad Hockey, David Moore, Siddharth Sood, Alexandra Gorelik, Danny Liew, Dolores Njoku, Amanda Nicoll
BACKGROUND: Volatile anaesthetics are known to cause drug-induced liver injury, a hepatotoxic reaction characterised by antibodies to trifluoroacetylated lipid and protein adducts and cytochrome p450 2E1. The incidence of volatile anaesthetic drug-induced liver injury from older agents has been described, but modern agents have not been prospectively studied. AIM: To determine prospectively the incidence of volatile anaesthetic drug-induced liver injury from sevoflurane and desflurane...
February 13, 2019: Alimentary Pharmacology & Therapeutics
Arie Regev, Melissa Palmer, Mark I Avigan, Lara Dimick-Santos, William R Treem, John F Marcinak, Daniel Seekins, Gopal Krishna, Frank A Anania, James W Freston, James H Lewis, Arun J Sanyal, Naga Chalasani
BACKGROUND: The last decade has seen a rapid growth in the number of clinical trials enrolling patients with nonalcoholic fatty liver disease and nonalcoholic steatohepatitis (NASH). Due to the underlying chronic liver disease, patients with NASH often require different approaches to the assessment and management of suspected drug-induced liver injury (DILI) compared to patients with healthy livers. However, currently no regulatory guidelines or position papers systematically address best practices pertaining to DILI in NASH clinical trials...
February 13, 2019: Alimentary Pharmacology & Therapeutics
Priscila Santiago, Ingrid Schwartz, Leonardo Tamariz, Cynthia Levy
BACKGROUND: First-line treatment for autoimmune hepatitis (AIH) typically includes corticosteroids in combination with azathioprine. Mycophenolate mofetil (MMF) is often used as a rescue therapy in patients who are intolerant of, or nonresponsive to, standard therapy. AIM: To systematically review studies and perform a meta-analysis on the efficacy and safety of MMF as a second-line therapy for AIH patients. METHODS: MEDLINE, EMBASE and Cochrane Central were searched for studies that reported data on efficacy and safety of MMF as a second-line therapy in AIH...
February 13, 2019: Alimentary Pharmacology & Therapeutics
Zobair M Younossi, Linda Henry, Janus P Ong, Atsushi Tanaka, Yuichiro Eguchi, Masashi Mizokami, Young-Suk Lim, Yock Young Dan, Ming-Lung Yu, Maria Stepanova
BACKGROUND: Although the prevalence of extrahepatic manifestations of chronic hepatitis C virus (HCV) infection has been reported from Western countries, their prevalence in East Asian countries is not well known. AIM: To perform a systematic review to quantify the prevalence of selected extrahepatic manifestations of HCV among patients from East Asia. METHODS: Medline, CINAHL, EMBASE, Cochrane and country-specific databases were reviewed according to standard guidelines for meta-analyses...
February 13, 2019: Alimentary Pharmacology & Therapeutics
Albert J Czaja
BACKGROUND: Disturbances in iron regulation have been described in diverse chronic liver diseases other than hereditary haemochromatosis, and iron toxicity may worsen liver injury and outcome. AIMS: To describe manifestations and consequences of iron dysregulation in chronic liver diseases apart from hereditary haemochromatosis and to encourage investigations that clarify pathogenic mechanisms, define risk thresholds for iron toxicity, and direct management METHODS: English abstracts were identified in PubMed by multiple search terms...
February 13, 2019: Alimentary Pharmacology & Therapeutics
Priya Vijayvargiya, Michael Camilleri, Duane Burton, Irene Busciglio, Alan Lueke, Leslie J Donato
BACKGROUND: Biomarkers in irritable bowel syndrome (IBS) may guide targeted therapy in this multifactorial disease. It has been suggested that 75% accuracy and cost <$500 categorise biomarkers as cost-effective. AIM: To identify differences in faecal bile acids, faecal fat and fasting serum C4 (7a-hydroxy-4-cholesten-3-one) and fibroblast growth factor 19 (FGF19) among patients with IBS-D, IBS-C and healthy controls and to determine accurate, cost-effective biomarkers for clinically relevant diarrhoea and constipation...
