Journals Alimentary Pharmacology & Ther...

Alimentary Pharmacology & Therapeutics
David Beaton, Linda Sharp, Liya Lu, Nigel Trudgill, Mo Thoufeeq, Brian Nicholson, Peter Rogers, James Docherty, Anna Jenkins, A John Morris, Thomas Rösch, Matthew Rutter
BACKGROUND: The value of lower gastrointestinal endoscopy (LGIE; colonoscopy or sigmoidoscopy) relates to its ability to detect clinically relevant findings, predominantly cancers, preneoplastic polyps or inflammatory bowel disease. There are concerns that many LGIEs are performed on low-risk patients with limited benefit. AIMS: To determine the diagnostic outcomes of LGIE for common symptoms. METHODS: We performed a cross-sectional study of diagnostic LGIE between March 2019 and February 2020 using the UK National Endoscopy Database...
April 18, 2024: Alimentary Pharmacology & Therapeutics
Maria Mironova, Harish Gopalakrishna, Gracia Maria Viana Rodriguez, Nehna Abdul Majeed, Asif A Hitawala, Ivan J Fuss, Jenna R E Bergerson, Alison J Faust, Jacqueline M Laurin, Jaha Norman-Wheeler, Shani Scott, Julian Hercun, Bernadette Redd, David E Kleiner, Christopher Koh, Theo Heller
BACKGROUND: Non-cirrhotic portal hypertension (NCPH) is a spectrum of liver diseases, including porto-sinusoidal vascular disorder, with portal hypertension (PH) in the absence of cirrhosis. The natural history and diagnostic approach to NCPH are not well understood. AIM: We aimed to evaluate disease progression and outcomes in NCPH. METHODS: Patients with or at risk for NCPH were enrolled in a single centre prospective study; two groups were formed based on the presence of specific features of PH, such as varices, collaterals, portal hypertensive gastropathy or portal hypertensive bleeding...
April 17, 2024: Alimentary Pharmacology & Therapeutics
Annalisa Aratari, Maria Lia Scribano, Daniela Pugliese, Valentina Baccolini, Fabiola De Biasio, Serena Verna, Chiara Morretta, Stefano Festa, Alessandro Armuzzi, Claudio Papi
BACKGROUND: Few data are available addressing the impact of post-operative management of Crohn's disease (CD) on long-term clinical course. AIM: To assess the evolution of post-operative management strategies over the last 40 years and their impact on the re-operation rate of CD. METHODS: We included 657 patients with CD who had undergone their first radical ileo-caecal resection between 1980 and 2020. Three cohorts were defined according to year of surgery: cohort 1 (1980-1998; n = 198), cohort 2 (1999-2009; n = 218) and cohort 3 (2010-2020; n = 241)...
April 14, 2024: Alimentary Pharmacology & Therapeutics
Kyuwon Kim, Jae Jun Park, Hyuk Yoon, Jun Lee, Kyeong Ok Kim, Eun Sun Kim, Su Young Kim, Sun-Jin Boo, Yunho Jung, Jun Hwan Yoo, Sung Wook Hwang, Sang Hyoung Park, Suk-Kyun Yang, Byong Duk Ye
BACKGROUND/AIM: We aimed to validate clinical decision support tools (CDSTs) to predict real-life effectiveness of vedolizumab (VDZ) in patients with inflammatory bowel disease. METHODS: We retrospectively enrolled patients with Crohn's disease (CD) or ulcerative colitis (UC) treated with VDZ at 10 tertiary referral centres in Korea between January 2017 and November 2021. We assessed clinical remission (CREM) and response (CRES), corticosteroid-free clinical remission (CSF-CREM) and response (CSF-CRES), biochemical response based on C-reactive protein (BioRES[CRP]) and faecal calprotectin (BioRES[FC]), endoscopic healing (EH), and the need to optimise or switch drugs based on CDST-defined response groups...
