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Alimentary Pharmacology & Therapeutics

J Dhaliwal, G B Chavhan, E Lurz, A Shalabi, N Yuen, B Williams, I Martincevic, A Amirabadi, P W Wales, W Lee, S C Ling, M Mouzaki
BACKGROUND: The prevalence of non-alcoholic fatty liver disease (NAFLD) in children is 8% in the general population, and 34% in the context of obesity. There is a paucity of data on the prevalence of hepatic steatosis in healthy children in Ontario. AIMS: To determine the prevalence of hepatic steatosis using abdominal computed tomography (CT) scans in a cohort of previously healthy children across the paediatric age spectrum in Ontario, Canada, and to determine association between measures of abdominal adiposity and hepatic steatosis...
July 11, 2018: Alimentary Pharmacology & Therapeutics
M E Joosse, M A Aardoom, P Kemos, D Turner, D C Wilson, S Koletzko, J Martin-de-Carpi, U L Fagerberg, C Spray, C Tzivinikos, M Sladek, R Shaoul, E Roma-Giannikou, J Bronsky, D E Serban, F M Ruemmele, H Garnier-Lengline, G Veres, I Hojsak, K L Kolho, I H Davies, M Aloi, P Lionetti, S Hussey, G Veereman, C P Braegger, E Trindade, A V Wewer, A C Hauer, A C H de Vries, R Sigall Boneh, C Sarbagili Shabat, A Levine, L de Ridder
BACKGROUND: Risk benefit strategies in managing inflammatory bowel diseases (IBD) are dependent upon understanding the risks of uncontrolled inflammation vs those of treatments. Malignancy and mortality in IBD have been associated with disease-related inflammation and immune suppression, but data are limited due to their rare occurrence. AIM: To identify and describe the most common causes of mortality, types of cancer and previous or current therapy among children and young adults with paediatric-onset IBD...
July 8, 2018: Alimentary Pharmacology & Therapeutics
M Laszkowska, S Mahadev, J Sundström, B Lebwohl, P H R Green, K Michaelsson, J F Ludvigsson
BACKGROUND: Earlier studies have produced highly varying risk estimates for the prevalence of coeliac disease (CD) in osteoporosis. AIMS: To investigate the prevalence of CD among individuals with osteoporosis. METHODS: We conducted a systematic review of articles published in PubMed, Medline or EMBASE through May 2017 to identify studies looking at prevalence of CD in patients with osteoporosis. Search terms included "coeliac disease" combined with "fractures", "bone disease", "bone density", "densitometry", "osteoporos*", "osteomal*", "osteodys" or "dexa" or "dxa" or "skelet"...
July 8, 2018: Alimentary Pharmacology & Therapeutics
L Stapersma, G van den Brink, E M Szigethy, J C Escher, E M W J Utens
BACKGROUND: The co-existence of psychological problems and paediatric inflammatory bowel disease (IBD) is receiving increasing attention. Most studies investigated anxiety and depression, with prevalence rates varying from 0% to 50%. A systematic review is necessary to provide clear insight into the prevalence of anxiety and depression in paediatric IBD. AIM: To systematically evaluate available data on the prevalence of anxiety and depressive symptoms and disorders in paediatric IBD (aged 6-18 years)...
July 8, 2018: Alimentary Pharmacology & Therapeutics
F Tovoli, G Negrini, R Farì, E Guidetti, C Faggiano, L Napoli, L Bolondi, A Granito
BACKGROUND: A gluten-free diet (GFD) is known to be associated with altered macronutrient intake and metabolic syndrome. Nonalcoholic fatty liver disease (NAFLD) is the hepatic hallmark of metabolic syndrome. The risk of NAFLD in patients with coeliac disease (CD) adhering to a GFD remains to be fully investigated; in particular, data from real-life clinical settings are lacking. AIMS: To assess the prevalence and relative risk of NAFLD in CD patients treated with a GFD...
July 8, 2018: Alimentary Pharmacology & Therapeutics
Y Wouters, M Theilla, P Singer, S Tribler, P B Jeppesen, L Pironi, L Vinter-Jensen, H H Rasmussen, F Rahman, G J A Wanten
BACKGROUND: The catheter lock solutions 2% taurolidine and 0.9% saline are both used to prevent catheter-related bloodstream infections (CRBSIs) in home parenteral nutrition patients. AIMS: To compare the effectiveness and safety of taurolidine and saline. METHODS: This multicentre double-blinded trial randomly assigned home parenteral nutrition patients to use either 2% taurolidine or 0.9% saline for 1 year. Patients were stratified in a new catheter group and a pre-existing catheter group...
July 5, 2018: Alimentary Pharmacology & Therapeutics
N Plevris, R Sinha, A W Hay, N McDonald, J N Plevris, P C Hayes
BACKGROUND: Hyaluronic acid is a recognised noninvasive marker of liver fibrosis. However, its prognostic ability has not been extensively studied. AIMS: To investigate the ability of an index serum hyaluronic acid measurement to independently predict transplant-free survival in patients with liver disease of varying aetiology and severity. METHODS: This was a retrospective single-centre cohort study. Serum hyaluronic acid was measured at the discretion of the attending clinicians, in patients attending the liver clinic, to assess disease severity...
