Gastroenterología y Hepatología (English Edition)最新文献

{"title":"The Spanish National Strategic Plan for Hepatitis C: A legacy of success","authors":"Javier Crespo , Agustín Albillos , María Buti","doi":"10.1016/j.gastre.2025.502457","DOIUrl":"10.1016/j.gastre.2025.502457","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502457"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of mobile applications in the management of hepatitis B: A systematic review","authors":"Judit Romero-Vico ,&nbsp;Elena Vargas-Accarino ,&nbsp;Adriana Palom ,&nbsp;Núria Fabrellas ,&nbsp;Maria Buti","doi":"10.1016/j.gastre.2025.502395","DOIUrl":"10.1016/j.gastre.2025.502395","url":null,"abstract":"<div><div><span>Hepatitis B virus<span> is a public health issue, with severe complications such as </span></span>cirrhosis<span><span><span> and liver cancer that impose significant economic, emotional, and psychosocial burdens. Despite the availability of a vaccine and oral treatments, effective management of this disease remains a challenge. Telemedicine and mobile applications have the potential to improve the management of </span>chronic diseases; this study examines their utility in hepatitis B. A search was conducted in four databases in November 2024 following the </span>PRISMA<span> guidelines. Out of 216 articles, seven studies were included. These studies evaluated the use of mobile applications in providing access to information, detection and linkage to care, quality of life<span> assessment, and vaccination promotion. The findings showed the usefulness of these tools, considering mobile applications as a helpful tool in the management and prevention of hepatitis B.</span></span></span></div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502395"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel desensitization therapy of mesalamine intolerance in patients with ulcerative colitis","authors":"Kenji Kinoshita ,&nbsp;Shintaro Sawaguchi ,&nbsp;Kai Toyoshima ,&nbsp;Sonoe Yoshida ,&nbsp;Takahiro Yamamura ,&nbsp;Kosuke Nagai ,&nbsp;Ikko Tanaka ,&nbsp;Kazuteru Hatanaka ,&nbsp;Yoshiya Yamamoto ,&nbsp;Hirohito Naruse ,&nbsp;Takehiko Katsurada ,&nbsp;Naoya Sakamoto","doi":"10.1016/j.gastre.2025.502347","DOIUrl":"10.1016/j.gastre.2025.502347","url":null,"abstract":"<div><h3>Background</h3><div>Mesalamine is the first-line drug for treating mild-to-moderate ulcerative colitis (UC); however, some patients develop symptoms of intolerance. Although several desensitization methods have been reported, these desensitization regimens were rather complicated for physicians to prescribe in daily clinical practice; therefore, it has not yet become a major therapeutic option for intolerance patients. Thus, we developed an alternative desensitization protocol.</div></div><div><h3>Methods</h3><div>We performed a single-center, retrospective study of patients with UC, who were intolerant to mesalamine and had undergone desensitization therapy. Desensitization starts with 50<!--> <!-->mg of granule mesalamine, with an increase in the dose by 50<!--> <!-->mg every week up to 200<!--> <!-->mg, followed by incremental doses of 100<!--> <!-->mg every week. After patients received dosages of more than 1000<!--> <!-->mg, the dose was increased by 200<!--> <!-->mg every week up to the target dose. Concomitant medications such as oral prednisolone or budesonide rectal foam were allowed during the protocol but were withdrawn before the end of desensitization. We evaluated the success rate of our mesalamine desensitization method and performed safety assessments during the protocol.</div></div><div><h3>Results</h3><div>Of 115 patients, 17 were intolerant to mesalamine. We excluded six patients who had severe disease or organ disorders. Overall, 11 patients received desensitization therapy without hospitalization. All 11 patients successfully underwent desensitization therapy and received the target dose of mesalamine (3000–4000<!--> <!-->mg/day) at the end of the protocol. No serious adverse events were observed during this protocol.</div></div><div><h3>Conclusions</h3><div>This retrospective study reports a successful and safe desensitization method for UC patients with mesalamine intolerance.