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Alimentary Pharmacology & Therapeutics

B Hameed, N A Terrault, R M Gill, R Loomba, N Chalasani, J H Hoofnagle, M L Van Natta
BACKGROUND: In a 72-week, randomised controlled trial of obeticholic acid (OCA) in non-alcoholic steatohepatitis (NASH), OCA was superior to placebo in improving serum ALT levels and liver histology. OCA therapy also reduced weight. AIMS: Because weight loss by itself can improve histology, to perform a post hoc analysis of the effects of weight loss and OCA treatment in improving clinical and metabolic features of NASH. METHODS: The analysis was limited to the 200 patients with baseline and end-of-treatment liver biopsies...
January 14, 2018: Alimentary Pharmacology & Therapeutics
W-K Chan, S Treeprasertsuk, K Imajo, A Nakajima, Y Seki, K Kasama, S Kakizaki, J-G Fan, M J Song, S K Yoon, Y-Y Dan, L Lesmana, K-Y Ho, K-L Goh, V W-S Wong
BACKGROUND: The Gut and Obesity Asia (GO ASIA) workgroup was formed to study the relationships between obesity and gastrointestinal diseases in the Asia Pacific region. AIM: To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients. METHODS: Retrospective study of biopsy-proven NAFLD patients from centres in the GO ASIA Workgroup...
January 14, 2018: Alimentary Pharmacology & Therapeutics
D Bettinger, D Martin, S Rieg, M Schultheiss, N Buettner, R Thimme, T Boettler
BACKGROUND: Proton pump inhibitors (PPI) are often used in patients with gastro-esophageal reflux and peptic ulcer disease. A higher risk for infectious diseases and for pyogenic liver abscess has been reported in patients with prolonged PPI intake. Although many patients have ongoing PPI treatment after diagnosis of liver abscess, there are no data available that focus on the prognostic impact of PPI treatment in these patients. AIM: To analyse the effect of PPI treatment on mortality in patients with pyogenic liver abscesses...
January 12, 2018: Alimentary Pharmacology & Therapeutics
F Ji, B Wei, Y H Yeo, E Ogawa, B Zou, C D Stave, Z Li, S Dang, N Furusyo, R C Cheung, M H Nguyen
BACKGROUND: Direct-acting antiviral (DAA) regimens have shown high efficacy and tolerability for patients with HCV genotype 1/1b (GT1/1b) in clinical trials. However, robust real-world evidence of interferon (IFN)-free DAA treatment for HCV GT1-infected patients in Asia is still lacking. AIM: To systematically review and meta-analyse the effectiveness and tolerability of IFN-free DAA therapy for HCV GT1 infection in Asia. METHODS: We included studies that enrolled adult patients with HCV GT1 infection in routine clinical practice in Asia, using IFN-free DAA regimens, and reported sustained virological response (SVR) after 12/24 weeks end-of-treatment by 31 May 2017...
January 12, 2018: Alimentary Pharmacology & Therapeutics
G S Sayuk, N Kanuri, C P Gyawali, B M Gott, B D Nix, R A Rosenheck
BACKGROUND: While opioid prescriptions have increased alarmingly in the United States (US), their use for unexplained chronic gastrointestinal (GI) pain (eg, irritable bowel syndrome) carries an especially high risk for adverse effects and questionable benefit. AIM: To compare opioid use among US veterans with structural GI diagnoses (SGID) and those with unexplained GI symptoms or functional GI diagnoses (FGID), a group for whom opioids have no accepted role. METHODS: Veterans Health Administration (VHA) administrative data from fiscal year 2012 were used to identify veterans with diagnostic codes recorded for SGID and FGID...
