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Alimentary Pharmacology & Therapeutics

Jessica K Dyson, Lin Lee Wong, Theophile Bigirumurame, Gideon M Hirschfield, Stuart Kendrick, Ye H Oo, Ansgar W Lohse, Michael A Heneghan, David E J Jones
BACKGROUND: Treatment paradigms in autoimmune hepatitis (AIH) have remained largely unchanged for decades. Studies report ≤20% of patients have sub-optimal treatment response with most requiring long-term therapy. AIM: The United Kingdom Autoimmune Hepatitis (UK-AIH) study was established to evaluate current treatment practice and outcomes, determine the unmet needs of patients, and develop and implement improved treatment approaches. METHODS: The United Kingdom Autoimmune Hepatitis study is a cross-sectional cohort study examining secondary care management of prevalent adult patients with a clinical diagnosis of autoimmune hepatitis...
September 18, 2018: Alimentary Pharmacology & Therapeutics
Shaji Sebastian, Christopher Black, Daniela Pugliese, Alessandro Armuzzi, Kapil Sahnan, Soad M Elkady, Kostas H Katsanos, Demitrios K Christodoulou, Christian Selinger, Giovanni Maconi, Nicola S Fearnhead, Uri Kopylov, Yana Davidov, Marta M Bosca-Watts, Pierre Ellul, Martina Muscat, Konstantinos Karmiris, Ailsa L Hart, Silvio Danese, Shomron Ben-Horin, Gionata Fiorino
BACKGROUND: Treatment paradigms for Crohn's disease with perianal fistulae (CD-pAF) are evolving. AIMS: To study the impact of multimodality treatment in CD-pAF on recurrence rates and the need for re-interventions and to identify predictive factors for these outcomes. METHODS: This was a multinational multicentre retrospective cohort study. Multimodality approach was defined as using a combination of medical treatments (anti-TNFs ± immunomodulators ± antibiotics) along with surgical approach (examination under anaesthesia (EUA) ± seton drainage) at diagnosis of CD-pAF...
September 18, 2018: Alimentary Pharmacology & Therapeutics
Ahmed Albusoda, James K Ruffle, Kathrine A Friis, Maximilian R Gysan, Asbjørn M Drewes, Qasim Aziz, Adam D Farmer
BACKGROUND: Irritable bowel syndrome (IBS) is common and is characterised by recurrent abdominal pain, which is a major contributor to healthcare seeking. The neurobiological basis of this pain is incompletely understood. Conditioned pain modulation is a neuromodulatory mechanism through which the brain inhibits the nociceptive afferent barrage through the descending pathways. Reduced conditioned pain modulation has been implicated in the pathophysiology of IBS, although to date only in studies with relatively small sample sizes...
September 11, 2018: Alimentary Pharmacology & Therapeutics
Fernando Bessone, Melisa Dirchwolf, María Agustina Rodil, María Valeria Razori, Marcelo G Roma
BACKGROUND: Nonalcoholic fatty disease (NAFLD) is the most common liver disease, since it is strongly associated with obesity and metabolic syndrome pandemics. NAFLD may affect drug disposal and has common pathophysiological mechanisms with drug-induced liver injury (DILI); this may predispose to hepatoxicity induced by certain drugs that share these pathophysiological mechanisms. In addition, drugs may trigger fatty liver and inflammation per se by mimicking NAFLD pathophysiological mechanisms...
September 7, 2018: Alimentary Pharmacology & Therapeutics
Brian E Lacy
BACKGROUND: Irritable bowel syndrome (IBS) is multifactorial in nature, and a wide range of therapies are available to manage symptoms of this common disorder. AIM: To provide an overview of the safety of interventions that may be used to manage patients with diarrhoea-predominant IBS (IBS-D). METHODS: Medline and Embase database searches (through 02 May 2018) to identify clinical studies that evaluated treatment safety and/or efficacy in adults with IBS-D...