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502347"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the gut–brain axis in a large cohort of patients with irritable bowel syndrome: Is there a link between depression and intestinal and extra-intestinal symptoms?","authors":"Facundo Pereyra ,&nbsp;Francisco Schlottmann ,&nbsp;María A. Casas ,&nbsp;Leandro Steinberg ,&nbsp;Lisandro Pereyra","doi":"10.1016/j.gastre.2025.502370","DOIUrl":"10.1016/j.gastre.2025.502370","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to determine the prevalence of intestinal and extra-intestinal symptoms according to depression severity in a large cohort of patients with irritable bowel syndrome (IBS).</div></div><div><h3>Patients and methods</h3><div>A consecutive series of patients with diagnosis of IBS according to Rome IV criteria undertaking a social-media based program (B15 program) were analyzed. The B15 program provides evidence-based dietary and non-pharmacological recommendations (i.e., mindfulness techniques and exercise) to improve gastrointestinal health. All patients completed the symptom-severity questionnaire (IBS-SSS) to determine severity of disease and the patient health questionnaire (PHQ9) to assess depressive symptoms. Patients’ depression severity was stratified according to the PHQ9 score: none (0–4), mild (5–9), moderate (10–14), moderately severe (15–19), and severe (20–27). Demographics, IBS phenotype and prevalence of intestinal and extra-intestinal symptoms were compared among groups.</div></div><div><h3>Results</h3><div>A total of 15,675 patients with IBS were included; 895 (12.1%) with none, 5709 (36.4%) with mild, 4279 (27.3%) with moderate, 2457 (15.7%) with moderately severe, and 1335 (8.5%) with severe depression. Mean IBS-SSS score was significantly higher in patients with depressive symptoms (none 256.5 vs. severe 324.1, <em>p</em> <!-->&lt;<!--> <!-->0.0001). IBS-M (mixed bowel habits alternating constipation and diarrhea) was more frequent in those with depression (<em>p</em> <!-->&lt;<!--> <!-->0.0001). The presence of bloating, heartburn, dyspepsia, and belching were significantly more common in patients with higher levels of depression (<em>p</em> <!-->&lt;<!--> <!-->0.0001). The prevalence and number of extra-intestinal symptoms were also associated with the severity of depression (<em>p</em> <!-->&lt;<!--> <!-->0.0001).</div></div><div><h3>Conclusions</h3><div>The presence and severity of depression are strongly associated with the prevalence of intestinal and extra-intestinal symptoms in patients with IBS. Stratifying patients based on both their symptomatic and psychological profile could help targeting therapy.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502370"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spanish Working Group in Crohn's Disease and Ulcerative Colitis (GETECCU) position paper for the management of non-perianal fistulizing Crohn’s disease","authors":"Iago Rodríguez-Lago ,&nbsp;Diego Casas-Deza ,&nbsp;Jordi Rimola ,&nbsp;Margalida Calafat ,&nbsp;Rocío Ferreiro-Iglesias ,&nbsp;Gianluca Pellino ,&nbsp;Nicolás Avellaneda ,&nbsp;Marisa Iborra ,&nbsp;Manuel Barreiro-de Acosta ,&nbsp;Ana Gutiérrez Casbas ,&nbsp;Luis Menchén ,&nbsp;Ingrid Ordás ,&nbsp;Francisco Rodríguez-Moranta ,&nbsp;Yamile Zabana","doi":"10.1016/j.gastre.2025.502450","DOIUrl":"10.1016/j.gastre.2025.502450","url":null,"abstract":"<div><div>Crohn’s disease consists on a complex condition where, despite most patients initially present with an inflammatory behavior, a significant proportion develop complicated lesions such as strictures, fistulas, abscesses, or even perforations. These lesions progressively increase over time and are associated with a higher risk of surgery and hospitalization. Despite significant advances in their management after the introduction of biological therapies, particularly anti-TNF agents, these complications continue to pose challenges for the multiple professionals involved in their care.</div><div>Fistulas that do not involve the perianal region (entero-enteric, entero-urinary, or entero-cutaneous) require a multidisciplinary strategy that combines medical, interventional, and surgical approaches. Their treatment ranges from general supportive measures to the use of antibiotics or, frequently, advanced therapies. Nevertheless, in cases of certain septic complications or those refractory to medical treatment, percutaneous drainage or surgical intervention remains essential.