January 12, 2018: Alimentary Pharmacology & Therapeutics
L Elkrief, M Ronot, F Andrade, M Dioguardi Burgio, T Issoufaly, M Zappa, O Roux, J Bissonnette, A Payancé, D Lebrec, C Francoz, O Soubrane, D Valla, F Durand, V Vilgrain, L Castera, P-E Rautou
BACKGROUND: Two algorithms based on sequential measurements of liver and spleen stiffness using two-dimensional shearwave elastography (2D-SWE) have been recently proposed to estimate clinically significant portal hypertension (hepatic venous pressure gradient [HVPG] ≥10 mm Hg) in patients with cirrhosis, with excellent diagnostic accuracy. AIM: To validate externally these algorithms in a large cohort of patients with cirrhosis. METHODS: One hundred and ninety-one patients with stable cirrhosis (Child-Pugh class A 39%, B 29% and C 31%) who underwent liver and spleen stiffness measurements using 2D-SWE at the time of HVPG measurement were included...
January 11, 2018: Alimentary Pharmacology & Therapeutics
M Dallio, M Masarone, S Errico, A G Gravina, C Nicolucci, R Di Sarno, L Gionti, C Tuccillo, M Persico, P Stiuso, N Diano, C Loguercio, A Federico
BACKGROUND: Bisphenol A is an endocrine disrupting chemical associated with type 2 diabetes mellitus (T2DM), cardiovascular disease and liver enzyme abnormalities. AIM: To evaluate bisphenol A plasma and urine levels in non-alcoholic fatty liver disease (NAFLD) patients compared to healthy subjects. Furthermore, we evaluated, in human HepG2 cells, the effects of exposure to different concentrations of bisphenol A on both oxidative stress induction and cell proliferation...
January 11, 2018: Alimentary Pharmacology & Therapeutics
P Collin, A Vilppula, L Luostarinen, G K T Holmes, K Kaukinen
BACKGROUND: The presenting symptoms of coeliac disease are often subtle and the diagnosis is frequently delayed or overlooked. Therefore, especially elderly patients may be denied the benefits conferred by gluten free diet which can be dramatically life-changing. AIM: To review the occurrence, clinical features, diagnosis and management in coeliac patients detected later in life. METHODS: To review manuscripts concerned with coeliac disease in the elderly and to derive subgroups of elderly people from publications on the disorder...
January 11, 2018: Alimentary Pharmacology & Therapeutics
P Wils, Y Bouhnik, P Michetti, B Flourie, H Brixi, A Bourrier, M Allez, B Duclos, M Serrero, A Buisson, A Amiot, M Fumery, X Roblin, L Peyrin-Biroulet, J Filippi, G Bouguen, V Abitbol, B Coffin, M Simon, D Laharie, B Pariente
BACKGROUND: Long-term outcome of ustekinumab in Crohn's disease (CD) has not been evaluated. AIM: To evaluate the long-term efficacy and safety of ustekinumab and identify the predictive factors of ustekinumab failure-free persistence in a cohort of anti-TNF refractory CD patients. METHODS: We performed a retrospective multicentre cohort study including all consecutive CD patients who began subcutaneous ustekinumab and presented a clinical response (defined as a significant improvement of CD-related clinical symptoms assessed by the patient's physician leading to continued ustekinumab) during the first year of treatment...
January 8, 2018: Alimentary Pharmacology & Therapeutics
H El-Khayat, Y Fouad, H I Mohamed, H El-Amin, E M Kamal, M Maher, A Risk
BACKGROUND: The Daclatasvir and Sofosbuvir combination therapy (SOF/DCV) has shown efficacy in patients with chronic hepatitis C in clinical trials. AIM: To investigate the efficacy and safety of SOF/DCV for treatment of patients with hepatitis C-related liver cirrhosis genotype 4. METHODS: Multicentre study involving 551 patients with liver cirrhosis genotype 4; 432 naïve patients and 119 treatment-experienced patients. All patients received SOF (400 mg) and DCV (60 mg) daily in addition to weight-based ribavirin (RBV) for 12 weeks and when RBV is contraindicated the treatment duration was extended to 24 weeks...
