European Journal of Gastroenterology & Hepatology最新文献

{"title":"Impact of biosimilars on the costs of advanced therapies for inflammatory bowel diseases: a population-based study in Italy.","authors":"Antonio Tursi, Walter Elisei, Annamaria Pia Terlizzi, Natale Antonino, Carlo Casamassima, Francesca Vittoria Rizzi, Federica Di Pierro, Eugenio Di Brino, Carlotta De Chiara, Marcello Covino, Alfredo Papa","doi":"10.1097/MEG.0000000000003159","DOIUrl":"10.1097/MEG.0000000000003159","url":null,"abstract":"<p><strong>Objective: </strong>The use of advanced therapies (biologics and small molecules) for treating inflammatory bowel diseases (IBD) has increased in recent years. We aimed to evaluate the incidence and prevalence of IBD in an Italian province (Barletta-Andria-Trani), the rate of IBD patients treated with advanced therapies, and their costs.</p><p><strong>Methods: </strong>Case searching used predefined read codes to systematically search computer diagnostic and prescription records from 1 January 2018 to 31 December 2023. All the cases of ulcerative colitis and Crohn's disease were extracted from the electronic database of the Local Health Agency 'Barletta-Andria-Trani'. The same database was queried to assess the rate of IBD patients treated with advanced therapies.</p><p><strong>Results: </strong>During the observational period, the prevalence of Crohn's disease and ulcerative colitis increased significantly from 146.6/100 000 to 203.6/100 000 [95% confidence interval (CI): 0.09-0.11] and from 303.2/100 000 to 408.3/100 000 (95% CI: 0.05-0.06), respectively. The incidence of Crohn's disease and ulcerative colitis showed no statistically significant increase: from 8.3/100 000 to 10.5/100 000 (95% CI: -0.6 to 1.44) and from 13.7/100 000 to 17.6/100 000 (95% CI: -0.12 to 1.6), respectively. The rate of IBD patients treated with advanced therapies increased from 11.9 to 19.3%. Opposite, the costs for advanced therapies decreased from € 1 481 558.19 to 1 171 132.50 (-20.95%).</p><p><strong>Conclusion: </strong>This population-based study found increased advanced therapies use partially because of the higher IBD prevalence observed during the study period, but with decreasing costs, mainly attributable to the significant use of anti-tumor necrosis factor αlpha biosimilars.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"902-908"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354272","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":"Tissue penetration of anti-tumour necrosis factor therapy in perianal fistulising Crohn's disease: a proof-of-concept study.","authors":"Sulak Anandabaskaran, Zhigang Liu, Luke Hanna, Phillip Lung, James L Alexander, Nick Powell, Susan J Connor, Phil Tozer, Ailsa Hart","doi":"10.1097/MEG.0000000000003169","DOIUrl":"10.1097/MEG.0000000000003169","url":null,"abstract":"<p><strong>Background: </strong>Perianal fistulising Crohn's disease (pfCD) remains a therapeutic challenge, with a limited sustained response to biological therapy. Although higher serum anti-tumour necrosis factor (TNF) levels are associated with improved fistula healing, tissue pharmacokinetics in pfCD are poorly understood. This proof-of-concept study aimed to establish the feasibility of quantifying anti-TNF concentrations within fistula tissue and evaluate their relationship with serum levels and treatment outcomes.</p><p><strong>Methods: </strong>Paired blood and fistula tract biopsies were obtained from 14 patients (infliximab, seven; adalimumab, seven) with active pfCD on established anti-TNF therapy (>14 weeks post-induction). The serum was processed by centrifugation within 8 h and stored at -80°C. Fistula tract biopsies were snap-frozen, homogenised, and extracted using an ELISA buffer proportional to tissue weight. Anti-TNF levels in the serum and tissue supernatants were quantified using standard and high-sensitivity ELISA assays, respectively.</p><p><strong>Results: </strong>All patients had detectable anti-TNF concentrations in both serum and fistula tissues. Tissue and serum levels showed a moderate positive correlation ( r  = 0.45, P  = 0.09), with a stronger and statistically significant association in the infliximab subgroup ( r  = 0.81, P  = 0.01). Higher fistula-to-serum ratios, reflecting enhanced tissue penetration, tended towards improved clinical and radiological outcomes and lower perianal disease activity index scores, although the difference was not statistically significant.