Alimentary Pharmacology & Therapeutics最新文献

{"title":"Prevalence of Opioid Use and Associated Healthcare Outcomes in Rome IV Irritable Bowel Syndrome in the United Kingdom","authors":"Mohsin F. Butt, Vivek C. Goodoory, Cho Ee Ng, Christopher J. Black, Alexander C. Ford, Maura Corsetti, Peter Paine","doi":"10.1111/apt.70400","DOIUrl":"https://doi.org/10.1111/apt.70400","url":null,"abstract":"The United Kingdom (UK) has one of the highest worldwide opioid prescription rates per capita. International guidelines caution against the use of opioids for chronic non-malignant pain, including irritable bowel syndrome (IBS).","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"28 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241368","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":"Correction to 'Risk of Hepatocellular Cancer in U.S. Patients With Compensated Cirrhosis Treated With Direct-Acting Antivirals Versus Interferon'.","authors":"","doi":"10.1111/apt.70397","DOIUrl":"https://doi.org/10.1111/apt.70397","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"128 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241053","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":"Improving Clinical Outcomes of Encapsulated Faecal Microbiota Transplantation for Clostridioides difficile Infection Through Empirical Donor Selection and Optimised Dosing: A Quality Improvement Study","authors":"Sara Ellegaard Paaske, Simon Mark Dahl Baunwall, Tone Rubak, Nina Rågård, Jens Kelsen, Mette Mejlby Hansen, Anders Bergh Lødrup, Søren Lyhne, Emilie Glavind, Christa Marie Culmback Fernis, Stine Hald, Lise Tornvig Erikstrup, Lars Vinter‐Jensen, Simon Lal, Susan Mikkelsen, Christian Erikstrup, Jens Frederik Dahlerup, Christian Lodberg Hvas","doi":"10.1111/apt.70395","DOIUrl":"https://doi.org/10.1111/apt.70395","url":null,"abstract":"BackgroundFaecal microbiota transplantation (FMT) is effective for <jats:italic>Clostridioides difficile</jats:italic> infection (CDI), but real‐world effectiveness data are warranted to refine treatment algorithms. We previously found that FMT effectiveness varied with donors, and the effect of a single capsule FMT administration was lower than expected.AimsTo improve FMT outcomes through empirical donor exclusion and application of an optimised capsule FMT dosing regimen.MethodsIn this multi‐site Danish quality improvement study, we included patients with CDI treated with capsule‐based FMT from 24 June 2019 to 30 September 2024. The primary outcome was cure of <jats:styled-content style=\"fixed-case\"><jats:italic>C. difficile</jats:italic></jats:styled-content>‐associated diarrhoea (CDAD) 8 weeks after FMT. We assessed this using statistical process control charts monitored separately for the primary FMT centre and the external FMT sites. We used multivariable, mixed‐effect logistic regression analysis to evaluate the impact of FMT dosing while adjusting for patient, donor and CDI‐related factors.ResultsWe included 1176 patients (1707 FMT treatments). At external FMT sites, the cure rate from one FMT treatment changed from 50% (95% confidence interval (CI): 45%–56%) to 59% (55%–63%) following the exclusion of three low‐performing donors in November 2022. After implementing a two‐dose capsule FMT dosing regimen in February 2024, the cure rate increased to 72% (65%–77%). The impact of the two‐dose capsule FMT dosing regimen remained statistically significant after adjustment (odds ratio 1.22; 95% CI 1.16–1.28; <jats:italic>p</jats:italic> &lt; 0.001).ConclusionEmpirical donor selection and a two‐dose capsule FMT regimen improved clinical outcomes in a large‐scale system treating patients with CDI.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"12 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228741","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 on “Telemetric Assessment and Comparison of Regional Colonic Metabolic Activity in Ambulant Healthy Individuals Using pH and Gas‐Sensing Wireless Motility Capsules”","authors":"Xuezheng Zhu, Daquan Liao, Shiye Huang, Yubin Feng, Ziye Zhuang","doi":"10.1111/apt.70393","DOIUrl":"https://doi.org/10.1111/apt.70393","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"97 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215929","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 on ‘Telemetric Assessment and Comparison of Regional Colonic Metabolic Activity in Ambulant Healthy Individuals Using pH and Gas‐Sensing Wireless Motility Capsules’: Authors' Reply","authors":"Phoebe A. Thwaites, Kourosh Kalantar‐Zadeh, Peter R. Gibson","doi":"10.1111/apt.70398","DOIUrl":"https://doi.org/10.1111/apt.70398","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"28 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215582","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":"Alterations in Gut Microbiota and Metabolism in Cirrhotic Portal Hypertension: Implications for Disease Progression","authors":"Qun Zhang, Jinghua Cui, Yixin Hou, Lining Guo, Hai Li, Guiqin Zhou, Xiaojing Wang, Bingbing Zhu, Ke Shi, Yi Zhang, Yufei Bi, Yanqiu Li, Lina Sun, Ying Feng, Jing Yuan, Xianbo Wang","doi":"10.1111/apt.70392","DOIUrl":"https://doi.org/10.1111/apt.70392","url":null,"abstract":"BackgroundAlthough gut microbiota has been implicated in various liver disorders, its relationship with cirrhotic portal hypertension (CPH) remains unclear.AimsTo investigate the structural and functional alterations of gut microbiota in patients with CPH and the potential role of these alterations in the progression of CPH.MethodsWe collected faecal samples from 35 patients with CPH and 71 patients without CPH (controls) to conduct microbiome and metabolomic analyses. Gut microbes, faecal metabolites and their functional pathways associated with CPH were identified using