Alimentary Pharmacology & Therapeutics最新文献

{"title":"Editorial: Clinical Impact of Lipid Profile Change After DAA Treatment in CHC Patients—Authors' Reply","authors":"Zahra Sarrafan-Chaharsoughi,&nbsp;Marc G. Ghany","doi":"10.1111/apt.70212","DOIUrl":"10.1111/apt.70212","url":null,"abstract":"<p>We wish to thank Dr. Cho for the kind summary and comments on our study ‘Clearance of Hepatitis C Viremia During Direct-Acting Antiviral Therapy Leads to Rapid Changes in Lipid and Lipoprotein Metabolism’ [<span>1, 2</span>]. We would like to highlight that the key and novel finding was that changes in lipid and lipoprotein levels occur rapidly within 24 h of initiating direct acting antiviral (DAA) therapy and were strongly correlated with decline in hepatitis C virus (HCV) viral load. The observation that dyslipidaemia was associated with many DAA agents and regimens and hypolipidaemia was seen with acute HCV infection and hyperlipidaemia with resolution of infection further strengthens our hypothesis that the changes in lipid and lipoprotein levels are virally mediated [<span>3, 4</span>]. Paradoxically, the decrease in HCV viraemia was associated with an increased expression of hepatic genes associated with de novo lipogenesis, particularly sterol regulatory element-binding protein 1 (SREBP1) and transmembrane 6 superfamily member 2 (TM6SF2) [<span>5</span>]. This interesting finding has been observed in other studies and requires further in vitro investigation. The dyslipidaemia associated with HCV clearance was associated with an increase in short-term cardiovascular risk using the Atherosclerotic Cardiovascular Disease (ASCVD) and Framingham risk scores. Although the outcome of HCV clearance on long-term cardiovascular risk remains unsettled the results of this and other studies suggest an increased cardiovascular risk [<span>6, 7</span>]. Therefore, we suggest that patients who have recovered from chronic HCV infection should be monitored for long-term cardiovascular outcomes. Those with persistent dyslipidaemia should be considered for risk lowering strategies. The effect of HCV eradication on long-term cardiovascular outcomes is currently being evaluated in a prospective 10-year follow-up study.</p><p><b>Zahra Sarrafan-Chaharsoughi:</b> writing – original draft, writing – review and editing. <b>Marc G. Ghany:</b> writing – original draft, writing – review and editing, supervision.</p><p>The authors' declarations of personal and financial interests are unchanged from those in the original article [<span>2</span>].</p><p>This article is linked to Sarrafan-Chaharsoughi et al. papers. To view this article, visit https://doi.org/10.1111/apt.70130 and https://doi.org/10.1111/apt.70155.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 2","pages":"216-217"},"PeriodicalIF":6.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228971","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":"Systematic Review: Use of Artificial Intelligence and Unmet Needs in Eosinophilic Oesophagitis","authors":"Ester Castagnaro,&nbsp;Enrico Felici,&nbsp;Roberta Spaccapelo,&nbsp;Mariangela Amoroso,&nbsp;Devis Moretti,&nbsp;Jean Pierre Saab,&nbsp;Annalisa Stassaldi,&nbsp;Andrea Tassone,&nbsp;Osvaldo Borrelli,&nbsp;Nicola De Bortoli,&nbsp;Giulio Del Corso,&nbsp;Edward Gaynor,&nbsp;Leanne Goh,&nbsp;Salvatore Oliva,&nbsp;Francesca Rea,&nbsp;Sara Renzo,&nbsp;Claudio Romano,&nbsp;Edoardo V. Savarino,&nbsp;Pierfrancesco Visaggi","doi":"10.1111/apt.70222","DOIUrl":"10.1111/apt.70222","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial intelligence (AI) has been applied extensively to eosinophilic oesophagitis (EoE), but its clinical impact and comprehensiveness remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To summarise the state of the art of applications of AI in EoE, identify gaps in the literature and disclose unmet needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a systematic review of applications of AI in diagnosis, prognosis, precision medicine and follow-up in EoE. We searched MEDLINE, Embase and Embase Classic (via Ovid) from inception until 28th February 2025. Clinical trials, cohort, case–control, cross-sectional and case series studies were eligible for inclusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 28 studies on AI in EoE, with 18 focusing on diagnosis. AI was used for histology image analysis in digital pathology in seven and endoscopic image analysis in three studies. AI-based non-invasive diagnostic predictive models showed high accuracy in detecting EoE. As a prognostic tool, AI showed potential in predicting