</p><p><strong>Conclusion: </strong>Anti-TNF levels in perianal fistula tissue are measurable and correlated with serum concentrations, supporting a mechanistic link between systemic exposure and local drug penetration. These findings highlight the feasibility of tissue-level pharmacokinetic assessments and warrant validation in larger prospective cohorts.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"925-932"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alarm symptoms at diagnosis of coeliac disease and long-term outcomes.","authors":"Aarij Sohail Iqbal","doi":"10.1097/MEG.0000000000003216","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003216","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 8","pages":"989"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307577","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":"Three is not a crowd: improving the study of chronic constipation.","authors":"Ana Isabel Ferreira, Cátia Arieira, Pedro Campelo, Sofia Xavier, José Cotter","doi":"10.1097/MEG.0000000000003164","DOIUrl":"10.1097/MEG.0000000000003164","url":null,"abstract":"<p><strong>Background: </strong>High-definition anorectal manometry (HD-ARM), balloon expulsion test (BET), and magnetic resonance defecography (MR defecography) are important tools in studying constipation. Our aim was to evaluate the prevalence of functional defecation disorders and structural anorectal alterations in patients with chronic constipation and compare the findings of HD-ARM and BET with MR defecography.</p><p><strong>Methods: </strong>Retrospective cohort study including patients with functional constipation or irritable bowel syndrome with constipation (IBS-C), refractory to medical therapy, submitted to HD-ARM, BET, and MR defecography. Patients were divided into three groups: (a) normal anorectal evacuation in HD-ARM and normal BET; (b) abnormal evacuation pattern and abnormal BET; and (c) normal anorectal evacuation pattern and abnormal BET, or abnormal evacuation pattern and normal BET.</p><p><strong>Results: </strong>A total of 64 patients were included, 49 with functional constipation (76.6%) and 15 with IBS-C (23.4%). In MR defecography, 47 patients had structural alterations (73.4%) and 15 had dyssynergia (23.4%). Overall, 19 patients were diagnosed with dyssynergic defecation (29.7%). Comparing the findings of HD-ARM and BET with MR defecography: in group 1 ( n  = 20), 15 patients had structural alterations (75.0%); in group 2 ( n  = 11), 8 had structural alterations (72.7%); and in group 3 ( n  = 33), 22 patients only had structural alterations (66.7%), 6 only had dyssynergic defecation (18.2%), and 2 had both (6.0%). MR defecography allowed the diagnosis of dyssynergic defecation in 8 patients (24.2%).</p><p><strong>Conclusion: </strong>One third of patients with functional constipation and IBS-C had dyssynergic defecation and three quarters had relevant structural anorectal alterations. Therefore, it is important to combine MR defecography with HD-ARM and BET in the study of constipation.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"909-915"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354225","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":"Association between albumin-bilirubin score, model for end-stage liver disease score, platelet-albumin-bilirubin score, and acute-on-chronic liver failure complications: a cross-sectional study in a Chinese population.","authors":"Jiejie Xie, Xiong Pei, Longyan Wang, Xiaopu Ma, Yan Xie","doi":"10.1097/MEG.0000000000003221","DOIUrl":"10.1097/MEG.0000000000003221","url":null,"abstract":"<p><strong>Background and aims: </strong>Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation and high short-term mortality. We investigated whether the albumin-bilirubin (ALBI) score, model for end-stage liver disease (MELD) score, and platelet-albumin-bilirubin (PALBI) score independently predict major ACLF complications.</p><p><strong>Methods: </strong>This retrospective cross-sectional study enrolled 2104 ACLF patients (2017-2024) fulfilling Asian Pacific Association for the Study of the Liver 2019 criteria. ALBI, MELD, and PALBI were calculated within 48 h of admission. Multivariable logistic regression, restricted cubic spline, and receiver operating characteristic (ROC) analyses assessed associations with ascites, hepatic encephalopathy, hepatorenal syndrome (HRS), coagulopathy, splenomegaly, and spontaneous bacterial peritonitis.