European Journal of Gastroenterology & Hepatology最新文献

{"title":"Response to the letter to the editor by Zhou.","authors":"Eneli Katunin, Kalle Kurppa, Katri Kaukinen, Rakel Nurmi","doi":"10.1097/MEG.0000000000003229","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003229","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 11","pages":"1364"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105985","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":"COMPLY-CATeD: Celiac Adherence in Teens Diagnosed: an Italian multicentric study.","authors":"Annalisa Morelli, Monica Montuori, Francesca Ferretti, Antonella Diamanti, Silvia Francisci, Salvatore Oliva, Valeria Dipasquale, Claudio Romano, Alice Monzani, Francesco Graziano, Valentina Nosratian, Federica Malerba, Marco Crocco, Claudia Banzato, Francesco Valitutti, Chiara Maria Trovato","doi":"10.1097/MEG.0000000000003227","DOIUrl":"10.1097/MEG.0000000000003227","url":null,"abstract":"<p><strong>Objectives: </strong>Gluten-free diet (GFD) is, to date, the only effective therapeutic intervention for coeliac disease (CeD). Evaluation of dietary adherence is of the utmost importance in the management of CeD. However, in the paediatric population, there is limited data concerning the adherence to the GFD in patients diagnosed via bioptic confirmation compared to those diagnosed through the biopsy-sparing method, according to the ESPGHAN 2012 guidelines. In this multicentric study, we investigated dietary adherence in a group of adolescents with CeD, comparing patients diagnosed with the two different diagnostic modalities, and we proposed the validation of an evaluation tool for the GFD compliance in this population.</p><p><strong>Methods: </strong>A total of 206 patients aged 14-18 years, diagnosed between 2012 and 2019, all with CeD and on a GFD for at least 2 years, were included. Adherence was assessed using the Leffler questionnaire [Celiac Dietary Adherence Test (CDAT)] and the Biagi score.</p><p><strong>Results: </strong>Among participants, 81.1% had been diagnosed through biopsy. No significant difference in Biagi scores was observed between the two groups ( P  = 0.057). Regarding the CDAT, poor or suboptimal adherence (score: ≥13) was identified in 66 patients diagnosed by biopsy and 12 patients diagnosed by the biopsy-sparing approach ( P  = 0.362). A multivariate analysis exploring the influence of diagnostic method, age at diagnosis, and education level on CDAT scores did not reach statistical significance ( P  = 0.1, R2  = 0.031).</p><p><strong>Conclusion: </strong>Adherence to a GFD does not differ between adolescents diagnosed by biopsy and those diagnosed through the biopsy-sparing approach, irrespective of age at diagnosis or educational level.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1305-1310"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469787","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 tegoprazan-amoxicillin dual therapy versus bismuth-containing quadruple therapy for first-line Helicobacter pylori eradication: a systematic review and meta-analysis of randomized controlled trials.","authors":"Jin Ho Hwang, Ji Hoon Kim, Yo Han Lee, Jeong Hyun Lim, Kyoung Jin Min, Yeon Ji Kim","doi":"10.1097/MEG.0000000000003184","DOIUrl":"10.1097/MEG.0000000000003184","url":null,"abstract":"<p><p>Optimized bismuth quadruple therapy is a recommended first-line treatment for Helicobacter pylori infection but is limited by regimen complexity, whereas tegoprazan-amoxicillin dual therapy has emerged as a simplified alternative with limited comparative evidence. We conducted a systematic review and meta-analysis of randomized controlled trials comparing tegoprazan-amoxicillin dual therapy with bismuth-containing quadruple therapy (BQT) as first-line treatment for H. pylori infection. Electronic databases (PubMed, Embase, Web of Science Core Collection, and the Cochrane Library) were searched from inception through 24 December 2025. Intention-to-treat eradication rates were pooled using a random-effects model. Sensitivity analyses were performed by restricting comparators to proton pump inhibitor-based BQT. Safety outcomes were qualitatively synthesized. Five randomized controlled trials involving 1541 treatment-naïve participants were included. In intention-to-treat analyses, 14-day tegoprazan-amoxicillin dual therapy showed no statistically significant difference in eradication efficacy compared with BQT [risk ratio, 0.996; 95% confidence interval, 0.911-1.089; P = 0.93]. Sensitivity analysis restricted to proton pump inhibitor-based BQT yielded consistent results (risk ratio, 0.985; 95% confidence interval, 0.877-1.107; P = 0.80). Across individual studies, adverse events and treatment discontinuation were generally reported more frequently in BQT arms than in dual-therapy arms, although reporting of safety and adherence outcomes was not fully standardized. In randomized first-line trials, 14-day tegoprazan-amoxicillin dual therapy demonstrated eradication efficacy comparable to BQT. These findings suggest that 14-day tegoprazan-amoxicillin dual therapy may serve as an alternative first-line option, particularly when regimen simplicity and tolerability are prioritized.