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Alimentary Pharmacology & Therapeutics

G Oriolo, E Egmond, Z Mariño, M Cavero, R Navines, L Zamarrenho, R Solà, J Pujol, N Bargallo, X Forns, R Martin-Santos
BACKGROUND: Chronic hepatitis C is considered a systemic disease because of extra-hepatic manifestations. Neuroimaging has been employed in hepatitis C virus-infected patients to find in vivo evidence of central nervous system alterations. AIMS: Systematic review and meta-analysis of neuroimaging research in chronic hepatitis C treatment naive patients, or patients previously treated without sustained viral response, to study structural and functional brain impact of hepatitis C...
March 14, 2018: Alimentary Pharmacology & Therapeutics
L Gatta, C Scarpignato, G Fiorini, J Belsey, I M Saracino, C Ricci, D Vaira
BACKGROUND: The increasing prevalence of strains resistant to antimicrobial agents is a critical issue in the management of Helicobacter pylori (H. pylori) infection. AIMS: (1) To evaluate the prevalence of primary resistance to clarithromycin, metronidazole and levofloxacin (2) to assess the effectiveness of sequential therapy on resistant strains (3) to identify the minimum number of subjects to enrol for evaluating the effectiveness of an eradication regimen in patients harbouring resistant strains...
March 14, 2018: Alimentary Pharmacology & Therapeutics
J von Felden, J Vermehren, P Ingiliz, S Mauss, T Lutz, K G Simon, H W Busch, A Baumgarten, K Schewe, D Hueppe, C Boesecke, J K Rockstroh, M Daeumer, N Luebke, J Timm, J Schulze Zur Wiesch, C Sarrazin, S Christensen
BACKGROUND: Twelve weeks of the pangenotypic direct-acting antiviral (DAA) combination sofosbuvir/velpatasvir (SOF/VEL) was highly efficient in patients with hepatitis C virus (HCV) genotype 3 (GT3) infection in the ASTRAL-3 approval study. However, presence of resistance-associated substitutions (RASs) in the HCV nonstructural protein 5A (NS5A) was associated with lower treatment response. AIM: To assess the efficacy and safety of SOF/VEL ± ribavirin (RBV) and the impact of NS5A RASs and RBV use on treatment outcome in HCV GT3 infection in a real-world setting...
March 14, 2018: Alimentary Pharmacology & Therapeutics
S Støy, V C Patel, J P Sturgeon, G K Manakkat Vijay, T Lisman, W Bernal, D L Shawcross
BACKGROUND: Thrombocytopenia and circulating dysfunctional immune cells are commonly observed in patients with cirrhosis. Platelets may form complexes with neutrophils, monocytes and T cells modulating their function. We recently reported increased frequencies of platelet-complexed neutrophils in cirrhosis with evidence of neutrophil activation upon contact with healthy platelets in vitro. Whether this occurs in vivo following platelet transfusion and contributes to systemic inflammation and endothelial activation is unknown...
March 12, 2018: Alimentary Pharmacology & Therapeutics
T H Taft, J R Triggs, D A Carlson, L Guadagnoli, K N Tomasino, L Keefer, J E Pandolfino
BACKGROUND: Oesophageal hypervigilance and anxiety can drive symptom experience in chronic oesophageal conditions, including gastro-oesophageal reflux disease, achalasia and functional oesophageal disorders. To date, no validated self-report measure exists to evaluate oesophageal hypervigilance and anxiety. AIMS: This study aims to develop a brief and reliable questionnaire assessing these constructs, the oesophageal hypervigilance and anxiety scale (EHAS). METHODS: Questions for the EHAS were drawn from 4 existing validated measures that assessed hypervigilance and anxiety adapted for the oesophagus...
March 12, 2018: Alimentary Pharmacology & Therapeutics
W-L Chuang, J Jia, H L Y Chan, K-H Han, T Tanwandee, D Tan, X Chen, E Gane, T Piratvisuth, L Chen, Q Xie, J J-Y Sung, D Messinger, C Wat, G Bakalos, Y F Liaw
BACKGROUND: In the large randomised NEPTUNE study, peginterferon alfa-2a 180 μg/wk for 48 weeks produced higher hepatitis B e antigen (HBeAg) seroconversion rates 24 weeks post-treatment (36%) than a lower dose (90 μg/wk) and/or shorter duration (24 weeks) (range 14%-26%). AIM: To determine seroconversion rates 5 years after completion of treatment in NEPTUNE. METHODS: HBeAg-positive patients who completed 24 weeks' follow-up in NEPTUNE (with peginterferon alfa-2a 90 μg/wk × 24 weeks [group 1]; 180 μg/wk × 24 weeks [2]; 90 μg/wk × 48 weeks [3] or 180 μg/wk × 48 weeks [4]) were followed up...