February 10, 2019: Alimentary Pharmacology & Therapeutics
Ran Dong, Xianghuai Xu, Li Yu, Hongmei Ding, Jing Pan, Yiming Yu, Cuiqin Shi, Qiang Chen, Mengru Zhang, Hanjing Lv, Zhongmin Qiu
BACKGROUND: Neuromodulators are considered potential therapeutic options for refractory gastro-oesophageal reflux-induced chronic cough. AIM: To compare the efficacy of gabapentin and baclofen in patients with suspected refractory gastro-oesophageal reflux-induced chronic cough. METHODS: Two hundred and thirty-four patients with suspected refractory gastro-oesophageal reflux-induced chronic cough, who failed an 8-week course of omeprazole and domperidone, were recruited into the open-labelled study and randomly assigned to receive either gabapentin (maximum daily dose of 900 mg) or baclofen (maximum daily dose of 60 mg) for 8 weeks as add-on therapy to the previous treatment...
February 10, 2019: Alimentary Pharmacology & Therapeutics
Iris C Steenstraten, Kerem Sebib Korkmaz, Palak J Trivedi, Akin Inderson, Bart van Hoek, Mar D M Rodriguez Girondo, P W Jeroen Maljaars
BACKGROUND: After liver transplantation primary sclerosing cholangitis (PSC), the condition returns in the transplanted liver in a subset of patients (recurrent primary sclerosing cholangitis, rPSC). AIM: To define risk factors for rPSC. METHODS: We searched Pubmed, Embase, Web of Science, and Cochrane library for articles published until March 2018. Studies addressing risk factors for developing rPSC were eligible for inclusion. A random effects meta-analysis was conducted using hazard ratios (HR) as effect measure...
February 10, 2019: Alimentary Pharmacology & Therapeutics
Uday N Shivaji, Caroline L Sharratt, Tom Thomas, Samuel C L Smith, Marietta Iacucci, Gordon W Moran, Subrata Ghosh, Neeraj Bhala
BACKGROUND: Biological therapy is currently widely used to treat IBD. Infliximab, adalimumab and golimumab are currently licensed anti-TNF therapies. Biosimilar anti-TNF monoclonal antibodies are increasingly used. Anti-TNF therapies are widely used and their adverse effects are well characterised, and may cause significant morbidity and mortality in a small proportion of exposed patients. Gastroenterologists need to understand the mechanisms for these effects, recognise these swiftly and manage such events appropriately...
February 8, 2019: Alimentary Pharmacology & Therapeutics
Ayesha Shah, Mark Morrison, Daniel Burger, Neal Martin, Justin Rich, Mike Jones, Natasha Koloski, Marjorie M Walker, Nicholas J Talley, Gerald J Holtmann
BACKGROUND: Current data on small intestinal bacterial overgrowth (SIBO) in patients with inflammatory bowel diseases (IBD) are controversial. AIM: To conduct a systematic review and meta-analysis to determine the prevalence of SIBO in patients with ulcerative colitis (UC) and Crohn's disease (CD). METHODS: Electronic databases were searched up to May 2018 for studies reporting prevalence of SIBO in IBD patients. The prevalence rate of SIBO among IBD patients and the odds ratio (OR) and 95% CI of SIBO in IBD patients compared with controls were calculated...
February 8, 2019: Alimentary Pharmacology & Therapeutics
Peng Chen, Ying Li, Li Li, Qiao Yu, Kang Chao, Gaoshi Zhou, Yun Qiu, Rui Feng, Shanshan Huang, Yao He, Baili Chen, Minhu Chen, Zhirong Zeng, Shenghong Zhang
BACKGROUND: Owing to the importance of early treatment, simple and reliable methods for monitoring inflammatory bowel disease (IBD) are needed. AIMS: To determine whether circulating microRNAs are reliable biomarkers for IBD monitoring. METHODS: Serum levels of 17 candidate microRNAs were measured by quantitative real-time polymerase chain reaction in a discovery cohort (n = 120). Differentially expressed serum microRNAs were further investigated in an independent training cohort (n = 341)...
February 7, 2019: Alimentary Pharmacology & Therapeutics
Silvia Sookoian, Carlos J Pirola
BACKGROUND/AIM: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide. Characterised by abnormal fat accumulation in the liver, NAFLD presents high degree of comorbidity with disorders of the Metabolic syndrome, including type 2 diabetes, obesity and cardiovascular disease. These comorbidities have strong negative impact on the natural course of NAFLD and vice versa, whereby the presence of NAFLD substantially modifies the course and prognosis of Metabolic syndrome-associated diseases...
February 4, 2019: Alimentary Pharmacology & Therapeutics
Hannes Hagström, Jonas Höijer, Anna Andreasson, Matteo Bottai, Kari Johansson, Jonas F Ludvigsson, Olof Stephansson
BACKGROUND: In young men, high body mass index (BMI) has been linked to liver disease later in life, but it is unclear if this also applies to women. AIM: To study the association between BMI early in life and development of liver disease later in life in women. METHODS: We obtained data on early pregnancy BMI from 1 139 458 Swedish women between 1992 and 2015. National registers were used to ascertain incident severe liver disease, defined as cirrhosis, decompensated liver disease (hepatocellular carcinoma, oesophageal varices, hepatorenal syndrome or hepatic encephalopathy) or liver failure...