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 11","pages":"1247-1253"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105818","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":"Dietary B vitamin intake and risk of ulcerative colitis: a case-control study.","authors":"Yoshihiro Miyake, Keiko Tanaka, Chisato Nagata, Shinya Furukawa, Akira Andoh, Tetsuji Yokoyama, Naoki Yoshimura, Kenichiro Mori, Tomoyuki Ninomiya, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda, Mitsuru Saito, Katsuhisa Ohashi, Hirotsugu Imaeda, Kazuki Kakimoto, Kazuhide Higuchi, Hiroaki Nunoi, Yuji Mizukami, Seiyuu Suzuki, Sakiko Hiraoka, Hiroyuki Okada, Keitarou Kawasaki, Masaaki Higashiyama, Ryota Hokari, Hiromasa Miura, Teruki Miyake, Teru Kumagi, Hiromasa Kato, Naohito Hato, Koji Sayama, Yoichi Hiasa","doi":"10.1097/MEG.0000000000003217","DOIUrl":"10.1097/MEG.0000000000003217","url":null,"abstract":"<p><strong>Objectives: </strong>A meta-analysis showed that serum folate concentrations, but not vitamin B 12 concentrations, are lower in patients with ulcerative colitis compared to healthy controls. However, no epidemiological study has investigated the association between dietary intake of folate, vitamin B 12 , vitamin B 6 , vitamin B 2 , and vitamin B 1 and the risk of ulcerative colitis. This study examines this association using data from a multicenter, hospital-based, case-control study.</p><p><strong>Methods: </strong>The study included 384 cases of ulcerative colitis diagnosed within the past 3 years and 665 controls. Data were collected through a self-reported questionnaire. Dietary information was obtained using a 169-item semi-quantitative food frequency questionnaire. Adjustment was made for sex, age, pack-years of smoking, alcohol consumption, history of appendicitis, family history of ulcerative colitis, education level, and BMI.</p><p><strong>Results: </strong>Higher dietary intakes of folate and vitamin B 1 were independently associated with a decreased risk of ulcerative colitis after adjusting for confounding factors. The adjusted odds ratio for extreme quartiles was 0.60 [95% confidence interval (CI): 0.39 - 0.91, P for trend = 0.009) for folate and 0.54 (95% CI: 0.36 - 0.81, P for trend = 0.004) for vitamin B 1 . Dietary intake of vitamins B 12 , B 6 , or B 2 was not independently associated with ulcerative colitis risk.</p><p><strong>Conclusion: </strong>This is the first study to demonstrate significant inverse relationships between dietary intake of folate and vitamin B 1 and the risk of ulcerative colitis. Our results should be interpreted as exploratory and require validation through further, more focused studies.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1285-1289"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301525","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":"Metabolic-dysfunction associated steatotic liver disease: clinical features and noninvasive methods of detection in young adults with obesity.","authors":"Pino Sommese, Filomena Boccia, Pasquale Mugione, Ilaria De Rosa, Ludovica Guerriero, Salvatore Tolone, Iolanda Cafarella, Lorenzo Bertolino, Diego Cuccurullo, Ludovico Docimo, Emanuele Durante-Mangoni, Rosa Zampino","doi":"10.1097/MEG.0000000000003211","DOIUrl":"10.1097/MEG.0000000000003211","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Metabolic-dysfunction associated steatotic liver disease (MASLD) is a major cause of liver disease and frequently associated with obesity. This observational study with prospective enrollment aimed to evaluate the clinical and metabolic characteristics of MASLD and to compare the diagnostic accuracy of noninvasive methods versus liver histology in detecting MASLD.</p><p><strong>Patients and methods: </strong>Adults with a BMI > 35 kg/m 2 were enrolled. Data collected included clinical, metabolic, and hepatic parameters, as well as lifestyle and physical examination findings. Liver histology, obtained according to clinical practice, was compared with noninvasive diagnostic tools: Fatty Liver Index (FLI), NAFLD fibrosis score, aspartate aminotransferase/platelet ratio index test, liver elastography, fibrosis-4 index score, and ultrasound imaging.</p><p><strong>Results: </strong>Ninety-five patients (median age 35 years, predominantly female) were included. Comorbidities were rare. Laboratory results were largely normal, except for elevated insulin and triglyceride levels. Hepatic histology was available in 64 patients (67%). Steatosis was prevalent (84%) with a median score of 2. Ultrasound bright liver patterns and high FLI values (median 98) supported the histological findings. A median Histology Activity Index of 4 and fibrosis stage of 1 indicated mild inflammation and fibrosis, confirmed by noninvasive tests. Multivariate analysis showed a significant linear correlation between FLI and histological steatosis ( P  = 0.001), with FLI being the most accurate non-invasive predictor (area under the receiver operating characteristic: 0.765; P  = 0.001).