Alimentary Pharmacology & Therapeutics最新文献

{"title":"Pain and Sedative Medication Use Among Individuals With Inflammatory Bowel Disease: A Nationwide Population-Based Cohort Study.","authors":"Samantha Baillie,Sonia Saxena,Nishani Jayasooriya,Alex Bottle,Irene Petersen,Jonathan Blackwell,Richard Pollok","doi":"10.1111/apt.70247","DOIUrl":"https://doi.org/10.1111/apt.70247","url":null,"abstract":"BACKGROUNDIndividuals with inflammatory bowel disease (IBD) often experience pain, mood disturbances, and sleep disruption, which may lead to greater use of pain-relieving and sedative medications compared with the general population. These are associated with increased mortality, paradoxical worsening of pain, and inappropriate IBD treatment discontinuation. Chronic prescribing and co-prescribing increase the risk of respiratory depression, dependence, and overdose.METHODSUsing Clinical Practice Research Datalink, a large nationally representative dataset, we examined the annual prevalence of total, chronic (> 90 days opioids; > 28 days sedatives), and co-prescribed opioids, gabapentinoids and sedatives in adults with incident IBD from January 2010 to December 2019. Multivariable regression identified predictors of chronic or co-prescribing.RESULTSAmong 17,388 individuals, over 20% were prescribed a pain or sedative medication each year. Annual prevalence for opioids and gabapentinoids increased (13.6%-14% and 2.5%-5.6%, respectively) while sedative prevalence remained stable (8.4%). Chronic prescribing increased for strong opioids (3.6%-4.6%), weak opioids (3.6%-3.7%) and sedatives (4.2%-4.4%). Between 4.2% and 6.9% of individuals per year were co-prescribed opioids, gabapentinoids, and/or sedatives. Female sex, smoking, older age at diagnosis, Crohn's disease, and a diagnosis of inflammatory arthropathy, irritable bowel syndrome, fibromyalgia, or anxiety/depression were significantly associated with chronic and/or co-prescriptions of opioids or sedatives.CONCLUSIONA substantial proportion of individuals with IBD are prescribed pain and sedative medications, including long-term and co-prescriptions. Identifying high-risk patients is essential to ensure they are prioritised for limited resources, such as psychological therapies, as alternatives to harmful prescriptions.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"86 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533341","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":"Prescribing Inflammatory Bowel Disease Medications in Chronic Kidney Disease: A Practical Guide","authors":"Lynna Chen, Ashish Srinivasan, Suet‐Wan Choy, Jeffrey Van, Habeeb Habeeb, Andrew Nguyen, Abhinav Vasudevan","doi":"10.1111/apt.70262","DOIUrl":"https://doi.org/10.1111/apt.70262","url":null,"abstract":"BackgroundThe prevalence of chronic kidney disease (CKD) in patients with inflammatory bowel disease (IBD) is increasing. The pharmacokinetic profiles of IBD medications in patients with advanced‐stage CKD are not well studied.AimTo provide evidence‐based guidance on the use of medical therapies in patients with IBD and CKD.MethodsWe conducted a narrative review of literature up to 31 March 2025 on studies of therapies currently used for the treatment of IBD in the setting of CKD, with a focus on advanced kidney disease and use in renal replacement therapy.ResultsMesalazine can cause acute interstitial nephritis. Calcineurin inhibitors have been associated with nephrotoxicity. Methotrexate is contraindicated in advanced renal disease, including while on renal replacement therapy, due to higher risks of toxicity and myelosuppression. Dose adjustment of thiopurines should be considered in advanced renal disease due to metabolite accumulation. Monoclonal antibodies, including anti‐tumour necrosis factor therapy, anti‐integrin therapy and anti‐interleukin 12/23 therapies, appear to be safe in renal insufficiency, including haemodialysis. There is limited data available for small molecule therapies; drug metabolism profiles suggest they are safe in CKD, although, for Janus kinase (JAK) inhibitors, including tofacitinib and upadacitinib, dose reduction should be considered in advanced renal disease.ConclusionMost therapies used in IBD, particularly biologic therapies, appear safe and effective when used in patients with CKD, including those on renal replacement therapy. Caution should be considered when using conventional therapies and JAK inhibitors.