January 3, 2018: Alimentary Pharmacology & Therapeutics
N Fukui, P Golabi, M Otgonsuren, L de Avila, H Bush, Z M Younossi
BACKGROUND: Few studies have assessed the impact of hospice care in patients with primary liver cancer. AIM: To examine the determinants of hospice care and its effects on resource utilisation and survival among Medicare beneficiaries with primary liver cancer. METHODS: We utilised the Surveillance, Epidemiology and End result Registry (SEER) database from 2002 to 2009 for this cross-sectional study. A total of 3385 patients with primary liver cancer were included...
January 3, 2018: Alimentary Pharmacology & Therapeutics
P J Eddowes, N McDonald, N Davies, S I K Semple, T J Kendall, J Hodson, P N Newsome, R B Flintham, R Wesolowski, L Blake, R V Duarte, C J Kelly, A H Herlihy, M D Kelly, S P Olliff, S G Hübscher, J A Fallowfield, G M Hirschfield
BACKGROUND: Validated diagnostic tools that are accurate, cost effective and acceptable to patients are required for disease stratification and monitoring in NAFLD. AIMS: To investigate the performance and cost of multiparametric MRI alongside existing biomarkers in the assessment of NAFLD. METHODS: Adult patients undergoing standard of care liver biopsy for NAFLD were prospectively recruited at two UK liver centres and underwent multiparametric MRI, blood sampling and transient elastography withing 2 weeks of liver biopsy...
December 22, 2017: Alimentary Pharmacology & Therapeutics
S Fourati, J Guedj, S Chevaliez, T H T Nguyen, F Roudot-Thoraval, I Ruiz, A Soulier, G Scoazec, A Varaut, L Poiteau, M Francois, A Mallat, C Hézode, J-M Pawlotsky
BACKGROUND: The combination of sofosbuvir (SOF) plus an NS5A inhibitor for 12 weeks is highly efficacious in patients with chronic hepatitis C. As the costs of generic production of sofosbuvir and NS5A inhibitor are rapidly decreasing, the combination of these DAAs will be the standard treatment in most low- to middle-income countries in the future. AIM: To identify key predictors of response that can be used to tailor treatment decisions. METHODS: A cohort of 216 consecutive patients infected with HCV genotype 1 (1a: n = 57; 1b: n = 77), 2 (n = 4), 3 (n = 33) or 4 (n = 44) were treated with sofosbuvir (SOF) + daclatasvir (n = 176) or SOF + ledipasvir (n = 40) for 12 weeks...
December 22, 2017: Alimentary Pharmacology & Therapeutics
A Wilson, L E Jansen, R V Rose, J C Gregor, T Ponich, N Chande, R Khanna, B Yan, V Jairath, N Khanna, M Sey, M Beaton, K McIntosh, W A Teft, R B Kim
BACKGROUND: Azathioprine (AZA)-induced pancreatitis is an unpredictable and dose-independent adverse event affecting 2%-7% of patients with inflammatory bowel disease (IBD) patients treated with AZA. There are no tools in clinical practice to identify at-risk individuals; however, a genome wide association study (GWAS) identified a strong association between the Class II HLA gene region polymorphism (rs2647087) and thiopurine-induced pancreatitis. AIM: To independently confirm the findings of the GWAS in an IBD cohort, to evaluate its utility in clinical practice and to offer a novel AZA treatment algorithm for IBD based on pharmacogenomic principles...
December 22, 2017: Alimentary Pharmacology & Therapeutics
F Rainer, A Horvath, T D Sandahl, B Leber, B Schmerboeck, A Blesl, A Groselj-Strele, R E Stauber, P Fickert, P Stiegler, H J Møller, H Grønbaek, V Stadlbauer
BACKGROUND: Activated hepatic macrophages play a key role in inflammation and fibrosis progression in chronic liver disease. AIM: To assess the prognostic value of soluble (s)CD163 and mannose receptor (sMR) in cirrhotic patients and explore associations with markers of intestinal permeability (lactulose-mannitol ratio, diamine oxidase), bacterial translocation (endotoxin, lipopolysaccharide-binding protein) and markers of systemic immune activation (interleukin-6, interleukin-8, sCD14)...