food impaction, histologic disease severity and fibrosis. AI was used in precision medicine for biomarker discovery, endotype prediction based on transcriptomics and treatment personalisation, as well as in disease monitoring and follow-up. Unmet needs included insufficient studies on children/adolescents, prediction of treatment response and improvement of study designs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although AI showed promise at improving EoE management across various domains, most tools require validation on larger, independent and prospective cohorts. Several challenges, including algorithmic bias, data privacy, explainability and regulatory hurdles, need to be addressed for clinical implementation. Future studies should focus on developing non-invasive diagnostic tools for younger populations, treatment response prediction and disease monitoring.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 2","pages":"110-127"},"PeriodicalIF":6.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228973","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: Breath Testing for Colorectal Cancer Detection in Patients With a Positive Fecal Immunochemical Test: A Multicentre Prospective Cross-Sectional Study With External Validation","authors":"Milou L. M. van Riswijk,&nbsp;Kelly E. van Keulen,&nbsp;Adriaan C. I. T. L. Tan,&nbsp;Ruud W. M. Schrauwen,&nbsp;Wouter H. de Vos tot Nederveen Cappel,&nbsp;Peter D. Siersema,&nbsp;the eNose CRC study group","doi":"10.1111/apt.70207","DOIUrl":"10.1111/apt.70207","url":null,"abstract":"<p>Colorectal cancer (CRC) screening using fecal immunochemical tests (FIT) is suboptimal. This multicentre study evaluated an electronic nose (e-nose) for CRC detection in FIT-positive patients, along with reproducibility and external validation. Among 3469 participants (40.1% female, median age 64.3y), CRC was diagnosed in 5.0%; 25.1% had a normal colonoscopy. The e-nose showed poor diagnostic performance (AUC 0.542; sensitivity 39.5%; specificity 68.3%) and low reproducibility (ICC 0.22). Despite high patient acceptability (95.3% willingness-to-repeat), these findings suggest e-nose technology is not yet ready for clinical implementation. Further research is needed to standardise and validate e-nose devices before supplementing current screening methods. Clinicaltrials.gov Identifier NCT03346005 and NCT04357158.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 2","pages":"208-213"},"PeriodicalIF":6.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207249","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":"Occurrence and Management of Opportunistic Infections in Patients With Autoimmune Hepatitis: A Spanish Multicentre Study","authors":"María Del Barrio, Elena Ferreiro, Elena Gómez, Arantxa Caballero, Magdalena Salcedo, Alvaro Santos‐Laso, Andrea González‐Pascual, José Manuel Sousa, Judith Gómez, Indhira Pérez‐Medrano, Marta Quiñones Calvo, Conrado Fernández‐Rodriguez, Beatriz Mateos, Ana Arencibía, Mar Riveiro‐Barciela, Ignacio Vaz‐Romero, Diana Horta, Isabel Conde, Ismael El Hajra, Manuel Rodríguez‐Perálvarez, Marina Orti Cuerva, Margarita Sala, Montserrat García‐Retortillo, Tania Hernáez, Mireia Miquel, Jesús M. González‐Santiago, Javier Crespo, María‐Carlota Londoño, Álvaro Díaz‐González","doi":"10.1111/apt.70208","DOIUrl":"https://doi.org/10.1111/apt.70208","url":null,"abstract":"BackgroundThe management of autoimmune hepatitis (AIH) is based on immunosuppressive agents that may increase the risk of opportunistic infections (OI). However, data on their prevalence and incidence are lacking, which may explain the absence of specific management recommendations.AimsTo characterise the screening, occurrence and treatment of OI in patients with AIH.MethodsRetrospective multicentre study conducted in 20 Spanish centres involving patients with AIH treated with corticosteroid‐based regimens.ResultsFrom 2000 to 2023, 2893 AIH patients were treated. Latent Tuberculosis Infection (LTBI) screening was performed in five out of 20 centres, identifying 37 patients with LTBI, of whom 15 (40.5%) received LTBI therapy. No treated or untreated LTBI patients developed active Tuberculosis (aTB). In contrast, only six patients (0.2%) from the entire cohort developed aTB during follow‐up, with a median of 13.3 years from AIH diagnosis, without differences in risk factors or immunosuppressive therapy.Regarding other OI, no patient developed <jats:italic>Pneumocystis jirovecii</jats:italic>‐related pneumonia, 14 patients (0.48%) developed invasive candidiasis and 16 patients (0.55%) experienced infection due to <jats:italic>Aspergillus</jats:italic> spp. Notably, invasive candidiasis predominantly occurred in chronic AIH (71.4%), whereas Aspergillus infections were associated with severe forms of AIH and an increased risk of death. Less frequent OI included those caused by viruses (Cytomegalovirus, Varicella Zoster and Herpes Simplex), bacteria (Nocardia and Listeria) or fungi (Cryptococcus).ConclusionsThe occurrence of OI in AIH is very low, suggesting that LTBI screening and treatment may be unnecessary. In contrast, Aspergillus infection seems to be associated with acute severe AIH with dismal prognosis.