Alimentary Pharmacology & Therapeutics最新文献

{"title":"Impact of Inflammatory Activity on Anorectal Function in Patients With Ulcerative Colitis: A Prospective Study","authors":"Ana Sanahuja Martínez,&nbsp;Pilar Mas Mercader,&nbsp;Joan Tosca Cuquerella,&nbsp;Marta Maia Boscá Watts,&nbsp;Maria Rosario Antón Ausejo,&nbsp;Carles Suria Bolufer,&nbsp;Víctor Merino Murgui,&nbsp;David Moro Valdezate,&nbsp;Stephanie García Botello,&nbsp;Isabel Pascual Moreno,&nbsp;Miguel Mínguez Pérez","doi":"10.1111/apt.70855","DOIUrl":"10.1111/apt.70855","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Anorectal symptoms are common in ulcerative colitis (UC), yet the impact of inflammatory activity on anorectal function remains unclear. We evaluated the relationship between inflammatory activity and anorectal function and its effect on symptom development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective observational study on patients with UC and active disease attending our center. Clinical, biochemical, and endoscopic assessments were performed together with high-resolution anorectal manometry (HR-ARM) and rectal electronic barostat testing at two time points: during active disease and 4–6 months after treatment initiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-six UC patients and 10 healthy volunteers were included. During active disease, fecal incontinence (FI), urgency, and tenesmus were reported by 66.7%, 91.7%, and 83.3% of patients, respectively. After treatment, symptoms improved; however, a subset of patients remained symptomatic: 32.3% still reported FI, 54.8% urgency, and 51.6% tenesmus. Greater endoscopic and histological activity correlated with lower sensory thresholds and reduced rectal capacity and compliance (all <i>p</i> &lt; 0.05). The Mayo endoscopic subscore correlated inversely with desire to defecate volume (<i>ρ</i> = −0.41, <i>p</i> = 0.014) and maximum tolerated volume (<i>ρ</i> = −0.53, <i>p</i> = 0.001) and positively with anal pressure during the defecatory manoeuver (<i>r</i> = 0.35, <i>p</i> = 0.037). Barostat parameters remained altered after treatment compared with healthy controls, including in patients who achieved histological remission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Inflammatory activity in UC impairs anorectal function by increasing rectal sensitivity and reducing rectal compliance and capacity, contributing to persistent symptoms. Ongoing dysfunction after remission highlights the need for diagnostic and therapeutic strategies addressing anorectal involvement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 8","pages":"1135-1148"},"PeriodicalIF":6.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451555","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":"Time to Positivity of a Rapid HBsAg Assay as a Surrogate Marker of Quantitative HBsAg: Multicentre Proof-of-Concept Study","authors":"Asegedech Asmamaw,&nbsp;Judit Romero,&nbsp;Nega Berhe,&nbsp;Mengistu Legesse,&nbsp;Zelalem Desalegn,&nbsp;Ariadna Rando-Segura,&nbsp;Amanda Cohn,&nbsp;Elena Vargas-Accarino,&nbsp;Adriana Palom,&nbsp;Juan Carlos Ruiz-Cobo,&nbsp;Mar Riveiro Barciela,&nbsp;Asgeir Johannessen,&nbsp;Maria Buti","doi":"10.1111/apt.70892","DOIUrl":"10.1111/apt.70892","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Point-of-care (POC) diagnostics for hepatitis B virus (HBV) are limited to qualitative results. This study evaluated whether the time to positivity of a rapid HBsAg assay could serve as a surrogate marker of quantitative HBsAg (qHBsAg) and virological activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicentre, prospective proof-of-concept study included cohorts from Spain and Ethiopia. Adults with chronic or resolved HBV infection and healthy controls were enrolled. Paired venous and capillary blood samples were collected; capillary blood was tested with Determine HBsAg2 rapid test recording time to positivity, while qHBsAg and HBV DNA were measured using immunoassay and PCR, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 513 HBsAg-positive individuals were included (263 Spain; 250 Ethiopia). All healthy controls and individuals with resolved infection tested negative. Time to positivity showed an inverse correlation with qHBsAg in both