July 4, 2018: Alimentary Pharmacology & Therapeutics
R El Sharkawy, K Thabet, P Lampertico, S Petta, A Mangia, T Berg, M Metwally, A Bayoumi, A Boonstra, W P Brouwer, A Smedile, M L Abate, A Loglio, M W Douglas, A Khan, R Santoro, J Fischer, D J Leeming, C Liddle, J George, M Eslam
BACKGROUND: Host genetic modifiers of the natural history of chronic hepatitis B (CHB) remain poorly understood. Recently, a genome-wide association study (GWAS)-identified polymorphism in the STAT4 gene that contributes to the risk for hepatocellular carcinoma (HCC) was shown to be associated with the full spectrum of hepatitis B virus (HBV) outcomes in Asian patients. However, the functional mechanisms for this effect are unknown and the role of the variant in modulating HBV disease in Caucasians has not been investigated...
July 2, 2018: Alimentary Pharmacology & Therapeutics
H L Y Chan, D Messinger, G V Papatheodoridis, M Cornberg, Q Xie, T Piratvisuth, H Ren, P T Kennedy, A Thompson, A Caputo, G Bakalos, V Pavlovic, P Lampertico
BACKGROUND: Peginterferon induces off-treatment responses in approximately one-third of patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. AIMS: The aim of this study was to develop an easy-to-use baseline prediction score to identify hepatitis B virus (HBV) genotype B-/C-infected HBeAg-positive Asian patients likely to respond to peginterferon alfa-2a. METHODS: Generalised additive models, multiple logistic regression (MLR) analysis and internal validation methods were applied to data from 647 HBeAg-positive patients from China, Hong Kong and Taiwan to develop a scoring system to predict response 24 weeks after completing a 48-week course of peginterferon alfa-2a...
June 29, 2018: Alimentary Pharmacology & Therapeutics
M C Tan, H B El-Serag, X Yu, A P Thrift
BACKGROUND: Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) may reduce the risk of oesophageal adenocarcinoma (OAC) in Barrett's oesophagus; however, current epidemiologic studies are inconclusive. AIM: To evaluate the independent effects of PPIs and H2RAs on risk of OAC in patients with Barrett's oesophagus. METHODS: We conducted a nested case-control study of male veterans diagnosed with Barrett's oesophagus. Cases with incident OAC were matched by incidence density sampling on birth year and Barrett's diagnosis date to controls with Barrett's oesophagus who did not develop OAC...
June 29, 2018: Alimentary Pharmacology & Therapeutics
M Mandorfer, B Scheiner, A F Stättermayer, P Schwabl, R Paternostro, D Bauer, B Schäfer, H Zoller, M Peck-Radosavljevic, M Trauner, T Reiberger, P Ferenci, A Ferlitsch
BACKGROUND: The rs738409 C>G p.I148M variant in the patatin-like phospholipase domain containing 3 (PNPLA3)-gene promotes triglyceride accumulation in hepatocytes and hepatic stellate cell activation and has previously been linked to hepatic steatosis/liver fibrosis. AIM: To investigate its impact on hepatic decompensation and (liver-related) mortality in patients who had already developed portal hypertension. Moreover, we assessed its link with hepatic steatosis as evaluated by controlled attenuation parameter...
June 29, 2018: Alimentary Pharmacology & Therapeutics
L Gragnani, G Cerretelli, S Lorini, C Steidl, A Giovannelli, M Monti, L Petraccia, S Sadalla, T Urraro, P Caini, A Xheka, A Simone, U Arena, M Matucci-Cerinic, D Vergani, G Laffi, A L Zignego
BACKGROUND: Cryoglobulinaemic vasculitis (CV) is a lymphoproliferative disorder related to hepatitis C virus (HCV) infection; anti-viral therapy is the first therapeutic option. CV can be incapacitating, compromising the patients' quality of life (QoL). In a controlled study, interferon-based therapy was associated with a lower virological response in vasculitic patients than in patients without vasculitis. Limited, uncontrolled data on direct-acting anti-virals are available. AIM: To evaluate safety, clinical efficacy, virological response and the impact of interferon-free treatment on QoL in HCV patients with and without mixed cryoglobulinaemia (MC)...
June 28, 2018: Alimentary Pharmacology & Therapeutics
S Singh, M Fumery, W J Sandborn, M H Murad
BACKGROUND: There are limited data to inform positioning of agents for treating moderate-severe Crohn's disease (CD). AIM: We assessed comparative efficacy and safety of first-line (biologic-naïve) and second-line (prior exposure to anti-tumour necrosis factor [TNF]-α) agents) biologic therapy for moderate-severe CD, through a systematic review and network meta-analysis, and appraised quality of evidence (QoE) using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach...
