Clinical Gastroenterology and Hepatology最新文献

{"title":"Daily or twice daily treatment with topical steroids results in similar responses in eosinophilic esophagitis.","authors":"Craig C Reed, Sean S LaFata, Timothy S Gee, Hannah L Thel, Brenderia A Cameron, Angela Z Xue, Akshatha Kiran, Adolfo A Ocampo, Justin McCallen, Christopher J Lee, Stephanie A Borinsky, Walker D Redd, Trevor Barlowe, Rayan N Kaakati, Cary C Cotton, Swathi Eluri, Evan S Dellon","doi":"10.1016/j.cgh.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.10.016","url":null,"abstract":"<p><strong>Background and aims: </strong>Few data compare topical corticosteroid (tCS) dosing regimens and outcomes. We aimed to compare treatment outcomes in eosinophilic esophagitis (EoE) patients by once or twice daily dosing regimens.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study utilizing the UNC EoE Clinicopathologic Database of newly diagnosed EoE patients treated with a tCS who had a follow-up endoscopy with biopsy. Baseline data and outcomes were extracted. Bivariate and multivariate analyses compared patients at baseline and following initial tCS given as a once or twice daily dose.</p><p><strong>Results: </strong>522 patients met inclusion criteria, 122 patients on once daily dosing (72% male; 91% white) and 400 patients on twice daily dosing (66% male; 89% white). Patients on twice daily dosing were older (28.8 ± 18.2 vs. 24.3 ± 18.0; p = 0.01) and reported more heartburn (40% vs. 25%; p = 0.004). On bivariate analysis, global symptomatic response (78% vs. 76%; p = 0.82), post-treatment eosinophil count (20.8 ± 27.2 vs. 25.6 ± 39.4; p = 0.21), post-treatment EREFS (2.2 ± 1.8 vs. 2.2 ± 2.0; p = 0.92), and histologic response (<15 eos/hpf; 56% vs 58%; p = 0.66) did not differ. Candida was less frequent with daily dosing (2% vs. 8%; p = 0.04). In multivariate analysis, the odds of histologic response did not differ by dose groups (aOR: 1.03; 95% CI: 0.67 - 1.60).</p><p><strong>Conclusions: </strong>EoE outcomes did not differ by daily or twice daily dosing regimens. These results inform tCS dosing regimens and reassure that both are effective.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Candidates for MASLD Treatment with Indeterminate Vibration-Controlled Transient Elastography.","authors":"David Marti-Aguado, José Miguel Carot-Sierra, Aida Villalba-Ortiz, Harris Siddiqi, Rose Marie Vallejo-Vigo, Carmen Lara-Romero, Marta Martín-Fernández, Matías Fernández-Patón, Clara Alfaro-Cervello, Ana Crespo, Elena Coello, Víctor Merino-Murgui, Egbert Madamba, Salvador Benlloch, Judith Pérez-Rojas, Víctor Puglia, Antonio Ferrández, Victoria Aguilera, Cristina Monton, Desamparados Escudero-García, Paloma Lluch, Rocío Aller, Rohit Loomba, Manuel Romero-Gomez, Luis Marti-Bonmati","doi":"10.1016/j.cgh.2024.10.014","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.10.014","url":null,"abstract":"<p><strong>Background & aims: </strong>A noteworthy proportion of patients with metabolic dysfunction-associated steatotic liver disease (MASLD) have an indeterminate vibration-controlled transient elastography (VCTE). Among these patients, we aimed to identify candidates for MASLD treatment by diagnosing significant fibrosis.</p><p><strong>Methods: </strong>Real-world prospective study including a large dataset of MASLD patients with paired VCTE and liver biopsy from 6 centers. A total of n=1196 patients were recruited and divided in training (3 centers, Spain), internal validation (2 centers, Spain), and external validation (1 center, United States) cohorts. In patients with indeterminate liver stiffness measurements (LSM:8-12 kPa), a diagnostic algorithm was developed to identify significant fibrosis, defined as histological stage ≥F2. Statistical analysis was performed using gaussian mixture model (GMM) and k-means unsupervised clusterization.