Clinics and research in hepatology and gastroenterology最新文献

{"title":"The prevalence of small intestine bacterial overgrowth in irritable bowel syndrome is much higher with lactulose than glucose breath test: Results of a retrospective monocentric study","authors":"François Mion ,&nbsp;Fabien Subtil ,&nbsp;Christelle Machon ,&nbsp;Sabine Roman ,&nbsp;Anne Mialon","doi":"10.1016/j.clinre.2024.102482","DOIUrl":"10.1016/j.clinre.2024.102482","url":null,"abstract":"<div><h3>Background</h3><div>Glucose (GBT) and lactulose (LBT) breath tests have been recommended for the diagnosis of small intestinal bacterial overgrowth (SIBO). LBT may yield a higher prevalence of SIBO diagnosis, because of its limited small bowel absorption, and therefore colonic fermentation. The aim of this retrospective study was to confirm this hypothesis, in irritable bowel syndrome patients (IBS).</div></div><div><h3>Methods</h3><div>Among a cohort of 995 patients who underwent GBT or LBT, 287 with typical IBS according to Rome IV criteria, without past digestive surgery or significant medical comorbidities, were included.</div></div><div><h3>Results</h3><div>155 IBS patients underwent GBT, and 132 LBT (71% women, mean age 45±15, mean BMI: 22.6±4.3 kg/m²). There were no difference between both groups in terms of demographics, IBS type and severity of symptoms. The prevalence of SIBO according to LBT was 47%, versus 4.5% only with GBT (p&lt;0.001). The prevalence of methane values ≥ 10 ppm were similar in both groups (34%).</div></div><div><h3>Conclusion</h3><div>LBT is very frequently positive in IBS patients, as compared to GBT. The 2 tests are thus not interchangeable for the diagnosis of SIBO. Furthermore, the positivity of both tests was not correlated with symptoms, which may indicate a poor clinical interest of these tests in IBS.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102482"},"PeriodicalIF":2.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic effects of fecal microbial transplantation on alcoholic liver injury in rat models","authors":"Yue Zhang ,&nbsp;Pengfei Li ,&nbsp;Bo Chen ,&nbsp;Ruipeng Zheng","doi":"10.1016/j.clinre.2024.102478","DOIUrl":"10.1016/j.clinre.2024.102478","url":null,"abstract":"<div><h3>Objective</h3><div>Disruption of gut microbiota is closely related to the progression of alcoholic liver disease (ALD). This study aimed to explore the therapeutic effect of fecal microbiota transplantation (FMT) in ALD rats using a combination of microbiological and metabolomic techniques.</div></div><div><h3>Methods</h3><div>Three liver injury rat models were constructed using alcohol, CCL4, and alcohol combined with CCL4, and administered an FMT treatment comprising the fecal microbiota of healthy rats via the gastric route for 12 consecutive weeks. We measured the therapeutic effect of FMT treatment on liver inflammation, intestinal mucosal barrier, and bacterial translocation in ALD rats using 16S rRNA and UPLC-Q/TOF-MS technology to detect the effects of FMT on the intestinal microbiota and metabolic patterns of ALD rats.</div></div><div><h3>Results</h3><div>FMT treatment effectively improved liver function, prolonged survival time, improved the intestinal mucosal barrier, reduced bacterial translocation, alleviated liver inflammation, and delayed the progression of liver fibrosis in three types of liver injury models. The microbiome and metabolomic results showed that FMT can effectively improve gut microbiota disorder in ALD rats and improve metabolic patterns by regulating metabolic pathways such as the arachidonic acid and retinol pathways.</div></div><div><h3>Conclusion</h3><div>FMT treatment could reverse alcohol induced liver injury by improving gut microbiota and metabolic patterns in ALD rats, and oral FMT could be an effective therapeutic approach for ALD.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102478"},"PeriodicalIF":2.