June 19, 2018: Alimentary Pharmacology & Therapeutics
F Rieder, D Bettenworth, C Ma, C E Parker, L A Williamson, S A Nelson, G van Assche, A Di Sabatino, Y Bouhnik, R W Stidham, A Dignass, G Rogler, S A Taylor, J Stoker, J Rimola, M E Baker, J G Fletcher, J Panes, W J Sandborn, B G Feagan, V Jairath
BACKGROUND: Fibrotic stricture is a common complication of Crohn's disease (CD) affecting approximately half of all patients. No specific anti-fibrotic therapies are available; however, several therapies are currently under evaluation. Drug development for the indication of stricturing CD is hampered by a lack of standardised definitions, diagnostic modalities, clinical trial eligibility criteria, endpoints and treatment targets in stricturing CD. AIM: To standardise definitions, diagnosis and treatment targets for anti-fibrotic stricture therapies in Chron's disease...
June 19, 2018: Alimentary Pharmacology & Therapeutics
T Furuta, S Baba, M Yamade, T Uotani, T Kagami, T Suzuki, S Tani, Y Hamaya, M Iwaizumi, S Osawa, K Sugimoto
BACKGROUND: Although autoimmune gastritis (AIG) is generally considered relatively rare, we frequently encounter AIG among patients at to our hospital who have experienced at least two episodes of Helicobacter pylori eradication failure. AIMS: We investigated the incidence of AIG in consecutive patients who consulted our department for H. pylori eradication with reference to eradication history. METHODS: A total of 404 consecutive patients who visited the H...
June 19, 2018: Alimentary Pharmacology & Therapeutics
P J Tozer, P Lung, A J Lobo, S Sebastian, S R Brown, A L Hart, N Fearnhead
BACKGROUND: Evidence from groups who have studied fistula aetiology and extrapolation from interventional studies supports a multifactorial hypothesis of Crohn's perianal fistula, with several pathophysiological elements that may contribute to fistula formation, persistence and resistance to treatment. AIM: An evidence synthesis of current understanding of pathophysiological factors underlying Crohn's perianal fistula is presented, exploring the fundamental reasons why some treatments succeed and others fail, as a means of focussing clinical knowledge on improving treatment of Crohn's perianal fistula...
June 19, 2018: Alimentary Pharmacology & Therapeutics
E Han, Y-H Lee, B K Kim, J Y Park, D Y Kim, S H Ahn, B-W Lee, E S Kang, B-S Cha, K-H Han, S U Kim
BACKGROUND: Sarcopenia is significantly associated with the degree of liver fibrosis. This study investigated the influence of sarcopenia on liver fibrosis in individuals with chronic hepatitis B. METHODS: Data from the Korean National Health and Nutrition Examination Surveys 2008-2011 were analysed. The sarcopenia index (total appendicular skeletal muscle mass [kg]/body mass index [kg/m2 ]) was calculated using dual-energy X-ray absorptiometry. Sarcopenia was defined as the lowest quintile sarcopenia index value (cut-offs: 0...
June 19, 2018: Alimentary Pharmacology & Therapeutics
A Loglio, M Iavarone, G Grossi, M Viganò, M G Rumi, F Facchetti, G Lunghi, A Sangiovanni, M Colombo, P Lampertico
BACKGROUND: Long-term oral nucleos(t)ide analogue (NUC) therapy in hepatitis B virus (HBV)-related compensated cirrhotics prevents clinical decompensation but not hepatocellular carcinoma (HCC) development. AIMS: To define the clinical features and outcomes of HCC in long-term NUC-treated HBV patients. METHODS: All HCCs developing between 2005 and 2016 in NUC-treated HBV patients under surveillance were studied, excluding those that occurred within the first 6 months of therapy...
June 19, 2018: Alimentary Pharmacology & Therapeutics
C R Rowan, D Keegan, K Byrne, G Cullen, H E Mulcahy, J Sheridan, E J Ryan, A de Vries, G D'Haens, G A Doherty
BACKGROUND: Ustekinumab (USK) is licenced for intravenous induction and subcutaneous (S/C) maintenance in Crohn's disease. AIM: To evaluate ustekinumab trough concentrations and clinical response with exclusive subcutaneous ustekinumab induction. METHODS: Patients with Crohn's disease who initiated treatment with subcutaneous ustekinumab at a single academic centre were included in this pilot study. A dosage of 360 mg ustekinumab was given subcutaneously in divided doses; 180 mg at Week 0, 90 mg at Week 1 and 90 mg at Week 2, with corresponding ustekinumab trough concentrations assessed to Week 8...
June 19, 2018: Alimentary Pharmacology & Therapeutics
Y-H J Shao, T-S Chan, K Tsai, S-Y Wu
BACKGROUND: Proton pump inhibitor (PPI) use has been reported to be associated with liver damage and might possibly be carcinogenic. AIMS: We examined whether long-term PPI use increases the risk of hepatocellular carcinoma (HCC) in patients without viral hepatitis B or C. METHODS: We conducted a nested case-control study in a cohort of patients without viral hepatitis in Taiwan from 2000 to 2013. In total, 29 473 HCC cases and 294 508 matched controls were included...
June 13, 2018: Alimentary Pharmacology & Therapeutics
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