</p><p><strong>Results: </strong>From the eligible population, 33%, 29%, and 31% had indeterminate VCTE in the training, internal and external validation samples, respectively. Controlled attenuation parameter (CAP) allowed the differentiation of GMM clusters with a cut-off of 280 dB/m (AUC:0.89 [95%CI:0.86-0.97]). Within patients with <280 dB/m, a LSM between 8.0-9.0 kPa showed a 93% sensitivity and a 91% negative predictive value to exclude significant fibrosis. Among patients with ≥280 dB/m, a LSM between 10.3-12.0 kPa diagnosed significant fibrosis with a 91% specificity. Applying this algorithm to the validation cohorts, 36% of the indeterminate VCTE were re-allocated. The re-allocated high-risk group showed a prevalence of 86% significant fibrosis, opening the therapeutic window for MASLD patients.</p><p><strong>Conclusion: </strong>To identify candidates for MASLD treatment among indeterminate VCTE, an algorithm-based on the sequential combination of LSM and CAP thresholds can optimize the diagnosis of moderate-to-advanced fibrosis.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Switch from Off-Label Swallowed Topical Corticosteroids to Budesonide Orodispersible Tablets in Eosinophilic Esophagitis patients.","authors":"Gaia Pellegatta, Francesca Paola Giugliano, Elisabetta Mastrorocco, Baiardini Ilaria, Cesare Hassan, Alessandro Repici","doi":"10.1016/j.cgh.2024.07.049","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.07.049","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food Swamps and Food Deserts Impact on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Mortality in US Counties.","authors":"Annette Paik, Linda Henry, Leyla De Avila, Saleh AlQahtani, Fatema Nader, James M Paik, Zobair M Younossi","doi":"10.1016/j.cgh.2024.08.053","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.08.053","url":null,"abstract":"<p><strong>Background & aims: </strong>Lacking access to quality food may increase the risk of MASLD. We investigated associations between food environment factors (food deserts and food swamps) and MASLD-related mortality across the United States (US).</p><p><strong>Methods: </strong>MASLD-related deaths were obtained from the National Vital Statistics System (NVSS) (2016-2020) and food environment factors from Food Environment Atlas (FEA). Food deserts are areas where low-income residents have limited access to affordable and nutritious food due to a scarcity of nearby grocery stores. Food swamps are areas oversaturated with outlets offering limited healthy food options.</p><p><strong>Results: </strong>Counties in the highest mortality quartile (4th quartile) compared to the lowest mortality quartile (1st quartile) were predominantly located in the South region (78.7% vs. 23.5%) and rural areas (76.1% vs. 26.6%). These counties also had higher rates of elderly residents (19.4% vs. 16.5%), Hispanic residents (13.1% vs. 10.5%), household crowding (2.83% vs. 2.37%), no broadband internet subscription (23.9% vs. 12.7%), no high school diploma (16.1% vs. 9.0%), poverty rates (30.2% vs. 18.5%), unemployment rates (6.4% vs. 4.7%), food deserts (8.7% vs. 5.8%) and food swamp ratio (5.69 vs. 4.28) (all p-values <.001). After adjusting for county socio-demographic and clinical factors and regions, mixed-effects linear regression models showed significant differences in mortality rates (per 100,000) between counties with the highest versus lowest quartiles of food deserts (25.65 vs. 12.75, adjusted difference = 3.66 [95% CI: 2.66-4.72]) and food swamps (27.13 vs. 20.15 per 100,000, adjusted difference = 3.57 [95% CI: 2.44-4.71]).</p><p><strong>Conclusions: </strong>In the United States, addressing socio-demographic and food environment disparities is paramount to reduce MASLD-related mortality.