</div><div>Although these lesions have a significant impact, evidence regarding the best strategies in this context, as well as the efficacy and safety of different therapies in these patients, remains limited. This is highlighted by the absence of specific recommendations in current guidelines. The objective of this document is to provide a comprehensive overview of non-perianal fistulizing Crohn's disease, addressing its epidemiological, clinical, and therapeutic aspects from a multidisciplinary perspective.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502450"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost analysis of hidden hepatitis D virus infection in Spain","authors":"Xavier Forns ,&nbsp;Manuel Rodríguez ,&nbsp;Raquel Domínguez-Hernández ,&nbsp;Helena Cantero ,&nbsp;Laura Salinas-Ortega ,&nbsp;Miguel Ángel Casado","doi":"10.1016/j.gastre.2025.502337","DOIUrl":"10.1016/j.gastre.2025.502337","url":null,"abstract":"<div><h3>Introduction</h3><div>A significant percentage of patients coinfected with hepatitis B virus (HBV) and hepatitis D virus (HDV) are undiagnosed. Coinfected patients progress to advanced liver disease faster than HBV monoinfected patients, thereby consuming more healthcare resources. The aim was to perform an analysis to determine the cost of hidden HDV infection in Spain.</div></div><div><h3>Methods</h3><div>An analytical model was developed to estimate the prevalence of hidden HDV infection with/without advanced liver disease at the time of diagnosis. An epidemiological flow chart was established to quantify undiagnosed chronic hepatitis D patients. The percentages of patients with compensated cirrhosis (CC), decompensated cirrhosis (DC), hepatocellular carcinoma (HCC) and requiring liver transplantation (LT) and their annual costs were subsequently obtained from the literature. Direct healthcare costs were considered within a time horizon of 1 year. For patients without advanced disease, the consumption of healthcare resources was obtained from an experts panel.</div></div><div><h3>Results</h3><div>A total of 2180 patients with hidden HDV infection were estimated; of these, 1188 (54%) had advanced liver disease (29%-CC, 57%-DC, and 8%-HCC) or underwent LT (6%), and 992 (46%) patients did not have advanced disease. The total annual cost of hidden HDV would be € 17.8<!--> <!-->million (€ 16.9<!--> <!-->million with advanced disease and € 882,400 for those without).</div></div><div><h3>Conclusions</h3><div>Hidden HDV infection represents a high economic burden in Spain due to the rapid progression of liver disease in affected patients. These results highlight the importance of early diagnosis to prevent future clinical and economic burden related to liver disease progression.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502337"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic study as a tool in the diagnosis of rare diseases with nonspecific hepatic manifestations","authors":"Neus Saloni Gomez ,&nbsp;Ignacio Ros Arnal ,&nbsp;Silvia Izquierdo Álvarez ,&nbsp;Ruth García Romero","doi":"10.1016/j.gastre.2025.502367","DOIUrl":"10.1016/j.gastre.2025.502367","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502367"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High persistence rate at one year- follow-up of subcutaneous vedolizumab at standard dose after switching endovenous vedolizumab, even in those previously intensified: Results of a Spanish multicentre observational study","authors":"Laura Andrés ,&nbsp;Marisa Iborra ,&nbsp;Raquel Vicente ,&nbsp;Lara Arias ,&nbsp;Pilar Nos ,&nbsp;Ana Royo-Esteban ,&nbsp;Beatriz Sicilia","doi":"10.1016/j.gastre.2025.502379","DOIUrl":"10.1016/j.gastre.2025.502379","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Subcutaneous (sc) vedolizumab<span> is an alternative to intravenous (iv) vedolizumab for the treatment of patients with mild-to-moderate flares of </span></span>inflammatory bowel disease (IBD).