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-life effectiveness of allogeneic expanded adipose-derived mesenchymal stem cell therapy for perianal fistulizing refractory Crohn's disease","authors":"Maria Alonso-Gomez ,&nbsp;Anne Laure Charlois ,&nbsp;Eddy Cotte ,&nbsp;Claire Gay ,&nbsp;Pauline Danion ,&nbsp;Emilie Malezieux ,&nbsp;Romain Altwegg ,&nbsp;Gilles Boschetti ,&nbsp;Stéphane Nancey","doi":"10.1016/j.clinre.2024.102473","DOIUrl":"10.1016/j.clinre.2024.102473","url":null,"abstract":"<div><h3>Background</h3><div>Real life data about the long-term efficacy of darvadstrocel for treating perianal fistulas in Crohn's disease (CD) remain scarce. Aim: To report the effectiveness and safety of darvadstrocel therapy to close perianal fistula in a real-life cohort of CD patients.</div></div><div><h3>Methods</h3><div>All patients with CD suffering complex draining perianal fistulas who consecutively underwent administration of a single local injection of darvadstrocel at two centres were followed up and evaluated. The primary endpoint was clinical remission (closure of all external openings with no discharge at pressure) at week 24. Combined remission (defined as clinically plus MRI-assessed fistula closure) were also assessed at week 24 and 52.</div></div><div><h3>Results</h3><div>A total of 36 CD patients (19 Male, mean age 38.5 years) were included with a median follow up of 16 months. Clinical remission was achieved in 17 out of 36 patients (47.2 %) and combined remission in 15 out of 36 patients (41.6 %) at week 24. At week 52, clinical and combined remission was achieved in 17 out of 36 patients (47.2 %) and in 15 out of 33 evaluable patients (45.4 %), respectively.</div></div><div><h3>Conclusion</h3><div>In this real-world setting, a successful response to darvadstrocel therapy based on clinical remission was reported in around half of the patients and combined remission including radiological assessment in more than 4 out of 10 patients.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102473"},"PeriodicalIF":2.6,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of endoscopic treatment strategies for R0 resection of rectal neuroendocrine tumors smaller than 10 mm","authors":"Jieti Wang ,&nbsp;Xiaolan Zhang ,&nbsp;Ke Chen ,&nbsp;Yun Liang ,&nbsp;Yuan Liu ,&nbsp;Ziting Jiang ,&nbsp;Yiping He ,&nbsp;Jie Chen ,&nbsp;Jianqiang Liu","doi":"10.1016/j.clinre.2024.102469","DOIUrl":"10.1016/j.clinre.2024.102469","url":null,"abstract":"<div><h3>Background</h3><div>The optimal histologically complete (R0) resection methods of endoscopy for rectal neuroendocrine tumor (NET) ≤ 10 mm remains controversial. We aimed to assess the optimal endoscopic treatments for NETs.</div></div><div><h3>Methods</h3><div>The retrospective enrolled patients (<em>n</em> = 208) with rectal NETs were divided into 3 subsets according to pathological tumor size: 2 - 3 mm, 4 - 5 mm, and 6 - 10 mm NETs. Factors associated with R0 resection according to different endoscopic treatments (accidental diagnostic biopsy by cold forceps, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD)) and tumor size were investigated. All patients underwent follow-up and no local recurrence or metastasis were identified.</div></div><div><h3>Results</h3><div>A total of 208 patients were enrolled. In patients with 2 - 3 mm NETs, the R0 resection rate was 100.0 % for biopsy, EMR, and ESD. The R0 resection rate for biopsy of 4 - 5 mm and 6 - 10 mm NETs was 34.3 % and 0.0 % respectively, which was inferior to the EMR/ESD rate (4 - 5mm: <em>p</em> &lt; 0.001; 6 - 10 mm: <em>p</em> &lt; 0.001: respectively). For patients with ≤ 10 mm NETs, EMR and ESD had a comparable en bloc (<em>p</em> = 0.082) and R0 resection rates (<em>p</em> = 0.651).</div></div><div><h3>Conclusion</h3><div>Accidental diagnostic biopsy by cold forceps could be considered as the possible treatment for 2 - 3 mm rectal NETs. And for patients with ≤ 10 mm rectal NETs, both EMR and ESD might be sufficient.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102469"},"PeriodicalIF":2.