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"70 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201639","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: Reassessing Tenofovir Alafenamide Use Throughout Pregnancy—A New Horizon in Hepatitis B Therapy. Authors' Reply","authors":"Xingfei Pan,&nbsp;Calvin Q. Pan","doi":"10.1111/apt.70221","DOIUrl":"10.1111/apt.70221","url":null,"abstract":"&lt;p&gt;We are grateful to Dr. Vyas [&lt;span&gt;1&lt;/span&gt;] for his thoughtful comments and insights in response to our recent publication [&lt;span&gt;2&lt;/span&gt;]. We fully agree with his perspective that treatment decisions in this context must be individualised and guided by ALT, HBeAg status, HBV DNA levels, and fibrosis scores. As pregnancy progresses, physiological changes impose an increasing burden on the maternal liver, often exacerbating pre-existing hepatic conditions [&lt;span&gt;3&lt;/span&gt;]. Chronic hepatitis B (CHB) itself predisposes pregnant women to a higher incidence of pregnancy complications such as gestational diabetes and hypertensive disorders when compared to healthy mothers [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In light of the immunosuppressive state of pregnancy and the increased risk of HBV replication, oral antiviral therapy serves a dual purpose: reducing mother-to-child transmission (MTCT) and controlling maternal liver inflammation. Both tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) are effective as monotherapy in managing CHB; however, TAF has demonstrated a more favourable safety profile with less impact on bone and renal function in women of childbearing age. Although most available safety data focus on initiation in the third trimester, our study is among the first to demonstrate the safety and efficacy of TAF exposure throughout pregnancy, offering CHB mothers a viable option from the first trimester onward. In our ongoing research, we are conducting longitudinal follow-up of all mothers and infants in our cohort to assess the long-term effects of in utero TAF exposure. Prior work on TDF has shown no adverse impact on child growth or neurodevelopment at four years [&lt;span&gt;5&lt;/span&gt;], and we hope to provide similar reassurance regarding TAF.&lt;/p&gt;&lt;p&gt;We appreciate Dr. Vyas's emphasis on emerging biomarkers, including HBV RNA and HBcrAg, as future tools for more precise monitoring. However, due to their limited global availability and lack of standardisation, their use remains largely investigational. We hope future research will validate their clinical utility during pregnancy. Regarding generalisability, we concur that including pregnant women with comorbidities such as HIV or renal dysfunction would enhance real-world applicability. We purposefully excluded such cases in our initial trial to maintain internal validity and ensure maternal-fetal safety. Future studies should address these important populations.&lt;/p&gt;&lt;p&gt;Nonetheless, we share the concern raised about potential fetal safety. While our data suggest low rates of adverse outcomes, the possibility of congenital abnormalities cannot be entirely excluded. Thus, careful prenatal assessment during early gestation is essential, and the decision to initiate TAF must be based on an individualised benefit–risk evaluation that considers disease severity and fibrosis stage. Regarding gestational diabetes, we observed a higher but not statistically conclusive incidence among women initiati","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 3","pages":"366-367"},"PeriodicalIF":6.