Journals Alimentary Pharmacology & Ther...

Alimentary Pharmacology & Therapeutics
Zobair M Younossi, Maria Stepanova, Sean Felix, Thomas Jeffers, Elena Younossi, Zachary Goodman, Andrei Racila, Brian P Lam, Linda Henry
BACKGROUND: The presence of fibrosis in NAFLD is the most significant risk factor for adverse outcomes. We determined the cutoff scores of two non-invasive te sts (NITs) to rule in and rule out significant fibrosis among NAFLD patients. METHODS: Clinical data and liver biopsies were used for NAFLD patients included in this analysis (2001-2020). The enhanced liver fibrosis (ELF) and FIB-4 NITs were calculated. Liver biopsies were read by a single hematopathologist and scored by the NASH CRN criteria...
March 26, 2023: Alimentary Pharmacology & Therapeutics
Alessandro Mantovani, Serena Pelusi, Sara Margarita, Francesco Malvestiti, Michela Dell'Alma, Cristiana Bianco, Luisa Ronzoni, Daniele Prati, Giovanni Targher, Luca Valenti
BACKGROUND: The PNPLA3 p.I148M variant is the main genetic determinant of nonalcoholic fatty liver disease, and PNPLA3 silencing is being evaluated to treat this liver condition. Data suggest that the p.I148M variant predisposes to kidney damage, but the relative contribution to kidney function, compared to overall genetic susceptibility, is not defined. AIMS: We aimed to assess the effect of PNPLA3 p.I148M on the estimated glomerular filtration rate (eGFR) in individuals with metabolic dysfunction...
March 22, 2023: Alimentary Pharmacology & Therapeutics
Xiaoying Kang, Shengxin Liu, Bjorn Roelstraete, Hamed Khalili, Jonas F Ludvigsson
BACKGROUND AND AIMS: Microscopic colitis (MC) is a colonic inflammatory condition associated with autoimmune dysfunction. Type 1 diabetes (T1D) is a chronic disease induced by autoimmune destruction of pancreatic β-cells. We aimed to examine the association between T1D and MC. METHODS: A matched case-control study was conducted using the nationwide ESPRESSO cohort as study base. All biopsy-confirmed MC patients born after 1940 were identified and compared to biopsy-free individuals matched from the general population for T1D diagnosis using the Swedish National Patient Register...
March 22, 2023: Alimentary Pharmacology & Therapeutics
Veeral Ajmera, Na Wang, Hanfei Xu, Ching-Ti Liu, Michelle T Long
BACKGROUND: Adiposity amplifies the genetic risk of non-alcoholic fatty liver disease (NAFLD). AIM: We evaluated the association between overweight-years, a cumulative exposure based on the product of the duration and severity of excess body weight (body mass index (BMI) ≥ 25 kg/m2 ), and genetic risk on liver fat and fibrosis. METHODS: This is a longitudinal analysis derived from a prospective cohort of adults in the Framingham Heart Study who underwent genotyping and vibration-controlled-transient-elastography with controlled attenuation parameter...
March 16, 2023: Alimentary Pharmacology & Therapeutics
Gareth J Sanger, Paul L R Andrews
BACKGROUND: Drugs which can inhibit nausea/vomiting and/or increase gastric emptying are used to treat gastroparesis, mostly 'off-label'. Within each category, they act at different targets and modulate different physiological mechanisms. AIMS: Address the questions: In gastroparesis, why should blocking one pathway causing vomiting, be more appropriate than another? Why might increasing gastric emptying via one mechanism be more appropriate than another? METHODS: Drugs used clinically were identified via consensus opinions and reviews, excluding the poorly characterised...