December 21, 2017: Alimentary Pharmacology & Therapeutics
F Bär, T Kühbacher, N A Dietrich, T Krause, A Stallmach, N Teich, S Schreiber, J Walldorf, R Schmelz, C Büning, K Fellermann, J Büning, U Helwig
BACKGROUND: The most common complication after ileal pouch anal anastomosis in up to 50% of patients is an acute pouchitis. The majority of patients respond to antibiotic treatment. However, 10%-15% develops chronic antibiotic-dependent or refractory pouchitis which is usually hard to treat. AIM: To evaluate the effectiveness of vedolizumab in patients with chronic pouchitis. METHODS: Patients with chronic antibiotic-dependent or refractory pouchitis were treated with vedolizumab (300 mg at week 0, 2, 6 and 10) in 10 IBD centres and retrospectively registered...
December 19, 2017: Alimentary Pharmacology & Therapeutics
Y L He, S J Yang, C H Hu, J Dong, H Gao, T T Yan, J F Liu, Y Yang, D F Ren, L Zhu, Y R Zhao, T Y Chen
BACKGROUND: Hepatitis C virus (HCV) infection in patients undergoing haemodialysis is prevalent and aggressive. The treatment of chronic hepatitis C has been revolutionised by the advent of direct-acting antivirals (DAAs). However, the safety, efficacy, and tolerance of DAAs in the treatment of acute HCV infection in patients with end-stage renal disease who are on haemodialysis are unknown. AIM: To evaluate the safety and efficacy of sofosbuvir plus daclatasvir in this specific, difficult-to-treat population...
December 18, 2017: Alimentary Pharmacology & Therapeutics
S Tadbiri, L Peyrin-Biroulet, M Serrero, J Filippi, B Pariente, X Roblin, A Buisson, C Stefanescu, C Trang-Poisson, R Altwegg, P Marteau, T Vaysse, A Bourrier, S Nancey, D Laharie, M Allez, G Savoye, C Gilletta, C Gagniere, L Vuitton, S Viennot, A Aubourg, A-L Pelletier, G Bouguen, V Abitbol, M Fumery, P Claudepierre, Y Bouhnik, A Amiot
BACKGROUND: The effectiveness of vedolizumab as a treatment for extraintestinal manifestations (EIM) is questionable due to its gut-specificity. AIM: To assess effectiveness of vedolizumab for EIM in patients with inflammatory bowel disease (IBD) in a large real-life experience cohort. METHODS: Between June and December 2014, 173 patients with Crohn's disease and 121 with ulcerative colitis were treated with vedolizumab. Patients were followed until week 54...
December 18, 2017: Alimentary Pharmacology & Therapeutics
A L Lightner, N P McKenna, C S Tse, L E Raffals, E V Loftus, K L Mathis
BACKGROUND: Up to 80% of patients with Crohn's disease require an abdominal operation in their lifetime. As the use of vedolizumab is increasing for the treatment of Crohn's disease, it is important to understand its potential association with post-operative complications. AIM: We sought to compare 30-day postoperative infectious complication rate among vedolizumab-treated Crohn's disease patients vs those who had received TNFα inhibitors or no biologic therapy...
December 18, 2017: Alimentary Pharmacology & Therapeutics
M Song, M C Camargo, S J Weinstein, G Murphy, N D Freedman, J Koshiol, R Z Stolzenberg-Solomon, C C Abnet, S Männistö, D Albanes, C S Rabkin
BACKGROUND: Serum pepsinogen 1 (SPG1) and anti-Helicobacter pylori serology have been used for gastric risk stratification in Asia. AIM: To assess utility of these markers in a Western population. METHODS: SPG1 measurements were available for 21 895 Finnish male smokers in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. We used Cox proportional hazards models adjusted for potential confounders to estimate gastric cancer hazard ratios (HR) and 95% confidence intervals (95% CI) for low SPG1 (<25 μg/L)...
December 15, 2017: Alimentary Pharmacology & Therapeutics
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