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propensity score matching-based analysis of the effect of corticosteroids in treating severe drug-induced liver injury","authors":"Huanyu Wu ,&nbsp;Wanping Yan ,&nbsp;Ke Liu ,&nbsp;Jisheng Jing ,&nbsp;Wei Ye","doi":"10.1016/j.clinre.2024.102472","DOIUrl":"10.1016/j.clinre.2024.102472","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and aim&lt;/h3&gt;&lt;div&gt;There is no conventional treatment for patients with severe drug-induced liver injury (DILI) except for discontinuation of liver injury drugs and symptomatic supportive therapy. Opinions on whether corticosteroids can be used to treat severe DILI are conflicting, and most of the relevant clinical studies are case reports or retrospective studies, which still need to be supported by high-level evidence-based medical studies. This study aimed to evaluate the effect and tolerance of corticosteroids in patients with severe DILI. Risk factors associated with patient failure to cure were also explored.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Propensity score matching based on nearest-neighbor 1:1 matching was used to screen severe DILI patients in the corticosteroids and control groups. Severe DILI was defined as elevated serum ALT and/or ALP with TBIL≥5 ULN (5 mg/dL or 85.5 μmol/L) with or without INR ≥1.5. Patients were treated with conventional therapy combined with corticosteroids in the corticosteroids group and only conventional therapy in the control group.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 146 patients, 73 each in the corticosteroids and control groups, were included in this study. By analyzing the entire cohort, we found no significant difference in cure rates between patients in the corticosteroid group and control group (34.2% vs. 20.5 %, &lt;em&gt;p&lt;/em&gt; = 0.095), and there was no significant difference in the incidence of adverse effects between the two groups (20.5% vs. 20.5 %, &lt;em&gt;p&lt;/em&gt; = 1.000). However, TBIL decreased more in the corticosteroids group on day 7 (89.2 ± 107.6 μmol/L vs. 58.8 ± 70.7 μmol/L, &lt;em&gt;p&lt;/em&gt; = 0.046). In subgroup analyses, patients whose TBIL remained elevated despite conventional treatment had a higher TBIL decline on day 7,14 after use of corticosteroid (99.2 ± 98.5μmol/L vs. -23.3 ± 50.4μmol/L, &lt;em&gt;p&lt;/em&gt; &lt; 0.001; 120 ± 119.1μmol/L vs. 61.2 ± 98.5μmol/L, &lt;em&gt;p&lt;/em&gt; = 0.047). The cure rate of patients in the corticosteroid group was significantly higher than that of the control group (36.1 % versus 4.5 %, &lt;em&gt;p&lt;/em&gt; = 0.016). The proportion of patients with TBIL &lt;85.5 μmol/L was also significantly higher in the corticosteroid group than in the control group at day 7 (&lt;em&gt;p&lt;/em&gt; = 0.016) and day 14 (&lt;em&gt;p&lt;/em&gt; = 0.004) after treatment. In the subgroup analysis of patients with different clinical phenotypes, the causative agent was herbal, autoimmune antibody-positive and 40 % &lt; PTA ≤ 50 % of patients, corticosteroid use did not increase the cure rate of the patients. Univariate and multifactorial analyses found corticosteroid use to be a protective factor for failure to cure in patients with severe DILI (&lt;em&gt;p&lt;/em&gt; &lt; 0.001, OR:0.191,95 % CI:0.072–0.470), and peak TBIL to be a risk factor (&lt;em&gt;p&lt;/em&gt; = 0.003, OR:1.016,95 % CI:1.007–1.028).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The addition of corticosteroids could not increase the cure rate in patients wi","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102472"},"PeriodicalIF":2.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adenosquamous intrahepatic cholangiocarcinoma in a patient with primary sclerosing cholangitis and ulcerative colitis","authors":"Inês Coelho Rodrigues ,&nbsp;Laure Dibombe ,&nbsp;Pauline Guillouche ,&nbsp;Tamara Matysiak-Budnik ,&nbsp;Damien Bouda ,&nbsp;Yann Touchefeu","doi":"10.1016/j.clinre.2024.102471","DOIUrl":"10.1016/j.clinre.2024.102471","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102471"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-exposure to different bacterial species’ lipopolysaccharides with the NASH diet exacerbates NASH and liver fibrosis progression in mice","authors":"Yen-Peng Lee ,&nbsp;Chien-Chao Chiu ,&nbsp;Yung-Chi Chang ,&nbsp;Yi-Hsun Chen ,&nbsp;Wei-Kai Wu ,&nbsp;Ming-Shiang Wu ,&nbsp;Hsiao-Li Chuang","doi":"10.1016/j.clinre.2024.102470","DOIUrl":"10.1016/j.clinre.2024.102470","url":null,"abstract":"<div><h3>Background and aim</h3><div>With the obesity epidemic, nonalcoholic fatty liver disease (NAFLD) has become a public health concern, but its progression mechanism remains unclear. Experimental models mimicking human NAFLD/steatohepatitis (NASH) are crucial. This study simulates gut microbiota imbalance effects on NASH and liver fibrosis.