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of comorbidities on health-related quality of life in alcohol-related liver disease: a population-based survey.","authors":"Karen Dombestein Elde, Peter Jepsen, Natasja Von Wowern, Matilde Winther-Jensen, Marie Holm Eliasen, Anne Illemann Christensen, Lone Galmstrup Madsen, Gro Askgaard","doi":"10.1016/j.cgh.2024.09.035","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.035","url":null,"abstract":"<p><strong>Background and aims: </strong>Extra-hepatic comorbidities are common in alcohol-related liver disease (ALD). We examined associations between burden of comorbidities, alcohol, and smoking with low health-related quality of life (HRQoL) among patients with ALD.</p><p><strong>Methods: </strong>Patients with ALD and matched comparators were identified among respondents of the Danish National Health Surveys 2010-2017. Survey data included generic measures of physical and mental HRQoL (12-item Short Form), comorbidities, alcohol and smoking. Low HRQoL in ALD was defined as >1.5 standard deviations worse than the average HRQoL in the comparators. Odds ratios (OR) of low HRQoL was estimated with multivariable logistic regression adjusting for potential confounders.</p><p><strong>Results: </strong>We included 772 ALD patients, 53% of whom had cirrhosis; 37% had low physical HRQoL and 22% had low mental HRQoL. Disc herniation (found in 21%), osteoarthritis (36%), chronic obstructive pulmonary disease (COPD) (11%), cancer (6%), stroke (1%) and psychiatric disease (9%) were associated with low physical and/or mental HRQoL whereas alcohol use disorder (24%), diabetes (19%), acute myocardial infarction (1%), hypertension (34%) and osteoporosis (12%) were not. For example, osteoarthritis was associated with low physical [OR 2.17 (95% CI: 1.54-3.05)] and low mental HRQoL [OR 1.91 (95%CI: 1.27-2.88)]. For lifestyle factors, drinking > 20 units/week was associated with low physical and smoking > 20 cigarettes/day with low mental HRQoL, when compared to abstainers and non-smokers, respectively.</p><p><strong>Conclusion: </strong>Common comorbidities including COPD, musculoskeletal and psychiatric disease are associated with low HRQoL in ALD, independently of liver disease severity, and so are alcohol consumption and smoking. These findings highlight the importance of multidisciplinary management of patients with ALD.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yield and Effectiveness of Two-Sample Fecal Immunochemical Test-based Screening Program for Colorectal Cancer.","authors":"Zenghao Xu, Jinhua Yang, Jiabei He, Qilong Li, Xinglin Fei, Hao Bai, Kai Gao, Yuanliang He, Chen Li, Mengling Tang, Jianbing Wang, Mingjuan Jin, Kun Chen","doi":"10.1016/j.cgh.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.10.010","url":null,"abstract":"<p><strong>Background and aims: </strong>Colorectal cancer (CRC) incidence and mortality of China account for nearly 30% of the global attributable fraction. We aimed to estimate the yield and effectiveness of two-sample fecal immunochemical test (FIT)-based screening program in China.</p><p><strong>Methods: </strong>Eligible individuals were invited for two-sample FIT between 2007 and 2021, with positive ones (cutoff: 40 μg/g before 2013, and 20 μg/g thereafter) referred for colonoscopy. Participation rates, detection rates, and positive predictive values (PPVs) were calculated. Participants were classified into: FIT+ / colonoscopy compliers, FIT+ / colonoscopy non-compliers, and FIT- as controls. We compared CRC incidence and mortality, and calculated the age reaching comparable risk.