cohorts (Spain: <i>r</i> = −0.749; Ethiopia: <i>r</i> = −0.374; <i>p</i> &lt; 0.001 for both). No association was observed between time to positivity and HBV DNA levels. The performance to identify patients with HBsAg levels &lt; 1000 IU/mL was higher in Spain (AUROC 0.86) than in Ethiopia (AUROC 0.65). Better performance was observed for detecting HBsAg levels &lt; 100 IU/mL in both countries (AUROC 0.96 and 0.77, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Time to positivity in a rapid HBsAg assay correlated inversely with qHBsAg and may provide a simple, semi-quantitative estimate of antigen burden. Although unrelated to HBV DNA, it could expand the utility of point-of-care HBsAg testing beyond qualitative diagnosis, particularly where quantitative HBsAg assays are unavailable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 8","pages":"1149-1159"},"PeriodicalIF":6.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148675347","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: Sparse Mortality Events and the Apparent OS Benefit of TDF After HCC Resection. Authors' Reply","authors":"Jaehong Jeong,&nbsp;Hye Won Lee","doi":"10.1111/apt.70911","DOIUrl":"10.1111/apt.70911","url":null,"abstract":"&lt;p&gt;We thank Dr. Toshikuni for his thoughtful comments on our study [&lt;span&gt;1&lt;/span&gt;], which provided an opportunity to further examine the robustness of the overall survival (OS) advantage of tenofovir disoproxil fumarate (TDF) over entecavir (ETV) [&lt;span&gt;2&lt;/span&gt;]. We accept the central concern. The multivariable Cox model was intentionally restricted to seven parameters for 54 deaths, corresponding to approximately 7.7 events per variable. Although the conventional rule of 10 events per variable is commonly used as a practical guideline rather than a strict threshold [&lt;span&gt;3&lt;/span&gt;], we sought to assess the potential impact of the limited event count directly. Accordingly, we repeated the primary analysis using the approaches suggested by Dr. Toshikuni to evaluate the robustness of the findings and the potential for sparse-data bias [&lt;span&gt;4&lt;/span&gt;]. All estimates presented below were pooled across the same 40 multiply imputed datasets [&lt;span&gt;5&lt;/span&gt;] and are summarized in Table 1.&lt;/p&gt;&lt;p&gt;Firth's penalized likelihood, a commonly used approach to reduce small-sample and monotone-likelihood bias [&lt;span&gt;6, 7&lt;/span&gt;], yielded an essentially unchanged estimate for the comparison between ETV and TDF (adjusted hazard ratio [aHR] 0.49, 95% confidence interval [CI] 0.26–0.91; &lt;i&gt;p&lt;/i&gt; = 0.025, compared with 0.48 in the original model). The penalty acted only where the data were genuinely sparse, shrinking the TAF estimate, which rests on a single death, toward the null; this matches our own description of the TAF result as hypothesis-generating. Removing the TAF group and comparing ETV with TDF alone did not change the estimate either (aHR 0.47, 95% CI 0.25–0.88; &lt;i&gt;p&lt;/i&gt; = 0.018), so the unstable single-death stratum was not driving the association. An omnibus likelihood-ratio test for antiviral regimen, on 2 degrees of freedom and pooled across the imputed datasets, remained significant (&lt;i&gt;p&lt;/i&gt; = 0.036). Finally, a nonparametric bootstrap based on 1500 resamples yielded a median TDF aHR of 0.47, with a 95% percentile interval of 0.22–0.90 and the estimated hazard ratio (HR) below 1 in 99% of resamples.&lt;/p&gt;&lt;p&gt;The exception was the inverse-probability-of-treatment-weighted (IPTW) analysis with a robust variance: the estimate for ETV versus TDF lay in the same direction but no longer reached significance (HR 0.55, 95% CI 0.30–1.00; &lt;i&gt;p&lt;/i&gt; = 0.051). This lack of significance matches the IPTW comparison we already reported (global &lt;i&gt;p&lt;/i&gt; = 0.079). The IPTW and covariate-adjusted (primary Cox) models therefore agree in both direction and magnitude, with the IPTW estimate the more conservative.&lt;/p&gt;&lt;p&gt;Overall, the OS advantage of TDF persisted across the penalized, TAF-excluded, omnibus, and bootstrap analyses, making it unlikely that the finding was solely an artefact of the small number of events. The estimate was stable in magnitude, although its precision remains modest. We therefore stand by the conclusion that TDF was independently associated with","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 8","pages":"1175-1176"},"PeriodicalIF":6.