September 7, 2018: Alimentary Pharmacology & Therapeutics
Guillaume Le Baut, Laurent Peyrin-Biroulet, Guillaume Bouguen, Jean-Marc Gornet, Carmen Stefanescu, Aurélien Amiot, David Laharie, Romain Altwegg, Mathurin Fumery, Caroline Trang, Lucine Vuitton, Marion Simon, Cyrielle Gilletta de Saint Joseph, Stéphane Nahon, Ludovic Caillo, Emilie Del Tedesco, Laurianne Plastaras, Alexandre Aubourg, Guillaume Pineton de Chambrun, Philippe Seksik, Stéphanie Viennot
BACKGROUND: Genital fistulas represent a devastating complication of Crohn's disease. Only studies with small sample sizes have evaluated the efficacy of anti-TNF therapy for this complication. AIMS: To assess the efficacy of anti-TNF therapy for genital fistulas complicating Crohn's disease and to identify predictive factors associated with clinical response at 1 year. METHODS: Consecutive patients treated with anti-TNF therapy for genital fistulas complicating Crohn's disease from 1999 to 2016 in 19 French centres from the Groupe d'Etude Therapeutique des Affections Inflammatoires du tube Digestif were included in a retrospective cohort study...
September 7, 2018: Alimentary Pharmacology & Therapeutics
Riley Batchelor, Radya Kumar, Julia F M Gilmartin-Thomas, Ingrid Hopper, William Kemp, Danny Liew
BACKGROUND: Clopidogrel's anti-platelet effects may be attenuated by a pharmacokinetic interaction with co-prescribed proton pump inhibitors, which inhibit oxidative pathways that convert clopidogrel into its active metabolites. Despite this, the impact of PPIs on cardiovascular risk in the absence of clopidogrel is not well defined. AIM: To report on a systematic review and meta-analysis of the association between PPIs and cardiovascular risk, independent of clopidogrel...
September 4, 2018: Alimentary Pharmacology & Therapeutics
Marika Rudler, Nicolas Weiss, Vincent Perlbarg, Maxime Mallet, Simona Tripon, Romain Valabregue, Małgorzata Marjańska, Philippe Cluzel, Damien Galanaud, Dominique Thabut
BACKGROUND: Hepatic encephalopathy (HE) may occur after transjugular intrahepatic portosystemic shunt (TIPSS) placement. Multimodal magnetic resonance imaging (MRI), combining anatomical sequences, diffusion tensor imaging (DTI) and 1 H magnetic resonance spectroscopy, is modified in cirrhotic patients. AIMS: In cirrhotic patients indicated for TIPSS: (a) to describe multimodal MRI images before TIPSS; (b) to assess if TIPSS by itself induces changes in multimodal MRI; (c) to find predictors of HE after TIPSS...
September 4, 2018: Alimentary Pharmacology & Therapeutics
Fiorella Cañete, Míriam Mañosa, Ariadna Clos, Eduard Cabré, Eugeni Domènech
BACKGROUND: The convoluted relationship between obesity, bariatric surgery and inflammatory bowel disease (IBD) is of increasing interest. AIM: To analyse evidence regarding the role of bariatric surgery in the development of de novo IBD and its impact on clinical outcomes and safety in patients with established IBD. METHODS: A PubMed/Medline search was performed to identify studies reporting the development of IBD after bariatric surgery and the outcomes of IBD patients after bariatric surgery...
September 4, 2018: Alimentary Pharmacology & Therapeutics
Dragos Ciocan, Cosmin Sebastian Voican, Laura Wrzosek, Cindy Hugot, Dominique Rainteau, Lydie Humbert, Anne-Marie Cassard, Gabriel Perlemuter
BACKGROUND: Intestinal microbiota plays an important role in bile acid homeostasis. AIM: To study the structure of the intestinal microbiota and its function in bile acid homeostasis in alcoholic patients based on the severity of alcoholic liver disease. METHODS: In this prospective study, we included four groups of active alcoholic patients (N = 108): two noncirrhotic, with (noCir_AH, n = 13) or without alcoholic hepatitis (noCir_noAH, n = 61), and two cirrhotic, with (Cir_sAH, n = 17) or without severe alcoholic hepatitis (Cir_noAH, n = 17)...