April 14, 2024: Alimentary Pharmacology & Therapeutics
Mikkel Malham, Sabine Jansson, Helene Ingels, Marianne Hørby Jørgensen, Naja Hulvej Rod, Vibeke Wewer, Matthew P Fox
BACKGROUND: Paediatric-onset immune-mediated inflammatory diseases (pIMID) show more aggressive phenotypes than when diagnosed in adults. However, data on mortality are often extrapolated from adult studies. AIM: To estimate the effect of pIMID on mortality. METHODS: In a population-based cohort study using the nationwide Danish healthcare registers, we included all patients diagnosed with pIMID in Denmark from 1980 to 2018. PIMID were defined as ICD codes indicative of autoimmune hepatitis, primary sclerosing cholangitis, Crohn's disease, ulcerative colitis, juvenile idiopathic arthritis, lupus erythematosus, or vasculitis registered before age 18 years...
April 10, 2024: Alimentary Pharmacology & Therapeutics
Arta Aliu, Daan H C A Bosch, Daniel Keszthelyi, Ashkan Rezazadeh Ardabili, Jean-Frederic Colombel, Rachel Sawyer, Hans Törnblom, Ailsa Hart, Daisy M A E Jonkers, Marieke J Pierik, Zlatan Mujagic
BACKGROUND: Persistent gastrointestinal symptoms are prevalent in adult patients with inflammatory bowel disease (IBD), even when endoscopic remission is reached. These symptoms can have profound negative effects on the quality of life of affected patients and can be difficult to treat. They may be caused by IBD-related complications or comorbid disorders, but they can also be explained by irritable bowel syndrome (IBS)-like symptoms. AIMS: To provide a practical step-by-step guide to diagnose and treat persistent gastrointestinal symptoms in patients with IBD in remission via a personalised approach...
April 8, 2024: Alimentary Pharmacology & Therapeutics
Matthew J Townsend, Isaac J Benque, Michael Li, Shilpa Grover
BACKGROUND: Immune checkpoint inhibitors (ICIs) are effective oncologic agents which frequently cause immune-related adverse events (irAEs) which can impact multiple organ systems. Onco-Gastroenterology is a novel and emerging subspecialty within gastroenterology focused on cancer treatment-related complications. Gastroenterologists must be prepared to identify and manage diverse immune-mediated toxicities including enterocolitis, hepatitis, pancreatitis and other ICI-induced toxicities...
April 8, 2024: Alimentary Pharmacology & Therapeutics
Nikita Mittal, Harris Siddiqi, Egbert Madamba, Lisa Richards, Ricki Bettencourt, Veeral Ajmera, Rohit Loomba
BACKGROUND: There are limited data on the prevalence and treatment of at-risk metabolic dysfunction-associated steatohepatitis (MASH) among patients with type 2 diabetes (T2DM) in the United States. AIM: To estimate the prevalence of at-risk MASH in a prospectively recruited cohort of adults with T2DM using new nomenclature endorsed by multiple societies. METHODS: This prospective study enrolled adults aged ≥50 with T2DM from primary care and endocrinology clinics in southern California from 2016 to 2023...
April 8, 2024: Alimentary Pharmacology & Therapeutics
Nabil Noureddin, Daniel Q Huang, Ricki Bettencourt, Harris Siddiqi, Abdul M Majzoub, Tarek Nayfeh, Nobuharu Tamaki, Namiki Izumi, Atsushi Nakajima, Ramazan Idilman, Mesut Gumussoy, Digdem Kuru Oz, Ayse Erden, Tolga Gidener, Alina M Allen, Veeral Ajmera, Rohit Loomba
BACKGROUND & AIMS: The natural progression of hepatic decompensation in metabolic dysfunction-associated steatotic liver disease (MASLD) is not well-characterised. We aimed to describe it by conducting a retrospective analysis. METHODS: This longitudinal, retrospective analysis of well-characterised MASLD cohorts followed for hepatic decompensation and death. The sequence of liver-related events was evaluated, and the median time between hepatic decompensation episodes and death versus...