March 14, 2023: Alimentary Pharmacology & Therapeutics
Juan M Pericàs, Nicholas A Di Prospero, Quentin M Anstee, Peter Mesenbrinck, Mette S Kjaer, Jesús Rivera-Esteban, Franz Koenig, Elena Sena, Raluca Pais, Ramiro Manzano, Joan Genescà, Frank Tacke, Vlad Ratziu
BACKGROUND AND AIMS: Non-alcoholic steatohepatitis (NASH) constitutes a significant unmet medical need with a burgeoning field of clinical research and drug development. Platform trials (PT) might help accelerate drug development while lowering overall costs and creating a more patient-centric environment. This review provides a comprehensive and nuanced assessment of the NASH clinical development landscape. METHODS: Narrative review and expert opinion with insight gained during the EU Patient-cEntric clinicAl tRial pLatforms (EU-PEARL) project...
March 14, 2023: Alimentary Pharmacology & Therapeutics
Vivek C Goodoory, Cho E Ng, Christopher J Black, Alexander C Ford
BACKGROUND: Little is known about faecal incontinence (FI) in individuals with irritable bowel syndrome (IBS). AIMS: To compare characteristics of people with IBS reporting FI, compared with people with IBS who do not report FI. METHODS: We collected demographic, gastrointestinal and psychological symptoms, healthcare usage, direct healthcare costs, impact on work and activities of daily living, and quality of life data from individuals with Rome IV-defined IBS...
March 13, 2023: Alimentary Pharmacology & Therapeutics
Wei-Yu Kao, Elise Chia-Hui Tan, Hsin-Lun Lee, Yi-Hsiang Huang, Teh-Ia Huo, Chun-Chao Chang, Jeng-Fong Chiou, Ming-Chih Hou, Jaw-Ching Wu, Chien-Wei Su
BACKGROUND: There is still controversy about whether tenofovir disoproxil fumarate (TDF) and entecavir (ETV) have different effects on the outcomes of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). AIMS: The aim of this study was to compare the prognoses between ETV and TDF treatment among patients with HBV-related HCC after hepatectomy. METHODS: An analysis was done on data from the Taiwan Cancer Registry, which was linked to Taiwan National Health Insurance Research Database, for the years 2011-2016...
March 13, 2023: Alimentary Pharmacology & Therapeutics
Freddy Caldera, Aaron C Spaulding, Bijan Borah, Jim Moriarty, Ye Zhu, Mary S Hayney, Francis A Farraye
BACKGROUND: Recombinant zoster vaccine (RZV) is recommended for all adults ≥19 years of age who are at increased risk for HZ, including patients with inflammatory bowel disease (IBD). METHODS: A Markov model was constructed to compare the RZV cost-effectiveness with no vaccination in patients with Crohn's Disease (CD) and ulcerative colitis (UC). A simulated cohort of 1 million patients was used for each IBD group at ages 18, 30, 40, and 50. The primary objective of this analysis was to compare RZV cost-effectiveness in patients with CD and UC, comparing vaccination to no vaccination...
March 10, 2023: Alimentary Pharmacology & Therapeutics
Ohad Atia, Idan Goren, Tali Sharar Fischler, Yisca Loewenberg Weisband, Shira Greenfeld, Revital Kariv, Natan Ledderman, Eran Matz, Ramit Magen Rimon, Iris Dotan, Dan Turner, Henit Yanai
BACKGROUND: 5-aminosalicylates (5-ASA) are widely used in Crohn's disease (CD) despite guidelines advising otherwise. We aimed to assess in nationwide study the outcomes of first-line 5-ASA maintenance therapy (5-ASA-MT) compared with no maintenance treatment (no-MT) in patients with newly diagnosed CD. METHODS: We utilised data from the epi-IIRN cohort, including all patients with CD diagnosed in Israel between 2005 and 2020. Propensity score (PS) matching was utilised to compare outcomes in the 5-ASA-MT versus no-MT groups...
March 9, 2023: Alimentary Pharmacology & Therapeutics
Sarah L Melton, Kirstin M Taylor, Peter R Gibson, Emma P Halmos
BACKGROUND: Exclusive enteral nutrition (EEN) induces remission and mucosal healing in patients with Crohn's disease, but the mechanism of action remains unknown. AIM: To outline current understanding of the mechanisms of action of EEN. METHODS: From a comprehensive literature search, published data were critically examined in a narrative review. RESULTS: Multiple potential mechanisms of action have been identified. EEN optimises nutritional status...