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70911","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682504","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: Comparative Effectiveness in Chronic Constipation—Interpreting Real-World Evidence. Authors' Reply","authors":"Manjeet Kumar Goyal,&nbsp;Omesh Goyal","doi":"10.1111/apt.70899","DOIUrl":"10.1111/apt.70899","url":null,"abstract":"&lt;p&gt;We thank Dr. Shin for the thoughtful appraisal of our study [&lt;span&gt;1, 2&lt;/span&gt;]. It appropriately situates our findings within a persistent therapeutic uncertainty as although multiple pharmacological agents are available for chronic constipation refractory to conventional therapy, direct comparative evidence between mechanistically distinct agents remains sparse. Consequently, treatment selection is frequently determined by drug availability, clinician experience, symptom profile, comorbidities, etc. rather than evidence of comparative effectiveness [&lt;span&gt;3, 4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We concur that precision in study-design terminology is essential. Although the study was conceived to reflect real-world clinical practice, it is most appropriately characterised as a prospective, non-randomised comparative-effectiveness study rather than a pragmatic randomised trial [&lt;span&gt;2, 5&lt;/span&gt;]. Treatment selection remained at the discretion of the trial-blinded treating physician, without a protocol-specified allocation algorithm, stratification, or treatment preference for either agent. The groups were broadly comparable across measured baseline demographic and clinical characteristics, including bowel frequency, symptom burden, and constipation-related quality of life. This comparability does not preclude residual confounding; however, prospective enrolment, a standardised run-in period, prespecified outcomes, contemporaneous bowel diaries, and blinded outcome assessment and statistical analysis reduce the ascertainment and analytical bias and enhance the interpretability of the observed associations.&lt;/p&gt;&lt;p&gt;The findings demonstrated both quantitative magnitude and consistency across clinically relevant outcome domains. Sustained complete spontaneous bowel movement (CSBM) response was achieved by 55.6% of patients receiving elobixibat and 33.9% receiving prucalopride, corresponding to an absolute difference of 21.6 percentage points. Elobixibat was additionally associated with a greater increase in weekly CSBMs (2.5 vs. 1.8), a higher proportion of patients achieving a CSBM within 24 h of the initial dose (44.8% vs. 23.6%), and greater improvements in straining, abdominal discomfort, bloating, and constipation-related quality of life. Adverse-event frequencies were low and comparable between groups (10.2% vs. 8.5%). The concordant direction of these findings across bowel frequency, associated symptoms, and quality of life supports the internal coherence of the comparative signal. Nevertheless, secondary outcomes were not adjusted for multiplicity and should remain exploratory.&lt;/p&gt;&lt;p&gt;These findings should be interpreted alongside, rather than in place of, randomised evidence. Placebo-controlled trials have established the efficacy of elobixibat and prucalopride independently, whereas network meta-analysis ranked prucalopride highly at 12 weeks but demonstrated that comparative rankings varied according to endpoint and treatment duration [&lt;span&gt;6-8&lt;/span&gt;]. In ","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 8","pages":"1162-1163"},"PeriodicalIF":6.