February 3, 2019: Alimentary Pharmacology & Therapeutics
Rahima A Bhanji, Naoki Takahashi, Michael R Moynagh, Praveena Narayanan, Mounika Angirekula, Kristin C Mara, Ross A Dierkhising, Kymberly D Watt
BACKGROUND: Sarcopenia is associated with both increased wait-list mortality and mortality following liver transplantation. AIMS: To determine the course of sarcopenia from transplant evaluation until 1 year post-transplant, and its implications on hospitalisation and mortality following liver transplantation. METHODS: Two hundred and ninety-three transplant recipients from 2002 to 2006 had pre-transplant CT scans analysed at the third lumbar region for sarcopenia, myosteatosis and abdominal visceral fat content...
February 3, 2019: Alimentary Pharmacology & Therapeutics
Ammar Hassanzadeh Keshteli, Karen L Madsen, Rupasri Mandal, Guy E Boeckxstaens, Premysl Bercik, Giada De Palma, David E Reed, David Wishart, Stephen Vanner, Levinus A Dieleman
BACKGROUND: Evaluation of the metabolomic profile of patients with irritable bowel syndrome offers an opportunity to identify novel pathophysiological targets and biomarkers that could discriminate this disorder from related conditions. AIM: To identify potential urinary biomarkers that discriminate irritable bowel syndrome patients from ulcerative colitis patients in remission and healthy controls and to explore the pathophysiology of irritable bowel syndrome using a metabolomic approach...
January 31, 2019: Alimentary Pharmacology & Therapeutics
Vineet S Gudsoorkar, Ayah Oglat, Amita Jain, Ali Raza, Eamonn M M Quigley
BACKGROUND: Gallbladder dyskinesia (gallbladder spasm, biliary dyskinesia or chronic acalculous cholecystitis) is a poorly defined entity which presents as biliary-type pain without any identifiable organic pathology. Abnormal gallbladder ejection fraction (GBEF) is used by some to select those likely to benefit from cholecystectomy. The validity of this approach has been questioned. AIM: To systematically review the literature and summarise the evidence surrounding the practice of cholecystectomy based on GBEF for gallbladder dyskinesia...
January 31, 2019: Alimentary Pharmacology & Therapeutics
Victoria Wilkinson-Smith, Neele Dellschaft, Juliet Ansell, Caroline Hoad, Luca Marciani, Penny Gowland, Robin Spiller
BACKGROUND: Chronic constipation affects approximately 17% of the population worldwide and remains an important unmet need since patients are often dissatisfied with treatment. Kiwifruit may offer an alternative to traditional laxatives and have been shown to increase stool volume, frequency and improve consistency. AIMS: Using non-invasive MRI techniques, we assessed the effect of ingestion of kiwifruit on fluid distribution in the intestines and bowel function...
January 31, 2019: Alimentary Pharmacology & Therapeutics
Álvaro Díaz-González, Marco Sanduzzi-Zamparelli, Víctor Sapena, Ferran Torres, Neus LLarch, Gemma Iserte, Alejandro Forner, Leonardo da Fonseca, José Ríos, Jordi Bruix, María Reig
BACKGROUND: The positive results of the REFLECT trial in terms of survival (sorafenib vs lenvatinib) offer a new first-line option for hepatocellular carcinoma. Additionally, the expected results of immunotherapy could change the first-line treatment in hepatocellular carcinoma or the clinical trial design in first and second-line. AIMS: To evaluate the impact of dermatologic adverse events under sorafenib in hepatocellular carcinoma patients as a clinical marker to predict prognosis and critically evaluate outcomes within trials...
January 29, 2019: Alimentary Pharmacology & Therapeutics
Natasha Koloski, Michael Jones, Marjorie M Walker, Martin Veysey, Alkesh Zala, Simon Keely, Gerald Holtmann, Nicholas J Talley
BACKGROUND: The pathogenesis of functional GI disorders (FGIDs) is uncertain. However, underlying immune activation and psychological distress has been documented in irritable bowel syndrome (IBS) and functional dyspepsia (FD). Epidemiological data from the UK suggest that FGIDs are linked to atopy and certain autoimmune diseases but this has not been confirmed. AIM: To test if allergic or autoimmune diseases are independently associated with FGIDs, irrespective of psychological distress in a large population based study...
January 27, 2019: Alimentary Pharmacology & Therapeutics
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