April 3, 2024: Alimentary Pharmacology & Therapeutics
Palak J Trivedi, Katherine Arndtz, Nadir Abbas, Alison Telford, Liam Young, Rajarshi Banerjee, Peter Eddowes, Kartik S Jhaveri, Gideon M Hirschfield
BACKGROUND: Imaging markers of biliary disease in primary sclerosing cholangitis (PSC) have potential for use in clinical and trial disease monitoring. Herein, we evaluate how quantitative magnetic resonance cholangiopancreatography (MRCP) metrics change over time, as per the natural history of disease. METHODS: Individuals with PSC were prospectively scanned using non-contrast MRCP. Quantitative metrics were calculated using MRCP+ post-processing software to assess duct diameters and dilated and strictured regions...
April 3, 2024: Alimentary Pharmacology & Therapeutics
Fatima Hakak, Rajan N Patel, Richard B Gearry
BACKGROUND: Telehealth is a growing model of care, greatly accelerated with the demands of the COVID-19 pandemic. Telecare is a synchronous audio-visual or audio-only format of health delivery. AIMS: To evaluate the existing literature on telecare within adult gastroenterology subspecialties to determine if outcomes are comparable to traditional in-person consultations and to highlight the Pokapū Network, a local initiative in the Lakes Region of New Zealand, amongst these international findings...
April 1, 2024: Alimentary Pharmacology & Therapeutics
Mohamed I Elsaid, Na Li, Stephen A Firkins, Vinod K Rustgi, Electra D Paskett, Chathur Acharya, K Rajender Reddy, Chien Wei Chiang, Khalid Mumtaz
BACKGROUND/AIMS: We examined the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) initiation on long-term Adverse Liver Outcomes (ALO) in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) cirrhosis and type 2 diabetes using real-world data from the MarketScan database. METHODS: We conducted a retrospective cohort study of patients with MASLD cirrhosis and type 2 diabetes between 2012 and 2020. Cox proportional hazard models examine the association between GLP-1RAs initiation, modelled as time-dependent, and the risk of ALO, a composite endpoint defined by the first occurrence of hepatic decompensation(s), portal hypertension, hepatocellular carcinoma (HCC) or liver transplantation (LT)...
March 27, 2024: Alimentary Pharmacology & Therapeutics
Lindsay M Clarke, Jessica R Allegretti
BACKGROUND: Clostridioides difficile is the most common cause of healthcare-associated infection, and severe cases can result in significant complications. While anti-microbial therapy is central to infection management, adjunctive therapies may be utilised as preventative strategies. AIM: This article aims to review updates in the epidemiology, diagnosis, and management, including treatment and prevention, of C. difficile infections. METHODS: A narrative review was performed to evaluate the current literature between 1986 and 2023...
March 27, 2024: Alimentary Pharmacology & Therapeutics
Timothy McAuliffe, Joseph C Anderson, Robin J Larson, Douglas J Robertson
BACKGROUND: The faecal immunochemical test (FIT) is an inexpensive and convenient modality to screen for colorectal cancer. However, its one-time sensitivity for detecting colorectal cancer and cancer precursors is limited. There is growing interest in using the non-haemoglobin contents of FIT residual buffer to enhance colonic neoplasia detection. AIM: To establish from the literature a framework to catalogue candidate biomarkers within FIT residual buffer for non-invasive colorectal cancer screening...
March 27, 2024: Alimentary Pharmacology & Therapeutics
Danielle Adebayo, Florence Wong
BACKGROUND: Better understanding of disease pathophysiology has led to advances in managing ascites and its associated complications including hepatorenal syndrome-acute kidney Injury (HRS-AKI), especially medicinal and interventional advances. AIM: To review the latest changes in the management of ascites and HRS-AKI. METHODS: A literature search was conducted in Pubmed, using the keywords cirrhosis, ascites, renal dysfunction, acute kidney injury, hepatorenal syndrome, beta-blockers, albumin, TIPS and vasoconstrictors, including only publications in English...