</div></div><div><h3>Methods</h3><div>We used different bacterial sources of lipopolysaccharide (LPS), including <em>Escherichia coli</em> (GEC) and <em>Salmonella abortus equi</em> (GSE), combined with a Gubra Amylin NASH (GAN) diet to induce NASH and liver fibrosis.</div></div><div><h3>Results</h3><div>The GSE group showed significantly higher serum alanine aminotransferase, hydroxyproline, CD68-positive cells, α-smooth muscle actin, glial fibrillary acidic protein, and <em>TNF-α, COL1A1, TGF-β</em>, and <em>NLRP3</em> expressions compared to the the GAN group. The GSE group also had higher <em>Erysipelotrichaceae, Akkermansiaceae</em>, and <em>Bacteroidaceae</em> family numbers.</div></div><div><h3>Conclusions</h3><div>The GAN diet with LPS treatment successfully induced NASH and fibrosis making this model useful for preclinical NASH drug testing.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102470"},"PeriodicalIF":2.6,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selenium inhibits ferroptosis in ulcerative colitis through the induction of Nrf2/Gpx4","authors":"Jie Shi ,&nbsp;Shan Ji ,&nbsp;Mengyao Xu ,&nbsp;Yongan Wang ,&nbsp;Hui Shi","doi":"10.1016/j.clinre.2024.102467","DOIUrl":"10.1016/j.clinre.2024.102467","url":null,"abstract":"<div><h3>Background and aim</h3><div>Selenium, an essential micronutrient for human and has been reported to have a protective effect in ulcerative colitis (UC). However, the role of selenium in UC is unclear. Our aim was to investigate the mechanism of action of selenium in UC.</div></div><div><h3>Methods</h3><div>Serum selenium levels were measured in UC patients and healthy controls. In addition, the effect of sodium selenite supplementation on experimental colitis in mice treated with dextran sulfate sodium (DSS) was investigated. The effect of sodium selenite on IECs ferroptosis was evaluated by observing the cell mortality, intracellular ferrous content, lipid reactive oxygen species and mitochondrial membrane damage in DSS-treated Caco2 cells. In addition, glutathione peroxidase 4 (Gpx4) and nuclear factor erythroid 2-like 2 (Nrf2) were detected in Caco2 cells and mouse intestines to explore their mechanisms.</div></div><div><h3>Results</h3><div>The serum selenium content of UC patients was lower than that of healthy subjects. In addition, serum selenium levels were negatively correlated with disease activity. The in vivo results showed that selenium treatment could improve colitis induced by DSS and inhibit IECs ferroptosis. The in vitro results further showed that selenium inhibited the ferroptosis of Caco-2 cells induced by DSS. Nrf2/Gpx4 was up-regulated after selenium supplementation in vivo and in vitro.</div></div><div><h3>Conclusions</h3><div>Serum selenium level is associated with IECs ferroptosis in UC patients. Selenium can relieve DSS-induced colitis and inhibit IECs ferroptosis by up-regulating the expression of Nrf2/Gpx4.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102467"},"PeriodicalIF":2.6,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between single and combined exposures to environmental phenols and ulcerative colitis in American adults","authors":"Fu Xiao,&nbsp;Yusong Wei,&nbsp;Peng Zou,&nbsp;Xiaobin Wu","doi":"10.1016/j.clinre.2024.102468","DOIUrl":"10.1016/j.clinre.2024.102468","url":null,"abstract":"<div><h3>Objective</h3><div>The etiology of ulcerative colitis (UC) is complex and involves multiple factors, with exposure to environmental toxins potentially contributing greatly to its pathogenesis. Therefore, this study was carried out with the purpose of delving into the associations between single and combined exposures to environmental phenols and UC among American adults.