August 24, 2018: Alimentary Pharmacology & Therapeutics
Helen Vidot, Erin Cvejic, Sharon Carey, Simone Irene Strasser, Geoffrey William McCaughan, Margaret Allman-Farinelli, Nicholas Adam Shackel
BACKGROUND: Painful muscle cramps occur in the majority of patients with cirrhosis impacting significantly on quality of life and sleep patterns. They are frequently unrecognised or overlooked. Current management is based on anecdotal evidence or case study reports. AIM: To investigate the effect of oral taurine supplementation on frequency, duration, and intensity of muscle cramps in patients with chronic liver disease. METHODS: Patients with chronic liver disease who experienced three or more muscle cramps/week were enrolled in a double-blinded, randomised control, crossover, taurine dose-variable study...
August 23, 2018: Alimentary Pharmacology & Therapeutics
Jonathan G Stine, Brian J Wentworth, Alex Zimmet, Mary E Rinella, Rohit Loomba, Stephen H Caldwell, Curtis K Argo
BACKGROUND: Given the lack of long-term prospective studies, it is challenging for clinicians to make informed decisions about screening and treatment decisions regarding the risk of hepatocellular carcinoma (HCC) in patients with non-alcoholic steatohepatitis (NASH) who do not have cirrhosis. AIMS: To characterise the pooled risk of HCC in the non-cirrhosis population. METHODS: Published studies were identified through April 2016 in MEDLINE, Scopus, Science Citation Index, AMED and the Cochrane Library...
August 22, 2018: Alimentary Pharmacology & Therapeutics
Rosalie C Oey, Koos de Wit, Adriaan Moelker, Tugce Atalik, Otto M van Delden, Geert Maleux, Nicole S Erler, R Bart Takkenberg, Robert A de Man, Frederik Nevens, Henk R van Buuren
BACKGROUND: Evidence for the efficacy of TIPSS in ectopic variceal bleeding (EctVB) is largely based on relatively small series. AIM: To define the efficacy of TIPSS in EctVB. METHODS: Retrospective analysis of consecutive patients with chronic liver disease who presented with EctVB and received TIPSS in three tertiary centres in 1992-2016. RESULTS: The study included 53 patients (70% male, median age 61 years, median model for end-stage liver disease (MELD) score 11)...
August 22, 2018: Alimentary Pharmacology & Therapeutics
Claire Auzolle, Stephane Nancey, My-Linh Tran-Minh, Anthony Buisson, Benjamin Pariente, Carmen Stefanescu, Mathurin Fumery, Philippe Marteau, Xavier Treton, Nassim Hammoudi, Xavier Jouven, Philippe Seksik, Matthieu Allez
BACKGROUND: After ileocaecal resection for Crohn's disease (CD), inflammatory lesions frequently recur on the anastomosis and/or on the neo-terminal ileum. AIM: To identify predictors of early post-operative endoscopic recurrence. METHODS: From September 2010 to September 2017, the REMIND group conducted a prospective nationwide study in nine French academic centres. Data were collected at the time of surgery and endoscopy, performed 6-12 months after surgery...
August 20, 2018: Alimentary Pharmacology & Therapeutics
Adjoa Anyane-Yeboa, Akihiro Yamada, Haider Haider, Yunwei Wang, Yuga Komaki, Fukiko Komaki, Joel Pekow, Sushila Dalal, Russell D Cohen, Lisa Cannon, Konstantin Umanskiy, Radhika Smith, Roger Hurst, Neil Hyman, David T Rubin, Atsushi Sakuraba
BACKGROUND: Many patients with Crohn's disease will develop complications that require surgery. Recurrence after surgery is common. AIM: To assess racial differences in postoperative recurrence between African-Americans and Caucasians. METHODS: Medical records of Crohn's disease patients who underwent surgery (ileal, colonic, or ileocolonic resection) between June 2014 and June 2016 were reviewed. The primary endpoints were clinical and endoscopic remission at 6-12 months after a Crohn's disease surgery...