</p><p><strong>Results: </strong>All three scores increased significantly with worsening Child-Pugh class (P < 0.001). Per SD increase, ALBI predicted all six complications with adjusted odds ratios (ORs) ranging from 1.98 to 8.73. MELD showed similar predictive ability (ORs: 2.58-7.26). PALBI quartiles 2 and 3 remained significantly associated with HRS (P = 0.007 and P = 0.011, respectively). Restricted cubic spline revealed nonlinear dose-response relationships (P-nonlinearity < 0.005). ROC area under the curve values were consistently higher for MELD than ALBI and PALBI. Subgroup analyses confirmed stability across age, sex, BMI, smoking, and alcohol use.</p><p><strong>Conclusion: </strong>ALBI, MELD, and PALBI scores simply and reliably identify ACLF complications, helping clinicians intensify monitoring and tailor therapy for high-risk patients.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 8","pages":"959-970"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307534","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":"Comment on 'Associations between 12 insulin resistance surrogates with metabolic dysfunction-associated steatotic liver disease risk and all-cause mortality: data from the National Health and Nutrition Examination Survey III (1988-1994)'.","authors":"Neeraj Singh, Monika Srivastav","doi":"10.1097/MEG.0000000000003218","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003218","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 8","pages":"990"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307529","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":"Indirect comparison of endoscopic balloon dilatation, stent placement, and stricturotomy for lower gastrointestinal strictures in Crohn's disease: a systematic review and meta-analysis.","authors":"Abinash Subedi, Abdelkader Chaar, Fatima Keshia Suhail, Azhar Hussain, Ganesh Aswath, Vishnu Charan Suresh Kumar, Josh F Wallace, Dongliang Wang, James Evans, Subash Ghimire, Bishnu Sapkota, Idan Goren","doi":"10.1097/MEG.0000000000003172","DOIUrl":"10.1097/MEG.0000000000003172","url":null,"abstract":"<p><strong>Background and aims: </strong>Outcomes of endoscopic balloon dilatation (EBD), endoscopic stent placement (ESP), and endoscopic stricturotomy for Crohn's disease-related strictures vary across studies. We conducted an indirect meta-analysis to synthesize and compare outcomes.</p><p><strong>Methods: </strong>Data were extracted from multiple online databases. Primary outcomes of interest were: clinical success and technical success. Secondary outcomes of interest were: rate of adverse events, the rates of repeat endoscopic procedures, and surgery. Pooled proportions along with 95% confidence interval (CI) and odds ratio (OR) of each outcome were calculated.</p><p><strong>Results: </strong>We analyzed 39 studies: 25 on EBD (n = 1353), nine on ESP (n = 159), and five on endoscopic stricturotomy (n = 102). Pooled outcomes for EBD, ESP, and endoscopic stricturotomy, respectively, were: technical success (88, 93, and 95%), clinical success (62, 59, and 49%), adverse events (7, 25, and 17%), repeat procedures (17, 7, and 56%), and surgery (13, 25, and 9%). Compared with EBD, endoscopic stricturotomy showed significantly higher repeat endoscopy rates (OR = 6.165, 95% CI: 2.328-6.328, P < 0.05). Both endoscopic stricturotomy and ESP had higher adverse event rates than EBD (endoscopic stricturotomy: OR = 2.610, 95% CI: 1.095-6.221; ESP: OR = 4.214, 95% CI: 2.070-8.579; both P < 0.05). Differences in clinical and technical success, repeat procedures with ESP, and surgery were NS.</p><p><strong>Conclusion: </strong>Clinical and technical success were not significantly different between EBD, ESP, and endoscopic stricturotomy for Crohn's disease-related strictures. However, adverse events and repeat procedures were higher in ESP and endoscopic stricturotomy when compared with EBD.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 8","pages":"933-940"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307592","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":"Artificial intelligence-integrated nanotherapeutics for rare Peutz-Jeghers syndrome hamartoma-induced obstructions: latest clearance strategies.","authors":"Malaika Saqib, Nofal Saqib, Muhammad Talha, Shanza Abbas","doi":"10.1097/MEG.0000000000003210","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003210","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 8","pages":"987-988"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307597","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":"Safety of percutaneous gastrostomy tube placement in patients with cirrhosis: a multicenter matched cohort study.","authors":"Mohamed H Eldesouki, Mohamed Elgozair, Omar Alkasabrah, Ahmed Ibrahim, Mohammed Y Youssef, Marc J Zuckerman, Sherif E Elhanafi","doi":"10.1097/MEG.0000000000003213","DOIUrl":"10.1097/MEG.0000000000003213","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with cirrhosis may require enteral access; however, the safety of percutaneous gastrostomy tube placement in this population remains unclear. We aimed to evaluate the safety of percutaneous gastrostomy tube placement in patients with compensated and decompensated cirrhosis compared with non-cirrhotic controls.