March 9, 2018: Alimentary Pharmacology & Therapeutics
P F Vollebregt, A A van Bodegraven, T M L Markus-de Kwaadsteniet, D van der Horst, R J F Felt-Bersma
BACKGROUND: Patient reported outcomes regarding perianal disease and faecal incontinence in the community-based inflammatory bowel disease population are poorly described. AIMS: To determine the impacts of perianal disease and faecal incontinence on quality of life and employment in inflammatory bowel disease patients. METHODS: For this cross-sectional study, a comprehensive survey was sent out to members of the Dutch National Crohn's and Colitis patient organisation...
March 9, 2018: Alimentary Pharmacology & Therapeutics
A W Singer, K R Reddy, L E Telep, A O Osinusi, D M Brainard, M Buti, A P Chokkalingam
BACKGROUND: Eradication of hepatitis C virus (HCV) infection via interferon-based treatment lowers hepatocellular carcinoma risk; some research suggests this effect extends to interferon-free treatment. AIMS: The objective of this retrospective cohort study was to examine the association of direct-acting antiviral (DAA) exposure with risk of incident liver cancer in real-world data. METHODS: From United States administrative claims data through March 31, 2017, we identified 30 183 adult HCV patients exposed to DAAs...
March 7, 2018: Alimentary Pharmacology & Therapeutics
R Ungaro, R Fausel, H L Chang, S Chang, L A Chen, A Nakad, A El Nawar, I Prytz Berset, J Axelrad, G Lawlor, A Atreja, L Roque Ramos, J Torres, J-F Colombel
BACKGROUND: Case series suggest a possible association between bariatric surgery and incident IBD. AIM: The aim of this study was to evaluate the association between bariatric surgery and new-onset IBD. METHODS: We first conducted a multi-institutional case series of patients with a history of IBD and bariatric surgery. We next conducted a matched case-control study using medical and pharmacy claims from 2008 to 2012 in a US national database from Source Healthcare Analytics LLC...
March 7, 2018: Alimentary Pharmacology & Therapeutics
S Torvinen-Kiiskinen, A-M Tolppanen, M Koponen, A Tanskanen, J Tiihonen, S Hartikainen, H Taipale
BACKGROUND: Hip fractures are a major health concern among older persons with Alzheimer's disease, who usually use many concomitant drugs for several diseases. Evidence of the association between proton pump inhibitor use and risk of hip fracture is contradictory. AIM: To investigate whether the long-term use of proton pump inhibitor is associated with risk of hip fractures among community-dwelling persons with Alzheimer's disease. METHODS: In this nested case-control study, the nationwide MEDALZ data were utilised...
March 6, 2018: Alimentary Pharmacology & Therapeutics
H Philpott, M K Dougherty, C C Reed, M Caldwell, D Kirk, D J Torpy, E S Dellon
BACKGROUND: Swallowed topical corticosteroids are prescribed for eosinophilic oesophagitis (EoE), but there is a theoretical risk of adrenal insufficiency from their use. AIMS: To determine if the use of topical corticosteroids to treat EoE is associated with the development of adrenal insufficiency. METHOD: We conducted a systematic review of the published literature from January 1, 1950 to April 1, 2017 using Pubmed, Embase, Web of Science and Cochrane Central...
March 5, 2018: Alimentary Pharmacology & Therapeutics
G J Walker, L Moore, N Heerasing, P Hendy, M H Perry, T J McDonald, T Debenham, R Bethune, C Bewshea, C Hyde, G A Heap, A Singh, C Calvert, N A Kennedy, J R Goodhand, T Ahmad
BACKGROUND: Primary care faecal calprotectin testing distinguishes inflammatory bowel disease (IBD) from functional gut disorder in young patients presenting with abdominal symptoms; however, previous evaluations have excluded patients with alarm symptoms. AIMS: We sought to evaluate the diagnostic accuracy of calprotectin to distinguish IBD from functional gut disorder in young adults in whom general practitioners (GPs) suspected IBD; including patients reporting gastrointestinal alarm symptoms...
March 5, 2018: Alimentary Pharmacology & Therapeutics
D Attia, K El Saeed, W Elakel, T Elbaz, A Omar, A Yosry, M H Elsayed, M El Raziky, M Anees, W Doss, Y El Shazly, H Wedemeyer, G Esmat
BACKGROUND: Interferon-free regimens are associated with high sustained virological response; however, associated adverse effects have yet to be fully reported. AIM: To evaluate the adverse effects associated with the different direct-acting antiviral drug (DAA) regimens in Egyptian patients. METHODS: This multicenter retrospective study included all adverse effects during and after treatment with DAA regimens of 149 816 chronic hepatitis C treated Egyptian patients...