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"3 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547190","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":"Prevalence and Predictors of Symptoms of Anxiety or Depression at Diagnosis in Patients With Inflammatory Bowel Disease: An Inception Cohort","authors":"Christy Riggott, David J. Gracie, Alexander C. Ford","doi":"10.1111/apt.70248","DOIUrl":"https://doi.org/10.1111/apt.70248","url":null,"abstract":"BackgroundThe prevalence of symptoms of a common mental disorder, including anxiety or depression, is high among patients with established inflammatory bowel disease (IBD). This may represent a therapeutic target for affected patients. However, whether these symptoms arise from genuine gut‐brain effects, or are merely a consequence of a preceding adverse disease course is unclear.AimsTo assess prevalence and predictors of anxiety and depression in an inception cohort of patients with IBD.MethodsWe collected demographic data, disease‐related information, diagnosis of a pre‐existing common mental disorder, symptoms of a common mental disorder, using the hospital anxiety and depression score, and gastrointestinal symptom‐specific anxiety, using the Visceral Sensitivity Index (VSI), from individuals newly diagnosed with IBD during their index outpatient appointment or inpatient admission. The prevalence of symptoms of a common mental disorder at diagnosis, and predictors of the presence of these symptoms, were examined.ResultsOf 300 participants, 117 (39.0%) reported symptoms of a common mental disorder (107 (35.7%) anxiety, 47 (15.7%) depression). Younger age, female sex, tobacco use, a longer duration of symptoms prior to diagnosis, higher gastrointestinal symptom‐specific anxiety, and stressful life events in the preceding 12 months were associated with a significantly increased likelihood of reporting these symptoms. Higher gastrointestinal symptom‐specific anxiety remained significant following logistic regression (OR 2.19; 95% CI 1.00–4.79 for VSI moderate and OR 13.5; 95% CI 5.86–31.2 for VSI high, <jats:italic>p</jats:italic> &lt; 0.001 for trend).ConclusionPoor psychological health is highly prevalent at the time of an IBD diagnosis, suggesting genuine gut‐brain effects.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"27 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515200","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":"Research Communication: Prevalence of Acute Reactions After Gluten Ingestion in Patients With Coeliac Disease—A Retrospective Study","authors":"Gabriele Avino, Francesca Burlo, Mauro Perinot, Laura Badina, Grazia Di Leo, Egidio Barbi, Chiara Zanchi","doi":"10.1111/apt.70255","DOIUrl":"https://doi.org/10.1111/apt.70255","url":null,"abstract":"Most gluten exposures in patients with coeliac disease on gluten‐free diet were considered asymptomatic or causing chronic symptoms, but some report severe acute reactions like vomiting, diarrhoea and prostration. Assess acute reactions following gluten ingestion. Retrospective study on paediatric and adult patients. A questionnaire investigated symptoms after gluten ingestion. 221 adults and 53 children were enrolled; 72% reported symptoms within 4 h. Vomiting was most common in children, diarrhoea in adults. Patients on gluten‐free diet may experience acute symptoms after accidental gluten ingestion. Further research is needed on frequency, triggers, and implications.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"9 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515197","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":"Meta‐Analysis: Effects of Steatotic Liver Disease‐Associated Genetic Risk Alleles on Longitudinal Outcomes","authors":"Matthew Kubina, Vitchapong Prasitsumrit, Jarell Tan, Joo Wei Ethan Quek, Dhiraj Peddu, Ankit Mishra, Pojsakorn Danpanichkul, Jake P. Mann, Eric Trépo, Stephan Buch, Daniel Q. Huang, Cheng Han Ng, Mark D. Muthiah, Yu Jun Wong, Karn Wijarnpreecha, Vincent L. Chen","doi":"10.1111/apt.70256","DOIUrl":"https://doi.org/10.1111/apt.70256","url":null,"abstract":"BackgroundGenetic variants associated with risk of steatotic liver disease (SLD) may also influence clinical events.AimsTo perform a systematic review and meta‐analysis to determine the impact of SLD‐associated genetic variants on hepatic and extrahepatic complications in SLD.MethodsWe