</p><p><strong>Conclusions: </strong>In this young with obesity cohort, MASLD was common but with limited liver damage progression. FLI seems to be the best predictor of steatosis. Hypertriglyceridemia and hyperinsulinemia were associated with higher steatosis levels, reflecting the metabolic dysfunction of MASLD.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1319-1328"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469628","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-world limitations in the assessment of alarm symptoms at coeliac disease diagnosis: a critical appraisal.","authors":"Zubia Hassan, Tehreem Alam, Mehnaz Ejaz Khokhar, Ali Karim, Osamagbe Osaghae, Oghenekevwe Egbenine","doi":"10.1097/MEG.0000000000003269","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003269","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 11","pages":"1366"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105866","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":"The effect of tenofovir alafenamide fumarate on lipid profiles in pregnant women with hepatitis B virus.","authors":"Lin Zhu, Qianru Jin, Guorong Han","doi":"10.1097/MEG.0000000000003281","DOIUrl":"10.1097/MEG.0000000000003281","url":null,"abstract":"<p><strong>Purpose: </strong>Tenofovir alafenamide fumarate (TAF) and tenofovir disoproxil fumarate (TDF) are usually used in pregnant women with hepatitis B virus (HBV), yet TAF has been associated with unfavorable lipid profiles in other HBV-infected groups. Data regarding the effects on the lipid profiles of pregnant women are scarce. This study compared the effects of TAF and TDF on lipid profiles in this population.</p><p><strong>Methods: </strong>This retrospective study included 650 HBV-infected pregnant women, grouped into TAF and TDF cohorts based on the antiviral regimen. Generalized linear models were used to compare the effects of TAF and TDF on lipid levels, and causal mediation analysis was performed to assess whether the treatment difference in lipids was mediated by gestational weight gain.</p><p><strong>Results: </strong>At delivery, the geometric mean ratios for total cholesterol (10.8%), low-density lipoprotein cholesterol (14.2%), and high-density lipoprotein cholesterol (10.0%) were elevated in the TAF group compared to the TDF group (all P  < 0.001). An upward trend was also observed for triglycerides (6.3%; P  = 0.062). The causal mediation analysis indicated that gestational weight change was not a significant mediator, accounting for less than 3.3%. Maternal and infant safety profiles were similar for most outcomes.</p><p><strong>Conclusion: </strong>TAF is effective in chronic HBV-infected pregnant women, but its lipid-elevating effect relative to TDF warrants clinical attention.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1358-1363"},"PeriodicalIF":2.1,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012288","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":"Prevalence, risk factors, and clinical outcomes of extraintestinal manifestations in inflammatory bowel disease: a population-based study in china.","authors":"Yiwen Xu, Kerong Wu, Peizhao Liu, Chujun Ni, Weijie Li, Haiyang Jiang, Chenling Wu, Tianliang Liu, Jianan Ren, Yun Zhao","doi":"10.1097/MEG.0000000000003197","DOIUrl":"10.1097/MEG.0000000000003197","url":null,"abstract":"<p><strong>Background and aims: </strong>Extraintestinal manifestations (EIMs) complicate the management of inflammatory bowel disease, and their epidemiology in Chinese patients remains unclear. We aimed to determine their prevalence and examine associated risk factors and clinical outcomes.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of over 44 000 patients of all ages in eastern China using data from the China National Healthcare Big Data (East) Center (2019-2024). We examined diverse EIMs (articular, skin, ocular, and oral manifestations, primary sclerosing cholangitis, and autoimmune hepatitis) and compared clinical characteristics of patients with and without EIMs using multivariable logistic regression.</p><p><strong>Results: </strong>The overall prevalence of EIMs was higher in ulcerative colitis (20.46%) than in Crohn's disease (14.64%). Among pediatric patients (<18 years), EIMs were more frequent in Crohn's disease (13.08%) than in ulcerative colitis (10.18%). EIM prevalence increased progressively across the four age groups (<18, 18-40, 40-65, and >65 years; P  < 0.001). Risk factors included older age ( P  < 0.001), female sex in ulcerative colitis ( P  = 0.002), and pancolitis ( P  = 0.041), whereas in pediatric patients, EIMs were linked to younger age ( P  = 0.015). EIMs were also associated with corticosteroid use ( P  < 0.001), all-cause hospitalization ( P  = 0.044 in Crohn's disease; P  < 0.001 in ulcerative colitis), and other adverse clinical outcomes. A total of 1.9% of Crohn's disease and 3.5% of ulcerative colitis patients had multiple EIMs, most commonly involving peripheral arthritis.</p><p><strong>Conclusion: </strong>This first large-scale study of Chinese inflammatory bowel disease patients evaluates EIMs, revealing age-specific and population-specific patterns that inform risk identification and individualized management.