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650549","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":"Review Article: Immune Effector Cell-Mediated Enterocolitis Following CAR-T Cell Therapy—Clinical Features, Pathophysiology and Management","authors":"John A. Damianos,&nbsp;Yi Lin,&nbsp;Zongming Eric Chen,&nbsp;Kenneth J. C. Lim,&nbsp;Navreet M. Chowla","doi":"10.1111/apt.70920","DOIUrl":"10.1111/apt.70920","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionised the treatment of hematologic malignancies, and its use is expanding rapidly into numerous other disease states including autoimmune diseases. However, CAR-T therapy is associated with a spectrum of immune-related toxicities. In addition to the already well characterized cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, it has become apparent that rarely, CAR-T can cause gastrointestinal mucosal inflammation, termed immune effector cell-mediated enterocolitis (IEC-EC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This state-of-the-art review highlights the CAR-T mechanism and details the epidemiology, pathophysiology, clinical manifestations, endoscopic and histopathologic features, and management of IEC-EC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review presents the current state of knowledge through a comperhensive and detailed synthesis of all case series reported in the literature to date.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Occurring in up to approximately 6% of patients typically following B cell maturation antigen-targeted CAR-T therapy, IEC-EC presents with severe diarrhoea and malabsorption, responds poorly to treatment, and portends a dire prognosis. Multi-disciplinary management should centre on early diagnosis, supportive cares, assessment and treatment of infections, and step-up pharmacotherapy, often featuring biologics and small molecules drawn from the inflammatory bowel disease pharmacologic armamentarium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinicians should maintain a high degree of vigilance for IEC-EC in patients presenting with gastrointestinal symptoms following CAR-T treatment. Early recognition and multi-disciplinary treatment may improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 8","pages":"1046-1057"},"PeriodicalIF":6.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726341","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":"Clinical Trial: Intensive Supervised Nutritional Therapy Versus Guideline-Based Nutritional Advice for Sarcopenia in Decompensated Cirrhosis—A Randomised Controlled Trial","authors":"Gireesh Kumar Dhaked,&nbsp;Prabhat Narain Sharma,&nbsp;Kamlesh Kumar Sharma,&nbsp;Sudhir Maharshi,&nbsp;Shubham Agrawal,&nbsp;Rupesh Pokharna,&nbsp;Sandeep Nijhawan,&nbsp;Shyam Sunder Sharma","doi":"10.1111/apt.70938","DOIUrl":"10.1111/apt.70938","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sarcopenia is highly prevalent in decompensated cirrhosis and independently predicts adverse outcomes. Although nutritional therapy is guideline-recommended, evidence comparing specialist dietitian-supervised nutritional care with routine physician-delivered dietary advice remains limited.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To compare the efficacy of dietitian-supervised intensive nutritional therapy with physician-led guideline-based dietary advice for improving skeletal muscle mass, strength and physical performance in patients with decompensated cirrhosis and sarcopenia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this single-centre, open-label, randomised controlled trial, 180 patients with decompensated cirrhosis and sarcopenia were randomised (1:1) to dietitian-supervised intensive nutritional therapy or physician-led guideline-based dietary advice for 6 months. The intervention targeted energy intake of 35–40 kcal/kg/day and protein intake of 1.2–1.5 g/kg/day through structured dietitian supervision. The primary outcome was change in skeletal muscle index (SMI); secondary outcomes included handgrip strength (HGS), gait velocity, nutritional status, liver disease severity and clinical outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Dietitian-supervised therapy produced significantly greater improvements than physician-led care in SMI (between-group difference +2.50 cm&lt;sup&gt;2&lt;/sup&gt;/m&lt;sup&gt;2&lt;/sup&gt;; 95% CI 1.30–3.70), HGS (men: +7.5 kg, 95% CI 5.39–9.61; women: +4.8 kg, 95% CI 3.12–6.48) and gait velocity (+0.23 m/s; 95% CI 0.13–0.33) (all &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Serum albumin increased (+0.48 g/dL between groups) and CTP score improved (−1.30 points), whereas MELD score remained unchanged. Overall multidomain response occurred in 68.9% versus 37.8% of participants (RR 1.82, 95% CI 1.36–2.44; number needed to treat 3.2). Dietitian-supervised therapy independently predicted SMI response (OR 3.82; 95% CI 1.80–8.10). No significant differences were observed in mortality, hospitalisation or other major clinical events.