</p><p><strong>Results: </strong>Among 246,349 invitees, 150,524 (61.10%) participated in two-sample FIT, with 16,994 (11.29%) identified as FIT+; 12,816 (75.41%) underwent colonoscopy, yielding a detection rate and PPV of 0.57% and 6.70% for advanced neoplasia. Median follow-up was 10.58 years. Compared with FIT- participants, CRC incidence and mortality were relatively similar among FIT+ / colonoscopy compliers with hazard ratio (HR) and 95% confidence interval (CI) of 0.94 (0.75-1.19) and 1.62 (1.09-2.41), but higher among non-compliers with HR and 95% CI of 3.52 (2.85-4.34) and 4.41 (2.96-6.55). Taking CRC incidence and mortality risk of FIT- participants at age 50.0 as the benchmark, FIT+ / colonoscopy compliers reached same risk at 50.6 and 46.1 years, while non-compliers at age 38.0 and 37.9 years, respectively.</p><p><strong>Conclusions: </strong>Two-sample FIT could effectively identify high-risk populations, and colonoscopy compliance is associated with a lower risk of CRC incidence and mortality. This strategy might facilitate CRC screening practice in countries with large populations.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ENDOSCOPIC SEDATION TYPE DURING FLIP PANOMETRY DOES NOT SIGNIFICANTLY IMPACT FLIP MOTILITY CLASSIFICATION RELATIVE TO MANOMETRY.","authors":"Elena C Pezzino, John E Pandolfino, Erin Toaz, Peter J Kahrilas, Dustin A Carlson","doi":"10.1016/j.cgh.2024.09.032","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.032","url":null,"abstract":"<p><strong>Background & aims: </strong>Functional lumen imaging probe (FLIP) Panometry evaluates esophageal motility at the time of sedated endoscopy and often parallels high-resolution manometry (HRM) performed in awake patients. This study aimed to assess the impact of endoscopic sedation on FLIP evaluation of esophageal motility.</p><p><strong>Methods: </strong>Adult patients who completed FLIP Panometry during sedated endoscopy and had a conclusive Chicago Classification v4.0 diagnosis on HRM were included in this retrospective study. HRM diagnoses relative to FLIP Panometry motility classifications were compared by sedation type used during FLIP, i.e. conscious sedation (CS) with midazolam and fentanyl or monitored anesthesia care (MAC) with propofol.</p><p><strong>Results: </strong>454 patients (mean (SD) age 53 (17) years, 62% female) completed FLIP Panometry under CS (n=174, 38%) or MAC (n=280, 62%; 177/280 MAC included fentanyl). On comparison of CS vs MAC, HRM diagnoses within FLIP Panometry motility classifications did not differ (P=0.306 across all 5 FLIP Panometry classifications; P values 0.202-0.856 within specific FLIP classifications). The proportion of HRM diagnoses within each FLIP Panometry classification also did not differ between FLIP completed with CS vs MAC with fentanyl (P=0.098) or MAC without fentanyl (P=0.0261) CONCLUSIONS: Whether CS or MAC was used as sedation during FLIP did not have a clinically significant impact on the relationship between diagnosis on FLIP Panometry and HRM. This supports the validity of diagnosing esophageal motility disorders using FLIP Panometry during sedated endoscopy.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary antioxidant capacity, genetic susceptibility and polymorphism, and inflammatory bowel disease risk in a prospective cohort.","authors":"Jie Chen, Lintao Dan, Shuai Yuan, Tian Fu, Jiangwei Sun, Alicja Wolk, Jonas F Ludvigsson, Xue Li, Xiaoyan Wang, Susanna C Larsson","doi":"10.1016/j.cgh.2024.09.033","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.033","url":null,"abstract":"<p><strong>Background and aims: </strong>Oxidative stress is an essential factor in the pathogenesis of inflammatory bowel disease (IBD). A previous study found protective potential of some antioxidative nutrients against IBD. However, the association between total antioxidant capacity (TAC) of the diet and incident IBD is unclear.