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211192","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: Reassessing Tenofovir Alafenamide Use Throughout Pregnancy—A New Horizon in Hepatitis B Therapy","authors":"Ashish Kumar Vyas","doi":"10.1111/apt.70202","DOIUrl":"10.1111/apt.70202","url":null,"abstract":"&lt;p&gt;We read with interest the study by Pan et al. on tenofovir alafenamide (TAF) therapy throughout pregnancy in mothers with chronic hepatitis B (CHB) [&lt;span&gt;1&lt;/span&gt;]. This well-designed study, employing propensity score matching and subgroup analyses, provides reassuring evidence on TAF safety across all trimesters, demonstrating effective reduction of maternal hepatitis B virus (HBV) DNA levels and prevention of mother-to-child transmission (MTCT) by postpartum Week 28. The authors' rigorous methodology strengthens the limited literature on TAF use in pregnancy, and their findings are a valuable contribution to perinatal HBV management.&lt;/p&gt;&lt;p&gt;Despite these promising results, several aspects warrant further exploration to optimise maternal HBV management. Pregnancy induces a state of relative immunosuppression, which may exacerbate HBV replication, particularly in the third trimester when viral load peaks, heightening MTCT risk [&lt;span&gt;2, 3&lt;/span&gt;]. While Pan et al. highlight the efficacy of early TAF initiation, treatment decisions must be individualised, guided by baseline assessments of alanine aminotransferase (ALT), hepatitis B e-antigen (HBeAg) status, HBV DNA levels, and fibrosis scores. Our and other research have identified HBeAg positivity in placental tissue despite undetectable maternal serum HBeAg, suggesting the placenta as a potential HBV reservoir [&lt;span&gt;4, 5&lt;/span&gt;]. This underscores the need to investigate tissue-specific viral dynamics in MTCT risk stratification.&lt;/p&gt;&lt;p&gt;Emerging biomarkers, such as hepatitis B core-related antigen (HBcrAg), serum HBV RNA, and intrahepatic covalently closed circular DNA (cccDNA), may enhance precision in assessing viral activity during pregnancy. Additionally, our data indicate a correlation between hepatic expression of HBV entry receptors sodium taurocholate co-transporting polypeptide (NTCP) and asialoglycoprotein receptor (ASGPR) and maternal viral load [&lt;span&gt;5, 4&lt;/span&gt;]. Incorporating these biomarkers and receptor dynamics into future protocols could refine antiviral strategies and improve MTCT prediction.&lt;/p&gt;&lt;p&gt;The 28-week neonatal follow-up in the study by Pan et al. while encouraging, is insufficient to exclude late seroconversion or long-term developmental effects of in utero TAF exposure [&lt;span&gt;1&lt;/span&gt;]. Extended longitudinal studies are essential to confirm TAF's safety profile. Furthermore, the exclusion of women with co-infections (e.g., HIV) or renal dysfunction limits the study's applicability to real-world settings, where such comorbidities are prevalent. Future research should include these populations to ensure broader generalisability.&lt;/p&gt;&lt;p&gt;Optimal timing for antiviral initiation remains a critical gap, with global guidelines offering inconsistent recommendations [&lt;span&gt;5, 3&lt;/span&gt;]. Stratifying treatment based on HBV phase, liver inflammation, and non-invasive markers like quantitative hepatitis B surface antigen (HBsAg) or transient elastography could refine therapeutic","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 3","pages":"364-365"},"PeriodicalIF":6.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211190","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":"CD300A+ CD8+ T Cells as Predictive Biomarkers for Achieving Functional Cure in Chronic Hepatitis B Patients Undergoing Pegylated Interferon-Alpha Therapy","authors":"Peng Zhang, Wen-Xin Wang, Jing Li, Qiaolan Lv, Meng-Meng Zhu, You-Yuan Wang, Ming-Ju Zhou, Si-Yuan Chen, Yan-Mei Jiao, Xing Fan, Jin-Wen Song, Ruonan Xu, Cheng Zhen, Ming Shi, Fu-Sheng Wang, Junliang Fu, Chao Zhang","doi":"10.1111/apt.70214","DOIUrl":"https://doi.org/10.1111/apt.70214","url":null,"abstract":"Pegylated interferon-alpha (PEG-IFN-α) is the first choice for achieving functional cure (FC) in chronic hepatitis B (CHB), but only about 30% of patients achieve this outcome within a defined treatment duration. Given the critical role of CD8⁺ T cells as antiviral effectors, we investigated their changes during FC to identify novel predictive markers of treatment efficacy.