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1169-1179"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812695","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":"Comparative efficacy and safety of bi-flanged metal stents versus lumen-apposing metal stents for endoscopic drainage of pancreatic fluid collections: a systematic review and meta-analysis.","authors":"Muhammad Shahzil, Muhammad Hashim Faisal, Muhammad Hammad Khan, Syeda Fatima Abid, Minahel Shehzadi, Muhammad Saad Faisal, Ammad Javaid Chaudhary, Muhammad Sheharyar Warraich, Jennifer L Maranki","doi":"10.1097/MEG.0000000000003190","DOIUrl":"10.1097/MEG.0000000000003190","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic fluid collections (PFCs), particularly walled-off necrosis, are common complications of acute pancreatitis that often require endoscopic drainage. Bi-flanged metal stents (BFMS; NAGI; Taewoong Medical, Gyenoggi-do, Korea) and electrocautery-enhanced lumen-apposing metal stents (LAMS; AXIOS, Boston Scientific Corporation, Marlborough, Massachusetts, USA) are frequently used, but comparative data remain limited. This study aims to compare the efficacy and safety of BFMS and LAMS in the endoscopic drainage of PFCs.</p><p><strong>Methods: </strong>This meta-analysis followed the Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comprehensive database searches were conducted through November 2024 to identify studies comparing BFMS and LAMS for endoscopic ultrasound-guided drainage of PFCs. Outcomes were pooled using a random-effects model with RevMan Web, and statistical significance was defined as a P value less than 0.05.</p><p><strong>Results: </strong>Three studies ( n  = 627; 329 BFMS and 298 LAMS) met inclusion criteria. No significant differences were observed between BFMS and LAMS for technical success [odds ratio (OR): 1.16; 95% confidence interval (CI): 0.55-2.43] or clinical success (OR: 0.97; 95% CI: 0.51-1.87). Similarly, there were no differences in walled-off necrosis recurrence (OR: 2.01; 95% CI: 0.17-24.02), number of direct endoscopic necrosectomy sessions (OR: 0.52; 95% CI: 0.05-5.12), or mean number of endoscopic procedures (mean difference: 0.18, 95% CI: 2.08-2.45). Adverse events were also comparable between groups, including bleeding (OR: 0.64), infection (OR: 1.18), stent migration (OR: 1.83), and stent occlusion/dysfunction (OR: 1.71).</p><p><strong>Conclusion: </strong>BFMS and LAMS provide equivalent efficacy and safety in the endoscopic ultrasound-guided drainage of PFCs. Either stent type represents a viable therapeutic option. Further large-scale prospective studies are warranted to refine stent selection strategies.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1138-1150"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590877","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":"Positive conversion of latent tuberculosis screening in patients with inflammatory bowel disease on antitumor necrosis factor alpha drugs: a systematic review and meta-analysis.","authors":"Helio Rzetelna, Paula Santo, Heitor Siffert Pereira de Souza, Jacob Nichols, Cyrla Zaltman","doi":"10.1097/MEG.0000000000003180","DOIUrl":"10.1097/MEG.0000000000003180","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) patients undergoing antitumor necrosis factor-alpha (anti-TNF) therapy are at increased risk of developing tuberculosis (TB), making screening before anti-TNF initiation mandatory. Repeated screening during treatment is not yet recommended because of a lack of studies to support this practice. We aimed to determine the proportion of patients who develop latent TB during anti-TNF therapy. We systematically searched studies from MEDLINE, Embase, and Lilacs, and performed a single-arm meta-analysis investigating the positive conversion rate in IBD patients under anti-TNF therapy with previous negative TB screening. We calculated the combined proportion with 95% confidence interval, using the random-effects model. A P value less than 0.05 was considered statistically significant for subgroup differences. We included 13 studies from nine countries with 1153 patients. The overall positive conversion rate was 9.20%. Portugal had 18.01% of positive conversion, Spain 4.51%, and the USA 1.11%. Tests for subgroup differences were statistically significant for subgroup analysis by country and consistency of test used (performig same test as baseline). Subgroup analyses by continent, study design, or specific test (tuberculin skin test or interferon-gamma release assay) showed no statistical difference. Meta-regression analysis showed a significant positive association between positive conversion and TB incidence. In conclusion, IBD patients on anti-TNF therapy can have a positive conversion rate of 9.20%. Higher conversion rates were seen in European and Asian studies compared with those in the Americas (particularly the USA). TB prevention strategies should, therefore, be individualized and based on geographic location and risk factors.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1130-1137"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503555","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}