March 5, 2018: Alimentary Pharmacology & Therapeutics
S Van Hees, S Bourgeois, H Van Vlierberghe, T Sersté, S Francque, P Michielsen, D Sprengers, H Reynaert, J Henrion, S Negrin Dastis, J Delwaide, L Lasser, J Decaestecker, H Orlent, F Janssens, G Robaeys, I Colle, P Stärkel, C Moreno, F Nevens, T Vanwolleghem
BACKGROUND: Stopping nucleos(t)ide analogues (NA) after hepatitis B e antigen (HBeAg) seroconversion is associated with high relapse rates in Asian patients, but data in Caucasian cohorts are scarce. Clinical course, outcomes and immunological aspects of chronic hepatitis B infections differ substantially between distinct ethnicities. AIM: The aim of this study was to determine relapse rates, factors predicting relapse and clinical outcomes after nucleos(t)ide analogue cessation in a large, predominantly Caucasian cohort of chronic hepatitis B patients with nucleos(t)ide analogue-induced HBeAg seroconversion...
March 2, 2018: Alimentary Pharmacology & Therapeutics
R Schwarzer, D Kivaranovic, R Paternostro, M Mandorfer, T Reiberger, M Trauner, M Peck-Radosavljevic, A Ferlitsch
BACKGROUND: Sequential measurements of hepatic venous pressure gradient (HVPG) are used to assess the haemodynamic response to nonselective betablockers (NSBBs) in patients with portal hypertension. AIMS: To assess the rates of HVPG response to different doses of carvedilol. METHODS: Consecutive patients with cirrhosis undergoing HVPG-guided carvedilol therapy for primary prophylaxis of variceal bleeding between 08/2010 and 05/2015 were retrospectively included...
February 28, 2018: Alimentary Pharmacology & Therapeutics
Y E Chon, K S Jung, M-J Kim, J-Y Choi, C An, J Y Park, S H Ahn, B K Kim, S U Kim, H Park, S K Hwang, K S Rim, K-H Han, D Y Kim
BACKGROUND: A proportion of chronic hepatitis B (CHB) patients are diagnosed with advanced hepatocellular carcinoma (HCC) despite regular surveillance. AIMS: To determine predictors for HCC detection failure in CHB patients who underwent regular surveillance. METHODS: CHB patients with well-preserved liver function, who underwent ultrasonography and alpha-foetoprotein (AFP) analysis every 6 months, were enrolled. Cox regression analysis was used to identify predictors for detection failure, defined as HCC initially diagnosed at Barcelona Clinic Liver Cancer (BCLC) stage B or C...
February 28, 2018: Alimentary Pharmacology & Therapeutics
R M Genta, A Sonnenberg, K Turner
BACKGROUND: The normal content of eosinophils in the adult duodenum remains undefined. Therefore, there is no foundation for evidence-based criteria to diagnose eosinophilic duodenitis. AIM: This study aimed at: (1) establishing the range of the eosinophil density in the mucosa of the duodenum of normal adults, and (2) determining the biopsy-based prevalence of isolated eosinophilic duodenitis in a large population of adults. METHODS: We counted intact eosinophils in three separate high-power fields (hpf area = 0...
February 27, 2018: Alimentary Pharmacology & Therapeutics
M J Tong, C Q Pan, S-H B Han, D S-K Lu, S Raman, K-Q Hu, J K Lim, H W Hann, A D Min
BACKGROUND: Hepatitis B virus (HBV) infection is common with major clinical consequences. In Asian Americans, the HBsAg carrier rate ranges from 2% to 16% which approximates the rates from their countries of origin. Similarly, HBV is the most important cause of cirrhosis, hepatocellular carcinoma (HCC) and liver related deaths in HBsAg positive Asians worldwide. AIM: To generate recommendations for the management of Asian Americans infected with HBV. METHODS: These guidelines are based on relevant data derived from medical reports on HBV from Asian countries as well as from studies in the HBsAg positive Asian Americans...
February 26, 2018: Alimentary Pharmacology & Therapeutics
G J Webb, S R Rahman, C Levy, G M Hirschfield
BACKGROUND: The use of rifampicin for cholestatic pruritus is accompanied by concerns over safety, but the availability of real-world prescribing data is relatively limited. AIM: We sought to describe the rate and characteristics of rifampicin-induced hepatitis in a mixed aetiology cohort of patients with established liver disease and cholestatic pruritus. METHODS: Retrospective review of records for out-patients commenced on rifampicin for pruritus 2012-2016 inclusive...
February 22, 2018: Alimentary Pharmacology & Therapeutics
A B Friedman, S J Brown, P Bampton, M L Barclay, A Chung, F A Macrae, J McKenzie, J Reynolds, P R Gibson, S B Hanauer, M P Sparrow
BACKGROUND: Thiopurine hypermethylation towards 6-methylmercaptopurine (6MMP) instead of 6-thioguanine nucleotides (6TGN) is associated with inefficacy in patients with IBD. Allopurinol reverses such hypermethylation. AIMS: To prospectively determine efficacy of allopurinol-thiopurine combination and to compare 2 doses of allopurinol. DESIGN: In a multicentre, double-blind trial, patients with clinically active or steroid-dependent IBD and thiopurine shunting were randomised to 50 or 100 mg/d allopurinol and 25% of their screening thiopurine dose, which was subsequently optimised, aiming for 6TGN of 260-500 pmol/8x108 RBCs...
February 21, 2018: Alimentary Pharmacology & Therapeutics
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