</div></div><div><h3>Aims</h3><div><span>To analyse the persistence rate of the sc vedolizumab and its pharmacokinetics in patients previously treated with iv vedolizumab; describing clinical and biochemical </span>remission rates at one year, and comparing previous intravenous intensification regimens.</div></div><div><h3>Methods</h3><div>Multicenter, descriptive, observational, and retrospective study of a cohort of 54 patients with IBD treated with iv vedolizumab for more than six months, who were switched to sc vedolizumab under a standard regimen, 32 patients (59%) with a diagnosis of ulcerative colitis (UC) and 22 patients (41%) with Crohn’s disease (CD).</div></div><div><h3>Results</h3><div>After one year of follow-up, 93% of the patients continued with vedolizumab, 100% were in clinical remission, and 86% achieved biochemical remission (calprotectin &lt; 150). A progressive increase in vedolizumab levels was observed after switching to sc vedolizumab, with statistical significance (<em>p</em> &lt; 0.05). 14 patients (25.9%) were on an intensified regimen before switching to sc vedolizumab. However, all patients remained on subcutaneous vedolizumab at a dose of 108 mg every two weeks without the need for intensification.</div></div><div><h3>Conclusion</h3><div>After switching to sc vedolizumab in patients with endovenous vedolizumab treatment, high persistence rate at one year of follow-up is achieved, with a greater tendency to biochemical remission, which is more pronounced in previously intensified patients without the need for subcutaneous vedolizumab intensification.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502379"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index does not influence loss of response to tumor necrosis factor inhibitors in Crohn's disease","authors":"Carla Bortolin Fonseca ,&nbsp;Roberta Petry ,&nbsp;Luciana Harlacher ,&nbsp;Laryssa Hanauer ,&nbsp;Carlos Fernando Magalhães Francesconi ,&nbsp;Paulo Gustavo Kotze ,&nbsp;Cristina Flores","doi":"10.1016/j.gastre.2025.502372","DOIUrl":"10.1016/j.gastre.2025.502372","url":null,"abstract":"<div><h3>Objectives</h3><div>Moderate to severe Crohn's disease (CD) treatment was revolutionized by introducing anti-tumor necrosis factor (TNF) agents, which is still a cornerstone of the treatment. It is speculated that adipose tissue may influence treatment response, especially for non-weight-adjusted agents.</div></div><div><h3>Patients and methods</h3><div>Research comparing the effectiveness of anti-TNFs between eutrophic and overweight patients may impact clinical management. We performed a retrospective analysis of a CD patient database. The primary endpoint was loss of response (LOR) after 54 weeks with infliximab (IFX) and adalimumab (ADA) in patients with body mass index (BMI) &lt;25 and ≥25. Secondary endpoints were steroid-free remission and endoscopic remission rate.</div></div><div><h3>Results</h3><div>One hundred seventy-nine CD patients were evaluated; 48.9% had LOR after 54 weeks of anti-TNF therapy. Fifty-four patients had a BMI ≥25, with 51 receiving IFX and 28 receiving ADA. The univariate analysis identified LOR in 56.5% of the patients with IFX and 34.9% in the ADA group (<em>p</em> <!-->=<!--> <!-->0.009). In the 54-week multivariate analysis, loss of response in the IFX group with BMI ≥25 had a relative risk of 1.04 [CI 0.60–1.80 (<em>p</em> <!-->=<!--> <!-->0.891)] compared to patients with BMI &lt;25. Being overweight or obese led to a risk of 1.50 for LOR for ADA at 54-week time point [CI 0.60–3.74 (<em>p</em> <!-->=<!--> <!-->0.0387)]. Clinical remission at 54 weeks was similar between BMI groups.</div></div><div><h3>Conclusions</h3><div>Being overweight did not influence the LOR to treatment when IFX and ADA were compared, nor did it affect clinical and endoscopic remission after 54 weeks.</div></div>","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 7","pages":"Article 502372"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cricopharyngeal bar: A rare entity","authors":"Jeronimo Toro-Calle ,&nbsp;Daniel Herrera ,&nbsp;Maria Alejandra Mesa","doi":"10.1016/j.gastre.2025.502348","DOIUrl":"10.1016/j.gastre.2025.502348","url":null,"abstract":"","PeriodicalId":100569,"journal":{"name":"Gastroenterología y Hepatología (English Edition)","volume":"48 6","pages":"Article 502348"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}