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"3 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144193177","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":"Higher Prescribed Opioid Use Among Adults With Crohn's Disease Than General Population: A Nationwide Cohort Study in Sweden 2006–2021","authors":"Mehdi Osooli,&nbsp;Siri Voghera,&nbsp;Gustaf Bruze,&nbsp;Caroline Nordenvall,&nbsp;SWIBREG Study Group,&nbsp;Hamed Khalili,&nbsp;Charlotte Hedin,&nbsp;Pär Myrelid,&nbsp;Åsa H. Everhov,&nbsp;Jonas F. Ludvigsson,&nbsp;Ola Olén","doi":"10.1111/apt.70203","DOIUrl":"10.1111/apt.70203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Population-based data on prescribed opioid use among adults with Crohn's disease (CD) remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This nationwide register-based study included individuals ≥ 18 years with incident (2008–2019) or prevalent (2008–2021) CD and up to 10 individually matched reference individuals without inflammatory bowel disease. We categorised opioid dispensations as weak (e.g., tramadol) or strong (e.g., oxycodone). We calculated the prevalence of ≥ 1 dispensation and mean daily doses (MDD) of opioids per 6 month period from 2 years before until 5 years following CD diagnosis (for incident cohort) and annual dispensation and MDD of opioids (for prevalent cohort).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 10,527 patients with incident CD and 96,123 references, opioid dispensations were two-fold among patients 2 years before diagnosis (26.2% vs. 12.6%) and remained high 13–36 months after diagnosis (26.5% vs. 11.7%). In the prevalent cohort (32,306 patients and 289,516 reference individuals), there was a declining trend in the use of dispensed opioids. During observation, the use of weak opioids decreased substantially among individuals with CD (16.0% vs. 6.0%) and reference individuals (8.0% vs. 3.0%). However, opioid MDD only decreased substantially among those with CD between 2008 and 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adults with incident CD had a two-fold higher use of dispensed opioids than references 2 years before diagnosis, which peaked at three- and four-fold higher use around diagnosis and remained high for 3–5 years. The decreased use of weak opioids might explain the recent decline in opioid consumption among patients with CD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 4","pages":"440-452"},"PeriodicalIF":6.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144193176","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":"Editorial: Chronic Hepatitis B at the Intersection of Immigration, Acculturation, and Social Determinants of Health—Authors' Reply","authors":"Kali Zhou,&nbsp;Christine C. Hsu","doi":"10.1111/apt.70217","DOIUrl":"10.1111/apt.70217","url":null,"abstract":"&lt;p&gt;We appreciate the commentary provided by Drs. Hoang and Ko on our study and appreciate the summary they have provided [&lt;span&gt;1, 2&lt;/span&gt;]. We want to highlight and discuss several important considerations in our study. We acknowledge Drs. Hoang and Ko's comment that our FOCUS-HBV cohort was a highly selected cohort and potentially not generalisable to an unlinked immigrant chronic hepatitis B population in the United States (US). This is an important point. However, what is rather interesting and surprising is that although the majority of the patients were recruited from hepatology subspecialty clinics, only 43.5% had optimal medical adherence, which was defined as 100% adherence to annual testing for HBV DNA, ALT, and ultrasound for hepatocellular carcinoma surveillance if indicated. This leads us to believe—consistent with data on hepatocellular carcinoma surveillance in general [&lt;span&gt;3&lt;/span&gt;]—that outside of the subspecialty context such as primary care, adherence is very likely to be even lower.&lt;/p&gt;&lt;p&gt;With concerns around lack of generalisability due to a highly selected cohort skewed towards higher education and income, there are two things to keep in mind. One, an immigrant chronic HBV population will be predominantly Asian, and based on data from the Pew Research Center, a majority (56%) of Asian immigrants over the age of 25 have a bachelor's degree or more [&lt;span&gt;4&lt;/span&gt;], underscoring the background of Asians that have immigrated here. Two, 36% of the cohort did not answer the survey question on income (with those that did not answer likely skewing towards lower incomes), and of those who did, 43% had an income less than $50,000, which is considered to be the cut-point differentiating between low income and middle-income households according to Pew Research Center. Overall, we feel that our cohort with respect to demographics is reasonably representative of the US foreign-born chronic HBV population.