March 25, 2024: Alimentary Pharmacology & Therapeutics
Dennis L Shung, Loren Laine
BACKGROUND: Acute upper gastrointestinal bleeding (UGIB) is a common emergency requiring hospital-based care. Advances in care across pre-endoscopic, endoscopic and post-endoscopic phases have led to improvements in clinical outcomes. AIMS: To provide a detailed, evidence-based update on major aspects of care across pre-endoscopic, endoscopic and post-endoscopic phases. METHODS: We performed a structured bibliographic database search for each topic...
March 22, 2024: Alimentary Pharmacology & Therapeutics
Rohit Loomba, Ginger Clark, Jeff Teckman, Veeral Ajmera, Cynthia Behling, Mark Brantly, David Brenner, Jeanine D'Armiento, Michael W Fried, Janani S Iyer, Mattias Mandorfer, Don C Rockey, Monica Tincopa, Raj Vuppalanchi, Zobair Younossi, Aleksander Krag, Alice M Turner, Pavel Strnad
BACKGROUND: Alpha-1 antitrypsin liver disease (AATLD) occurs in a subset of patients with alpha-1 antitrypsin deficiency. Risk factors for disease progression and specific pathophysiologic features are not well known and validated non-invasive assessments for disease severity are lacking. Currently, there are no approved treatments for AATLD. AIMS: To outline existing understanding of AATLD and to identify knowledge gaps critical to improving clinical trial design and development of new treatments...
March 22, 2024: Alimentary Pharmacology & Therapeutics
Marta Paula Pereira Coelho, Thais Pontello de Vries, Aline Marcos Pires, Milena Pereira Parreira, Érika Ramos de Alvarenga, Rodrigo Dias Cambraia, Rodrigo Ribeiro Dos Santos, Juliana Maria Trindade Bezerra, Enrico Antonio Colosimo, Gifone Aguiar Rocha, Luciana Diniz Silva
BACKGROUND: Results of studies evaluating the effect of viral eradication following direct-acting antiviral (DDA) therapy on skeletal muscle mass of patients with chronic hepatitis C (CHC) are scarce. AIM: To assess the components of sarcopenia (low muscle mass, low muscle strength and low physical performance) in a cohort of CHC individuals before and after DAA therapy. METHODS: We performed a longitudinal study of patients with CHC who underwent body composition assessment before (T0), and at 12 (T1) and 48 (T2) weeks after DDA therapy...
March 19, 2024: Alimentary Pharmacology & Therapeutics
Carolin V Schneider, Kai Markus Schneider, Anastasia Raptis, Helen Huang, Christian Trautwein, Rohit Loomba
BACKGROUND: The prevalence of at-risk metabolic dysfunction-associated steatohepatitis (at-risk MASH) has not been systematically assessed. AIM: To delineate the prevalence of at-risk MASH in a large population-based cohort. METHODS: We conducted a cross-sectional analysis of 40,189 patients in the UK Biobank who underwent liver MRI. Hepatic steatosis was determined by proton density fat fraction (PDFF) ≥5%. Based on AASLD criteria, participants were classified as alcohol-associated steatotic liver disease (ALD), metabolic dysfunction-associated steatotic liver disease (MASLD), combined metabolic alcoholic liver disease (MetALD) and at-risk MASH...
March 19, 2024: Alimentary Pharmacology & Therapeutics
Antonio De Vincentis, Federica Tavaglione, Shinichi Namba, Masahiro Kanai, Yukinori Okada, Yoichiro Kamatani, Samantha Maurotti, Claudio Pedone, Raffaele Antonelli Incalzi, Luca Valenti, Stefano Romeo, Umberto Vespasiani-Gentilucci
BACKGROUND AND AIMS: The European Association for the Study of the Liver introduced a clinical pathway (EASL CP) for screening significant/advanced fibrosis in people at risk of steatotic liver disease (SLD). We assessed the performance of the first-step FIB4 EASL CP in the general population across different SLD risk groups (MASLD, Met-ALD and ALD) and various age classes. METHODS: We analysed a total of 3372 individuals at risk of SLD from the 2017-2018 National Health and Nutrition Examination Survey (NHANES17-18), projected to 152...
March 18, 2024: Alimentary Pharmacology & Therapeutics
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