March 9, 2023: Alimentary Pharmacology & Therapeutics
Marta Garzón-Benavides, Ángela Ruiz-Carnicer, Verónica Segura, Blanca Fombuena, Francisco García-Fernandez, Salvador Sobrino-Rodriguez, Lourdes Gómez-Izquierdo, Marco Antonio Montes-Cano, Raquel Millan-Domínguez, María Del Carmen Rico, Carmen González-Naranjo, Juan Manuel Bozada-García, Cristóbal Coronel-Rodríguez, Beatriz Espin, Jacobo Díaz, Isabel Comino, Federico Argüelles-Arias, Ángel Cebolla, Manuel Romero-Gómez, Alfonso Rodriguez-Herrera, Carolina Sousa, Ángeles Pizarro-Moreno
BACKGROUND: Gluten-free diet (GFD) is the only treatment for patients with coeliac disease (CD) and its compliance should be monitored to avoid cumulative damage. AIMS: To analyse gluten exposures of coeliac patients on GFD for at least 24 months using different monitoring tools and its impact on duodenal histology at 12-month follow-up and evaluate the interval of determination of urinary gluten immunogenic peptides (u-GIP) for the monitoring of GFD adherence...
March 8, 2023: Alimentary Pharmacology & Therapeutics
Ikuo Hirano, Evan S Dellon, Sandeep K Gupta, David A Katzka, Margaret H Collins, Abigail M Wojtowicz, Brian Terreri, Wenwen Zhang, Mena Boules, Siddharth Bhatia, Nirav K Desai
BACKGROUND: Questions remain regarding the safety of swallowed topical corticosteroids in eosinophilic oesophagitis (EoE). AIM: To assess the safety of an investigational formulation of budesonide (budesonide oral suspension; BOS) from six trials. METHODS: Safety data were integrated from six trials (healthy adults: SHP621-101 [phase 1]; patients with EoE: MPI 101-01 and MPI 101-06 [phase 2]; SHP621-301, SHP621-302 and SHP621-303 [phase 3]) for participants who received ≥1 dose of study drug (BOS 2...
March 8, 2023: Alimentary Pharmacology & Therapeutics
Fabian Jost-Brinkmann, Münevver Demir, Alexander Wree, Tom Luedde, Sven H Loosen, Tobias Müller, Frank Tacke, Christoph Roderburg, Raphael Mohr
BACKGROUND AND AIMS: Phase III trials have established atezolizumab plus bevacizumab as the novel standard of care for patients with unresectable hepatocellular carcinoma (HCC). However, these trials raised concerns regarding treatment efficacy in non-viral HCC, and it remains unclear whether combination immunotherapy is safe and effective in patients with advanced cirrhosis. METHODS: One hundred patients with unresectable HCC initiated therapy with atezolizumab plus bevacizumab at our centre between January 2020 and March 2022...
March 8, 2023: Alimentary Pharmacology & Therapeutics
Kavish R Patidar, Mobasshir A Naved, Shaowli Kabir, Ananth Grama, Andrew S Allegretti, Giuseppe Cullaro, Sumeet K Asrani, Astin Worden, Archita P Desai, Marwan S Ghabril, Lauren D Nephew, Eric S Orman
BACKGROUND: In patients with cirrhosis and acute kidney injury (AKI), longer time to AKI-recovery may increase the risk of subsequent major-adverse-kidney-events (MAKE). AIMS: To examine the association between timing of AKI-recovery and risk of MAKE in patients with cirrhosis. METHODS: Hospitalised patients with cirrhosis and AKI (n = 5937) in a nationwide database were assessed for time to AKI-recovery and followed for 180-days...