&lt;/p&gt;&lt;p&gt;We also recognise that, not surprisingly, non-Asians were a minority in this cohort. African immigrants in the US have the second highest HBV prevalence (1.9%) but fewer were recruited into FOCUS-HBV than anticipated (only 2.6% of cohort). This highlights an important consideration and often challenge when ensuring diverse ethnic representation in research studies and when recruiting African American patients into clinical research. It has been shown from the Bronx West African HBV screening program that, despite attempts at linkage to care, only 37.8% diagnosed entered long-term care [&lt;span&gt;5&lt;/span&gt;]. In a qualitative study where West African immigrants were interviewed to understand barriers to screening, vaccination, and treatment, themes that were most common were awareness and trust in US healthcare providers [&lt;span&gt;6&lt;/span&gt;]. Although participants felt a high level of trust in US doctors, because becoming a doctor is more challenging in the US than in Africa, they also felt a lack of personal connection to their doctors; ","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 1","pages":"83-84"},"PeriodicalIF":6.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188971","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":"Editorial: Chronic Hepatitis B at the Intersection of Immigration, Acculturation and Social Determinants of Health","authors":"Thomas Hoang,&nbsp;Hin Hin Ko","doi":"10.1111/apt.70156","DOIUrl":"10.1111/apt.70156","url":null,"abstract":"&lt;p&gt;It is well-known that the burden of chronic hepatitis B (CHB) in Western countries is disproportionally shouldered by their immigrant populations [&lt;span&gt;1, 2&lt;/span&gt;]. In the United States, it is estimated that 60%–90% of CHB seroprevalence is attributed to its foreign-born (FB) population [&lt;span&gt;3&lt;/span&gt;]. Despite this high disease prevalence, data characterising this growing population have been limited to retrospective cohorts. Historically, it has been suggested that recent immigrants experience poorer health outcomes due to language barriers and challenges in accessing a foreign health care system [&lt;span&gt;4-7&lt;/span&gt;]. However, studies exploring the interrelationship between socioeconomic, cultural and immigration factors and CHB-related treatment outcomes remain scarce.&lt;/p&gt;&lt;p&gt;In a recent study, Zhou et al. [&lt;span&gt;8&lt;/span&gt;] addressed this gap by surveying 274 FB adult CHB patients across four centres in the United States. Their primary objective was to identify immigrant, demographic, socioeconomic and acculturation factors associated with close adherence to recommended CHB follow-up. In doing so, they were also able to characterise in a detail a large CHB immigrant patient population. Their multivariate analysis revealed that non-English survey language and non-Citizen status, but not acculturation, were associated with higher odds of optimal adherence to HBV (OR = 2.32, CI: 1.15–4.66 and OR = 2.05, CI: 1.01–4.15 respectively). These findings contrast previous reports of decreased healthcare access in the FB population, possibly attributable to the rising influx of higher socioeconomic status immigrants from Asia in the CHB context [&lt;span&gt;4, 5, 7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Social determinants of health (SDOH) continue to impact disease management, as college-level education increases (OR = 2.39, CI: 1.09–5.24) and Medicare utilisation decreases (OR = 0.42, CI: 0.19–0.94) optimal adherence to HBV monitoring. These results unsurprisingly underscore the importance of socioeconomic factors in chronic disease management, emphasising how interventions on these factors could significantly improve CHB-related outcomes [&lt;span&gt;9&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We commend the authors for their detailed characterisation of this large and highly diverse immigrant CHB patient population. However, several limitations should be considered. As with all surveys, the authors acknowledge the potential self-selection bias, as they recruited patients already engaged with medical care, who are more likely to adhere to monitoring. This excludes immigrant populations not yet connected to healthcare—a population that is challenging to capture in studies of this nature. As expected for CHB cohorts, non-Asian ethnicities are underrepresented (14.2%). The study population is also highly educated (70.1% with post-secondary education) with only 15.7% earning an annual household income of &lt; $25,000 per year. These factors limit generalisability, making it challenging to interpret the primary outco","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 1","pages":"81-82"},"PeriodicalIF":6.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188995","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}