searched PubMed, Embase and Medline databases from inception through July 4th, 2024 for studies on adults with SLD that reported effects of <jats:italic>PNPLA3</jats:italic>, <jats:italic>TM6SF2</jats:italic>, <jats:italic>MBOAT7</jats:italic>, <jats:italic>HSD17B13</jats:italic> and <jats:italic>GCKR</jats:italic> variants on the incidence of cirrhosis, major adverse liver outcomes (MALO), cardiovascular disease, extrahepatic malignancy and overall or cause‐specific mortality. We pooled hazard ratios and 95% confidence intervals from these outcomes to allow for comparison.ResultsWe screened 6475 studies and included 40 in the final analysis. <jats:italic>PNPLA3</jats:italic>‐rs738409‐GG genotype (vs. CC genotype) was associated with significantly higher incidence of MALO (sHR 2.30 [95% CI 1.66–3.18]), liver‐related mortality (sHR 2.83 [95% CI 1.58–5.06]) and all‐cause mortality (HR 1.24 [95% CI 1.04–1.47]). <jats:italic>TM6SF2</jats:italic>‐rs58542926‐CT or TT (vs. CC) genotype was associated with a higher incidence of hepatocellular carcinoma (sHR 2.12 [95% CI 1.66–2.70]). MALO was significantly associated with <jats:italic>MBOAT7</jats:italic> ‐rs641738‐TT (vs. CC) genotype (sHR 1.21 [95% CI 1.1–1.33]). Limitations in the literature include inconsistent outcome reporting and distribution of fibrosis stage, and a relative paucity of studies on both alcohol‐associated liver disease and non‐<jats:italic>PNPLA3</jats:italic> genetic variants.ConclusionsVariants in <jats:italic>PNPLA3</jats:italic>, <jats:italic>TM6SF2</jats:italic> and <jats:italic>MBOAT7</jats:italic> are significantly associated with hepatic outcomes, especially with advanced baseline liver disease, with modest effects on extrahepatic outcomes. Routine genotyping may improve risk stratification in SLD patients with advanced liver disease.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"16 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513164","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":"AP&T: Editors' Declarations of Interest","authors":"","doi":"10.1111/apt.70200","DOIUrl":"https://doi.org/10.1111/apt.70200","url":null,"abstract":"&lt;p&gt;Professor C. W. Howden, Editor&lt;/p&gt;&lt;p&gt;Professor Howden is a consultant/speaker for Phathom Pharmaceuticals, consultant/speaker for RedHill Biopharma, consultant/speaker for Meridian Diagnostics, and consultant for Sebela/Braintree. He owns stock in Antibe Therapeutics and has stock options in EndoStim.&lt;/p&gt;&lt;p&gt;Professor R. Loomba, Editor&lt;/p&gt;&lt;p&gt;Professor Loomba serves as a consultant to Aardvark Therapeutics, Altimmune, Arrowhead Pharmaceuticals, AstraZeneca, Cascade Pharmaceuticals, Eli Lilly, Gilead, Glympse bio, Inipharma, Intercept, Inventiva, Ionis, Janssen Inc., Lipidio, Madrigal, Neurobo, Novo Nordisk, Merck, Pfizer, Sagimet, 89 bio, Takeda, Terns Pharmaceuticals, and Viking Therapeutics. He has stock options in Sagimet biosciences. In addition, his institution received research grants from Arrowhead Pharmaceuticals, Astrazeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Eli Lilly, Galectin Therapeutics, Gilead, Intercept, Hanmi, Intercept, Inventiva, Ionis, Janssen, Madrigal Pharmaceuticals, Merck, Novo Nordisk, Pfizer, Sonic Incytes, and Terns Pharmaceuticals. He is also the co-founder of LipoNexus Inc.&lt;/p&gt;&lt;p&gt;Professor A. C. Ford, Associate Editor&lt;/p&gt;&lt;p&gt;Professor Ford has received grant/research support from GE Healthcare and Tillotts Pharma, and acted as a consultant/speaker for Dr. Falk, GE Healthcare, Sandoz, and Takeda Pharmaceuticals.&lt;/p&gt;&lt;p&gt;Professor G. M. Dusheiko, Associate Editor&lt;/p&gt;&lt;p&gt;Professor Dusheiko serves on independent data safety monitoring boards for Aligos, Arbutus, Glaxo Smith Kline, Janssen, Gilead, Precision Biosciences and Tune. In the past 2 years, he has received honoraria from Arbutus, Antios, Aligos and Gilead Sciences and he serves as an advisor to the National Medical Research Council, Singapore, the TherVacB Consortium (European Horizon Grant) and the A-Tango Consortium (EUH2020 grant).&lt;/p&gt;&lt;p&gt;Professor G. L.-H. Wong, Associate Editor&lt;/p&gt;&lt;p&gt;Professor Wong has served as an advisory committee member for AstraZeneca, Gilead Sciences, GlaxoSmithKline, Janssen, and Virion Biotherapeutics, and as a speaker for Abbott, AbbVie, Ascletis Pharmaceuticals, Bristol-Myers Squibb, Echosens, Ferring, Gilead Sciences, GlaxoSmithKline, Janssen, and Roche, and received research grants from Gilead Sciences.