March 7, 2023: Alimentary Pharmacology & Therapeutics
David Gunn, Rabia Topan, Lorna Barnard, Ron Fried, Ivana Holloway, Richard Brindle, Maura Corsetti, Mark Scott, Adam Farmer, Kapil Kapur, David Sanders, Maria Eugenicos, Nigel Trudgill, Peter Whorwell, John Mclaughlin, Ayesha Akbar, Lesley Houghton, Phil G Dinning, Qasim Aziz, Alexander C Ford, Amanda J Farrin, Robin Spiller
BACKGROUND: Ondansetron may be beneficial in irritable bowel syndrome with diarrhoea (IBS-D). AIM: To conduct a 12-week parallel group, randomised, double-blind, placebo-controlled trial of ondansetron 4 mg o.d. (titrated up to 8 mg t.d.s.) in 400 IBS-D patients. PRIMARY ENDPOINT: % responders using the Food and Drug Administration (FDA) composite endpoint. Secondary and mechanistic endpoints included stool consistency (Bristol Stool Form Scale) and whole gut transit time (WGTT)...
March 3, 2023: Alimentary Pharmacology & Therapeutics
Pablo Solís-Muñoz, María de la Flor-Robledo, Inmaculada García-Ruíz, Carlos E Fernández-García, Águeda González-Rodríguez, Naina Shah, Ramón Bataller, Michael Heneghan, Carmelo García-Monzón, José A Solís-Herruzo
BACKGROUND AND AIMS: Little is known about the extent of mitochondrial respiratory chain (MRC) activity dysfunction in patients with alcoholic hepatitis (AH). We aimed to assess the hepatic MRC activity in AH patients and its potential impact on the severity and prognosis of this life-threatening liver disease. METHODS: MRC complexes were measured in liver biopsies of 98 AH patients (non-severe, 17; severe, 81) and in 12 histologically normal livers (NL). Severity was assessed according to Maddrey's Index and MELD score...
March 2, 2023: Alimentary Pharmacology & Therapeutics
B W L C M Broeders, F Carbone, L M Balsiger, J Schol, K Raymenants, I Huang, A Verheyden, T Vanuytsel, J Tack
BACKGROUND: Functional dyspepsia (FD) is one of the most frequent conditions in gastroenterological outpatient health care. Most recent research in FD has shifted its focus to duodenal pathophysiological mechanisms, although current treatments still focus mainly the stomach. AIM: The aim of the study was to provide a comprehensive overview of the pathophysiology of FD focusing on a paradigm shift from gastric towards duodenal mechanisms. METHODS: We conducted a literature search in PubMed for studies describing mechanisms that could possibly cause FD...
March 1, 2023: Alimentary Pharmacology & Therapeutics
Mathurin Fumery, Stéphane Nancey, Jérôme Filippi, Romain Altwegg, Xavier Hébuterne, Gilles Boshetti, Mathilde Barraud, Jonathan Meynier, Stéphane Paul, Xavier Roblin
INTRODUCTION: Loss of response to golimumab occurs in nearly 40% of patients with ulcerative colitis (UC). Unlike others anti-TNF, no study has reported a correlation between serum golimumab level and response to drug intensification. The objective of this study was to evaluate the effectiveness and safety of golimumab intensification and to identify the best threshold of serum golimumab before drug intensification predictive of response. PATIENTS AND METHODS: We included all consecutive patients with active UC with loss of response to golimumab in a prospective multicentric cohort study...
February 27, 2023: Alimentary Pharmacology & Therapeutics
Xinrong Zhang, Terry Cheuk-Fung Yip, Yee-Kit Tse, Vicki Wing-Ki Hui, Guanlin Li, Huapeng Lin, Lilian Yan Liang, Jimmy Che-To Lai, Mandy Sze-Man Lai, Johnny T K Cheung, Henry Lik-Yuen Chan, Stephen Lam Chan, Alice Pik-Shan Kong, Grace Lai-Hung Wong, Vincent Wai-Sun Wong
BACKGROUND & AIMS: We aimed to determine the trends in risk factor control and treatment among patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D) in 2000-2020. METHODS: We conducted a territory-wide cohort study of adult patients with NAFLD and T2D diagnosed between 1 January 2000 and 31 July 2021 in Hong Kong. T2D was defined by use of any anti-diabetic agents, laboratory tests and/or diagnosis codes. RESULTS: This study included 16,084 patients with NAFLD and T2D (mean age, 54...
February 23, 2023: Alimentary Pharmacology & Therapeutics
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