August 20, 2018: Alimentary Pharmacology & Therapeutics
Helen Crocker, Crispin Jenkinson, Michele Peters
BACKGROUND: A better understanding of coeliac disease can be achieved by assessing health-related quality of life alongside clinical factors. Existing patient-reported outcome measures (PROMs) evaluating quality of life in coeliac disease have not been developed in accordance with the US Food and Drug Administration guidelines. AIM: To develop a PROM in accordance with best practice guidelines, capturing all aspects of quality of life important to adults with coeliac disease...
August 20, 2018: Alimentary Pharmacology & Therapeutics
Grace Lai-Hung Wong, Henry Lik-Yuen Chan, Yee-Kit Tse, Terry Cheuk-Fung Yip, Kelvin Long-Yan Lam, Grace Chung-Yan Lui, Cheuk-Chun Szeto, Vincent Wai-Sun Wong
BACKGROUND: In clinical trials involving patients with preserved renal function, tenofovir disoproxil fumarate (TDF) use was associated with mild renal impairment in 1% of patients. AIM: To compare serial renal function of entecavir (ETV)-treated, TDF-treated, and untreated patients with chronic hepatitis B. METHODS: We studied the risk of chronic kidney disease (CKD) progression in a territory-wide cohort of patients with chronic hepatitis B without treatment and of those on ETV or TDF treatment...
August 20, 2018: Alimentary Pharmacology & Therapeutics
Floris F van den Brand, Carin M J van Nieuwkerk, Bart J Verwer, Ynto S de Boer, Nanne K H de Boer, Chris J J Mulder, Elisabeth Bloemena, Christine M Bakker, Jan M Vrolijk, Joost P H Drenth, Adriaan C I T L Tan, Frank Ter Borg, Martijn J Ter Borg, Sven J van den Hazel, Akin Inderson, Maarten E Tushuizen, Gerd Bouma
BACKGROUND: Azathioprine (AZA) and mercaptopurine (MP) are the cornerstone of steroid-sparing strategies in autoimmune hepatitis (AIH). Up to 20% of patients do not tolerate or respond to these regimens. AIM: To retrospectively evaluate the tolerability and efficacy of tioguanine (thioguanine) (TG) therapy in selected patients with AIH and AIH variant syndromes. METHODS: Records of 52 patients who received TG therapy were retrieved from nine hospitals in the Netherlands...
August 15, 2018: Alimentary Pharmacology & Therapeutics
Bram Verstockt, Gitte Moors, Sumin Bian, Thomas Van Stappen, Gert Van Assche, Séverine Vermeire, Ann Gils, Marc Ferrante
BACKGROUND: Proactive testing of adalimumab serum levels is debated. AIM: To study the association between adalimumab serum levels at week 4 and the development of anti-adalimumab drug antibodies and long-term outcome in anti-TNF naive Crohn's disease patients. METHODS: Serum samples from 116 biologically naive Crohn's disease patients with active disease were prospectively collected at baseline, week 4 and 12. Adalimumab serum levels were measured using the RIDA® QUICK adalimumab lateral flow assay and anti-adalimumab drug antibodies were determined using a drug-resistant assay...
August 15, 2018: Alimentary Pharmacology & Therapeutics
Giuseppina Novo, Francesca Macaione, Lydia Giannitrapani, Maria Giovanna Minissale, Vito Bonomo, Francesco Indovina, Salvatore Petta, Maurizio Soresi, Giuseppe Montalto, Salvatore Novo, Antonio Craxi, Anna Licata
BACKGROUND: Cirrhosis is associated with morpho-functional cardiovascular alterations. AIMS: To detect early features of cardiovascular damage in HCV-compensated cirrhotic patients using myocardial deformation indices and carotid arterial stiffness, and further, to evaluate their short-term behaviour after HCV eradication with direct antiviral agents (DAAs). METHODS: Thirty-nine consecutive patients with HCV cirrhosis, without previous cardiovascular events, were studied and matched for age, gender and cardiovascular risk factors to 39 controls without liver or cardiovascular disease...
August 10, 2018: Alimentary Pharmacology & Therapeutics
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