multiple bioinformatics approaches. To understand the role of gut microbiota in the pathogenesis of CPH, we carried out faecal microbiota transplantation, CPH‐characteristic bacterial transplantation and antibacterial experiments in mice.ResultsMicrobial diversity was diminished, and gut microbial structures were altered in patients with CPH compared to the controls, primarily manifested as increased abundance of lipopolysaccharide‐producing bacteria and decreased abundance of anti‐inflammatory bacteria. This dysbiosis of gut microbiota was accompanied by changes in the faecal metabolome, particularly in arginine biosynthesis and nitric oxide production. Transplantation of gut microbiota from CPH patients, as well as the transplantation of CPH‐associated bacteria <jats:italic>Veillonella nakazawae</jats:italic>, was found to exacerbate CPH progression in mice. Antibiotic treatment significantly alleviated the CPH progression induced by N‐dimethylnitrosamine in mice.ConclusionsOur study reveals that gut microbiota dysbiosis is implicated in CPH progression, potentially providing new avenues for microbiome‐based treatment for CPH.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"75 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203091","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 Trends in the Rate of Colectomy in Ulcerative Colitis.","authors":"Richard Pollok","doi":"10.1111/apt.70368","DOIUrl":"https://doi.org/10.1111/apt.70368","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"96 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189472","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: Terlipressin Induced Bradycardia","authors":"Nancy Reau, Sujit Janardhan","doi":"10.1111/apt.70336","DOIUrl":"https://doi.org/10.1111/apt.70336","url":null,"abstract":"&lt;p&gt;Hepatorenal syndrome (HRS) is a devastating form of acute renal failure precipitated by haemodynamic dysregulation associated with end-stage liver disease. HRS often has a progressive course that results in the need for renal replacement therapy (dialysis) which can have grave impact on prognosis [&lt;span&gt;1&lt;/span&gt;]. In 2022, terlipressin was approved by the FDA for the treatment of HRS in the United States [&lt;span&gt;2&lt;/span&gt;]. Terlipressin induces splanchnic and systemic vasoconstriction. The resultant increase in mean arterial pressure (MAP) stimulates reflexive bradycardia. Previous studies have suggested that terlipressin is associated with other arrhythmias and ischaemic events [&lt;span&gt;3&lt;/span&gt;]. Whether terlipressin treatment was associated with significant cardiac adverse events (AE) in patients enrolled in large phase III clinical trials is unclear. Bajaj et al. analyse the cardiac AEs that were reported in three North American-centric Phase III randomised placebo-controlled trials examining terlipressin treatment of HRS (OT-0401, REVERSE, CONFIRM) [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;Bradycardia was the only cardiac AE occurring more frequently in patients treated with terlipressin compared to placebo. Bradycardia led to low rates of dose reduction or interruption but did not result in treatment discontinuation. Other arrhythmias, including atrial fibrillation, were similar in both treatment groups, likely reflecting the general haemodynamic instability of patients with HRS [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;This study presents several important findings. There was a trend towards higher baseline serum albumin levels in terlipressin-treated patients who experienced bradycardia compared to those who did not, correlating with higher doses of pre-treatment albumin administered to these patients. While the potential role of albumin in promoting bradycardia is unclear, this finding is in congruence with guidance recommendations for judicious albumin utilisation in diagnosing and treating HRS [&lt;span&gt;5&lt;/span&gt;]. Importantly, the incidence of bradycardia was not associated with a decrease in MAP or systemic blood pressure and did not influence response rates to treatment.&lt;/p&gt;\u0000&lt;p&gt;This study also raises several important points of discussion. While the authors note that no bradycardia AEs were considered serious (SAE), the AE was considered severe (defined as discomfort sufficient to renderer a patient &lt;i&gt;unable&lt;/i&gt; to perform normal daily activities) in 68% and 100% of terlipressin and placebo-treated patients, respectively. While this symptomatic bradycardia did not result in treatment discontinuation in the clinical trial setting, it may in real-world settings. Secondly, while patients with severe cardiovascular disease were excluded from the trial and the FDA recommends avoiding terlipressin in patients with a history of severe cardiovascular, cerebrovascular, or ischaemic disease [&lt;span&gt;2&lt;/span&gt;], it remains to be seen if patients with preexisting risk factors for arrh","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"91 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140590","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: Is Disease Clearance the Target in Ulcerative Colitis or a Stride Too Far?","authors":"R M Mathias,D Bogatic,R V Bryant","doi":"10.1111/apt.70291","DOIUrl":"https://doi.org/10.1111/apt.70291","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"1 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140331","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: Chronic Hepatitis Delta-We Need More Screening to Improve Knowledge on the Natural History.","authors":"J Ventre,A Abergel","doi":"10.1111/apt.70326","DOIUrl":"https://doi.org/10.1111/apt.70326","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140332","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}