</div></div><div><h3>Methods</h3><div>Survey data from the 2009–2010 National Health and Nutrition Examination Survey were selected for our research. The associations between single and combined exposures to environmental phenols and the prevalence of UC were analyzed using weighted multivariate logistic regression models as well as Bayesian kernel machine regression (BKMR).</div></div><div><h3>Results</h3><div>A total of 1,422 adults aged 20 years old and above were included in this study, 17 of whom had UC. The correlation matrix showed strong associations between 2,4-dichlorophenol (2,4-DCP) and 2,5-dichlorophenol (2,5-DCP) (<em>R</em> = 0.81), as well as between 2,4,5-trichlorophenol (2,4,5-TCP) and 2,4,6-trichlorophenol (2,4,6-TCP) (<em>R</em> = 0.73). The logistic regression model revealed that, after adjusting for confounders, exposure to environmental phenols was positively associated with the prevalence of UC, with 2,4,6-TCP showing a significant association (OR = 2.37, 95 % CI = 1.10, 5.09, <em>P</em> = 0.037). The BKMR analysis indicated an upward trend in the overall effect of combined exposures to environmental phenols on UC. All five phenols contributed to this effect, with 2,4,6-TCP exhibiting the most pronounced effect. When other compounds were fixed at the 50th percentile, the impact of the five phenols on UC demonstrated a positive association, without any noteworthy interaction among the compounds.</div></div><div><h3>Conclusion</h3><div>Our findings suggested that exposure to environmental phenols may contribute to the occurrence of UC among American adults.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102468"},"PeriodicalIF":2.6,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of ramucirumab in gastric or gastroesophageal cancer: A systematic review and meta-analysis","authors":"Rui Wu ,&nbsp;Sijia Yuan ,&nbsp;Yuxuan Wang ,&nbsp;Yangli Nan ,&nbsp;Zixiao Chen ,&nbsp;Hong Yuan ,&nbsp;Zixuan Wang ,&nbsp;Zuojing Li ,&nbsp;Dongsheng Zong","doi":"10.1016/j.clinre.2024.102466","DOIUrl":"10.1016/j.clinre.2024.102466","url":null,"abstract":"<div><h3>Background</h3><p>Ramucirumab is considered a potential treatment for gastric or gastroesophageal cancer; however, its safety has not been evaluated. This meta-analysis aimed to evaluate the efficacy and safety of ramucirumab for treating gastric or gastroesophageal cancer.</p></div><div><h3>Methods</h3><p>The databases of PubMed, Embase, and Cochrane Library were searched through October 2023. The search focused on randomized controlled trials (RCTs) comparing ramucirumab (with or without chemotherapy) to a placebo (with or without chemotherapy) in patients with gastric or gastroesophageal cancer. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were pooled.</p></div><div><h3>Results</h3><p>Seven RCTs with a total of 2613 patients were included. Compared with placebo (with or without chemotherapy), ramucirumab (with or without chemotherapy) significantly improved OS (HR: 0.90, 95% CI: 0.82–0.99, <em>p</em> = 0.030), PFS (HR: 0.74, 95% CI: 0.60–0.90, <em>p</em> = 0.003), ORR (OR: 1.39, 95% CI: 1.15–1.67, <em>p</em> &lt; 0.001), and DCR (OR: 1.91, 95% CI: 1.38–2.63, <em>p</em> &lt; 0.001). However, ramucirumab (with or without chemotherapy) also increased the incidence of decreased appetite (OR: 1.29, 95% CI: 1.09–1.53, <em>p</em> = 0.004), diarrhea (OR: 1.39, 95% CI: 1.01–1.91, <em>p</em> = 0.05), hypertension (OR: 3.13, 95% CI: 2.03–4.83, <em>p</em> &lt; 0.00001), and bleeding or hemorrhage (OR: 2.34, 95% CI: 1.93–2.85, <em>p</em> &lt; 0.00001).</p></div><div><h3>Conclusions</h3><p>Ramucirumab (with or without chemotherapy) can improve OS, PFS, ORR and DCR in patients with gastric or gastroesophageal cancer. However, it may also increase the incidence of specific AEs.</p></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 8","pages":"Article 102466"},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}