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In patients with decompensated cirrhosis and sarcopenia, dietitian-supervised intensive nutritional therapy produced greater improvements in skeletal muscle mass, strength and physical performance than routine physician-led guideline-based dietary advice.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;CTRI number (www.ctri.nic.in): CTRI/2023/12","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 8","pages":"1058-1070"},"PeriodicalIF":6.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816766","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: Mass Screening for Coeliac Disease—Growing Evidence but Is It Enough?","authors":"Marisa Stahl, Edwin Liu, Carlo Catassi","doi":"10.1111/apt.70997","DOIUrl":"https://doi.org/10.1111/apt.70997","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"7 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020067","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: Treatment Sequencing in Inflammatory Bowel Disease-Does the Line Matter More Than the Mechanism? Authors' Reply.","authors":"Carmen Yagüe Caballero, Santiago García-López, Diego Casas-Deza","doi":"10.1111/apt.71006","DOIUrl":"https://doi.org/10.1111/apt.71006","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149014849","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: Temporal Alignment of Proton Pump Inhibitor Exposure and Gastric Neuroendocrine Neoplasm Risk in Autoimmune Gastritis.","authors":"George Azzi, Sumaya Al-Ukaidey","doi":"10.1111/apt.71003","DOIUrl":"https://doi.org/10.1111/apt.71003","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149014865","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":"Medication Use and Risk of Microscopic Colitis: A Propensity‐Matched Analysis of US Adults ≥ 50 Years (2014–2024)","authors":"Yassine Kilani, Farah Heis, Andrew Dugaesescu, Youssef Hafez, Shadi Hamdeh, Wissam Kiwan, Mahmoud Y. Madi","doi":"10.1111/apt.70985","DOIUrl":"https://doi.org/10.1111/apt.70985","url":null,"abstract":"Background The association between medications—including non‐steroidal anti‐inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs) and selective serotonin reuptake inhibitors (SSRIs)—and microscopic colitis (MC) remains controversial. While earlier studies suggested increased risk, more recent analyses have challenged these findings, citing methodological limitations. We evaluated the risk of MC among commonly implicated medications using a large national U.S. database. Methods Using the TriNetX database (2014–2024), we conducted a retrospective cohort study including adults ≥ 50 years with at least one documented healthcare encounter and no prior MC or inflammatory bowel disease. Exposure was defined as ≥ 3 prescriptions within a drug class. Treatment groups (NSAIDs, PPIs, SSRIs, ACE inhibitors [ACEIs], angiotensin receptor blockers [ARBs], statins) were 1:1 propensity score‐matched (PSM) to untreated controls on age, sex, race, comorbidities and previous colonoscopy. The primary outcome was incident MC, identified by new diagnostic codes. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Results After PSM, cohorts included 907,266 NSAID, 750,009 PPI, 308,310 SSRI, 393,952 ACEI, 298,480 ARB users and 548,339 statin users. Over 2 years, MC risk was increased with NSAIDs (HR 1.15; 95% CI, 1.02–1.30), PPIs (HR 1.36; 95% CI, 1.19–1.54) and SSRIs (HR 1.52; 95% CI, 1.27–1.83). ACEIs, ARBs and statins were not associated with MC. Conclusions In this large cohort, NSAIDs, PPIs and SSRIs were associated with an increased risk of MC, whereas no significant association was observed for ACEIs, ARBs or statins. Medication review should be considered in patients with new‐onset chronic diarrhoea.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"16 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009903","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}