&lt;/p&gt;&lt;p&gt;Professor R. B. Gearry, Associate Editor&lt;/p&gt;&lt;p&gt;Professor Gearry is, or has been, a member of advisory boards for AbbVie, Janssen, Schering-Plough, Zespri, Baxter, and Celltrion. He has received honoraria or travel grants from AbbVie, Janssen, Schering-Plough, Zespri, Ferring, and Celltrion. He has received research grants for investigator-initiated studies from AbbVie, Janssen, Goodman-Fielder, Comvita, and Zespri.&lt;/p&gt;&lt;p&gt;Professor C. H. Seow, Associate Editor&lt;/p&gt;&lt;p&gt;Professor Seow is a member of advisory boards for Abbvie, Amgen, Bristol Myers Squibb, Celltrion, Ferring, Fresenius Kabi, Janssen, Lilly, Pfizer, Pharmascience, Sandoz, Sanofi, Shire, and Takeda and has been a speaker for Abbvie, Fresenius Kabi, Janssen, Li","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 2","pages":"108-109"},"PeriodicalIF":6.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Advancing Serologic Classification in Indeterminate Chronic Hepatitis B Through Dynamic and Integrated Frameworks-Authors' Reply.","authors":"Rui Huang,Mindie H Nguyen","doi":"10.1111/apt.70253","DOIUrl":"https://doi.org/10.1111/apt.70253","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"21 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488253","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":"Letter: Advancing Serologic Classification in Indeterminate Chronic Hepatitis B Through Dynamic and Integrated Frameworks.","authors":"Chun-Chieh Chen,Shiuan-Chih Chen","doi":"10.1111/apt.70227","DOIUrl":"https://doi.org/10.1111/apt.70227","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"17 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488265","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":"Review Article: Drug-Induced Liver Injury Associated With Antibody-Based Therapies in Haematologic Malignancies.","authors":"Mengmeng Lin,Yaping Xie,Jiahe Wu,Chong Zhang,Shanshan Shi,Nengming Lin,Xiangmin Tong,Yangling Li","doi":"10.1111/apt.70228","DOIUrl":"https://doi.org/10.1111/apt.70228","url":null,"abstract":"BACKGROUNDDrug-induced liver injury (DILI) is a leading cause of liver damage. It is especially prevalent in haematologic malignancies, complicating treatment regimens and posing a risk for severe outcomes such as acute liver failure. Antibody-based therapies have significantly improved treatment outcomes. However, these therapies are increasingly associated with liver injury, posing challenges in clinical management.AIMSThis review aims to examine the DILI associated with antibody-based therapies in haematologic malignancies, highlighting key mechanisms, risk factors, clinical management strategies, and identifying areas that require further research.METHODSWe conducted a comprehensive review of the literature on DILI induced by antibody-based therapies, including monoclonal antibodies, antibody-drug conjugates, and T-cell redirecting antibodies, specifically in the context of haematologic malignancies.RESULTSDILI associated with antibody-based therapies varies from mild transaminase elevations to severe liver injury. Risk factors include pre-existing liver disease, genetic predisposition, and therapy-specific mechanisms such as immune-mediated liver damage or direct hepatotoxic effects. Current management strategies involve routine liver function monitoring, dose modifications, and therapy discontinuation in severe cases. However, standardised guidelines remain lacking.CONCLUSIONSDILI remains a major challenge in the use of antibody-based therapies for haematologic malignancies. While progress has been made in understanding risk factors and management strategies, further research is essential to optimise patient care and balance therapeutic efficacy with liver toxicity risks.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"55 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488261","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":"Editorial: Beyond Viral Eradication-Scrutinising Outcomes After Hepatitis C Cure.","authors":"Wei-Fan Hsu,Cheng-Yuan Peng","doi":"10.1111/apt.70238","DOIUrl":"https://doi.org/10.1111/apt.70238","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"17 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488260","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}