</p><p><strong>Methods: </strong>We conducted a prospective cohort study including 186,195 IBD-free participants at baseline from the UK Biobank. We calculated dietary TAC using the oxygen radical absorbance capacity method based on repeated online 24-hour dietary recalls. Crohn's disease (CD) and ulcerative colitis (UC) were identified via inpatient register and primary care data. Genetic susceptibility for IBD was assessed by a polygenic risk score. Cox proportional hazard models were applied to estimate multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>During a median follow-up of 11.4 years, we identified 396 CD and 809 UC incident cases. Individuals with the highest quintile of dietary TAC had a lower risk of CD (27.0 vs 17.0 cases/100,000 person-years; aHR 0.66, 95% CI 0.49-0.90) but not UC (46.7 vs 35.5 cases/100,000 person-years; aHR 0.85, 95% CI 0.69-1.06) compared with the lowest group. We observed interactions between TAC and genetic susceptibility at both multiplicative (P-interaction=0.008/0.063 for CD/UC) and additive (both P values>1) scales. Additionally, a polymorphism of the endogenous antioxidant enzyme gene SOD2 (rs4880) modified the dietary TAC-UC association (P-interaction=0.039).</p><p><strong>Conclusion: </strong>This study suggests that a diet with high TAC may help prevent the development of IBD, particularly in individuals at high genetic risk of IBD and in mutation carriers of rs4880 in SOD2.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic panniculitis.","authors":"M Aourag, E T T L Tjwa, M Te Groen","doi":"10.1016/j.cgh.2024.08.052","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.08.052","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of incident cancer in patients with Inflammatory Bowel Disease with prior breast cancer: a multicenter cohort study.","authors":"Guillaume Le Cosquer, Julien Kirchgesner, Cyrielle Gilletta De Saint Joseph, Philippe Seksik, Aurélien Amiot, David Laharie, Maria Nachury, Cléa Rouillon, Vered Abitbol, Alexandre Nuzzo, Stéphane Nancey, Mathurin Fumery, Amélie Biron, Nicolas Richard, Romain Altwegg, Driffa Moussata, Benedicte Caron, Mathias Vidon, Catherine Reenaers, Mathieu Uzzan, Jean-Marie Reimund, Mélanie Serrero, Marion Simon, Alban Benezech, Félix Goutorbe, Anne-Laure Pelletier, Ludovic Caillo, Charlotte Vaysse, Florian Poullenot","doi":"10.1016/j.cgh.2024.09.034","DOIUrl":"10.1016/j.cgh.2024.09.034","url":null,"abstract":"<p><strong>Background and aims: </strong>Breast cancer is the most common malignancy observed in patients with inflammatory bowel diseases (IBD). The aim of our study was to evaluate incident cancer rate (recurrence or new-onset cancer) in a cohort of IBD patients with a history of breast cancer according to the subsequent IBD treatment provided.</p><p><strong>Methods: </strong>A multicenter retrospective study included consecutive IBD patients with prior breast cancer. The inclusion date corresponded to the diagnosis of index malignancy. Follow-up lasted from cancer diagnosis until the occurrence of incident cancer.</p><p><strong>Results: </strong>Among 207 patients included (median disease duration: 13 years [IQR 6 - 21]), first line treatment (median interval of 28 months [IQR 7 - 64]) was a conventional immunosuppressant in 19.3 % of patients, anti-TNF in 19.8 %, vedolizumab in 7.2 % and ustekinumab in 1.9 %. After a median follow-up of 71 months [IQR, 34 - 148], 42 (20%) incident cancers were observed (34 breast cancer recurrences). Adjusted incidence rates per 1000 person-years were 10.2 (95%CI 6.0- 16.4) for the untreated arm and 28.9 (95%CI 11.6-59.6) for exposed patients (p= 0.0519). There was no significant difference between treated patients and controls regarding incident-cancer free survival rates (p=0.4796). In multivariable analysis, factors associated with incident cancer were stage T4d (p=0.036), triple negative tumor (p=0.016) and follow-up of less than 71 months (p=0.005).</p><p><strong>Conclusion: </strong>We did not find a statistically significant increase in incident breast cancer related to IBD treatment beyond the already known poor prognostic factors of breast cancer.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}