</p><p><strong>Methods and results: </strong>Study cohorts were identified using the TriNetX US Collaborative Network database. Adult individuals with cirrhosis who underwent percutaneous gastrostomy placement were categorized as having compensated or decompensated cirrhosis and compared with matched non-cirrhotic controls. We assessed 30-day post-procedural complications. A total of 160 893 patients without cirrhosis, 2279 patients with compensated cirrhosis, and 3564 patients with decompensated cirrhosis who underwent percutaneous gastrostomy placement were identified. After matching, patients with decompensated cirrhosis experienced significantly higher rates of percutaneous gastrostomy-related hemorrhage [adjusted odds ratio (aOR) 2.37 (1.27-4.44)], percutaneous gastrostomy malfunction [aOR 1.68 (1.36-2.07)], peritonitis [aOR 13.67 (8.21-15.79)], sepsis [aOR 2.02 (1.74-2.34)], perforation [aOR 4.44 (2.23-8.84)], and gastrointestinal bleeding [aOR 2.99 (2.27-3.93)] compared with non-cirrhotic controls. However, in the compensated group, there were no significant differences in all complications, except mortality, compared with non-cirrhotic controls.</p><p><strong>Conclusion: </strong>In this large real-world cohort study, patients with decompensated cirrhosis were at higher risk of gastrostomy-related complications compared with non-cirrhotic controls. However, gastrostomy tube placement was found to be safe in patients with compensated cirrhosis. These findings highlight the importance of careful risk stratification and patient selection when considering gastrostomy tube placement in patients with cirrhosis.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"949-958"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053473","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":"Risk factors for hepatic failure after transarterial chemoembolization in patients with hepatocellular carcinoma: a systematic review and meta-analysis.","authors":"Vitchapong Prasitsumrit, Ben Thiravetyan, Tulaton Sodsri, Jerapas Thongpiya, Weerinth Puyati, Nipith Charoenngam","doi":"10.1097/MEG.0000000000003137","DOIUrl":"10.1097/MEG.0000000000003137","url":null,"abstract":"<p><p>Hepatic failure is a potentially fatal complication in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE). However, there is a lack of clear predictive factors for hepatic failure after TACE in HCC patients. This study aimed to identify all available data and determine the risk factors associated with hepatic failure after TACE in HCC patients. A systematic review and meta-analysis included 9 studies with a total of 1654 patients. The results showed that factors significantly associated with hepatic failure after TACE included female sex [odds ratio (OR) = 1.38, 95% confidence interval (CI) 1.09-1.75], low albumin [mean difference (MD) = -0.34, 95% CI: -0.61 to -0.07] and platelet (MD = -15.84, 95% CI: -23.62 to -8.05), high total bilirubin (MD = 0.64, 95% CI: 0.24-1.04), aspartate aminotransferase (MD = 25.45, 95% CI: 3.88-47.01), alanine aminotransferase (MD = 8.79, 95% CI: 0.15-17.42), international normalized ratio (MD = 0.18, 95% CI: 0.03-0.32), alpha-fetoprotein (MD = 74.05, 95% CI: 64.12-83.99), Model for End-Stage Liver Disease (MD = 3.41, 95% CI: 0.95-5.87), and high Child-Turcotte-Pugh class (OR = 4.66, 95% CI: 1.52-14.28), larger tumor size (MD = 7.75, 95% CI: 6.87-8.63), presence of portal vein thrombosis (OR = 1.78, 95% CI: 1.19-2.67), and high indocyanine green retention test after 15 min (ICG-R15 test) (MD = 16.75, 95% CI: 13.16-20.34). These findings may help clinicians with treatment planning, patient counseling, and postprocedural monitoring.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 8","pages":"893-901"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307578","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}