Alimentary Pharmacology & Therapeutics最新文献

{"title":"Editorial: Association of Antibiotic Exposure With Microscopic Colitis—Authors' Reply","authors":"Máté Szilcz, Jonas W. Wastesson, David Bergman, Kristina Johnell, Jonas F. Ludvigsson","doi":"10.1111/apt.70056","DOIUrl":"https://doi.org/10.1111/apt.70056","url":null,"abstract":"<p>We thank Drs. Tome and Pardi for their editorial on our study examining the association between antibiotic exposure and microscopic colitis (MC) [<span>1</span>]. We appreciate their careful literature review and insightful discussion regarding potential confounding factors that may influence the observed relationship between drug exposures and MC.</p>\u0000<p>As the editorial highlighted, studies investigating medications associated with MC have consistently encountered challenges in disentangling causation from confounding. We aimed to address this through a self-controlled design [<span>2</span>], in which cases acted as their own controls, thereby mitigating important confounders, such as genetic predisposition, that are difficult to account for in traditional cohort studies [<span>3</span>]. In studies where external controls are necessary, matching by clinical characteristics and healthcare engagement patterns can further reduce confounding, thereby strengthening causal inference. However, we acknowledge that detection bias remains a consideration. Patients experiencing gastrointestinal symptoms on certain medications (e.g., antibiotics) may be more likely to undergo endoscopic evaluation, thereby increasing MC detection.</p>\u0000<p>Medication exposures often occur in combination, particularly in older adults. These combinations (e.g., antibiotics combined with non-steroidal anti-inflammatory drugs or proton pump inhibitors) may amplify gastrointestinal side effects. The interplay of multiple drugs further complicates the challenge of establishing a direct causal link between any single medication and MC. Future research should investigate the impact of polypharmacy on MC incidence and severity, ideally through prospective, longitudinal studies with a rigorous selection of control groups.</p>\u0000<p>Looking ahead, comprehensive studies are needed to understand how various drugs alter the intestinal environment, contributing to MC development. One potential option is investigating the gut microbiome's role and how antibiotic-induced dysbiosis may prime the colonic mucosa for an aberrant immune response. Incorporating stool metagenomics, mucosal immunologic markers, and detailed pharmacokinetic/pharmacodynamic data into prospective studies could provide crucial insights into the pathophysiology of MC. Such investigations may pave the way for precision medicine approaches, enabling targeted interventions based on microbiome profiles, immune pathways, or genetic predispositions to prevent or mitigate MC in high-risk individuals [<span>4</span>].</p>\u0000<p>Large-scale data analyses using real-world evidence and electronic health record-based pharmacoepidemiologic studies could help to identify at-risk subgroups effectively. This might include older adults with multiple comorbidities, individuals with specific genetic or immune backgrounds, or patients requiring complex drug regimens. By leveraging big data analytics, future research could move beyond broad a","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"14 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485872","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: Lipidomics in MASLD and MetALD—Authors' Reply","authors":"Kai Markus Schneider, Carolin V. Schneider","doi":"10.1111/apt.70058","DOIUrl":"https://doi.org/10.1111/apt.70058","url":null,"abstract":"<p>We appreciate the insightful editorial [<span>1</span>] highlighting the significance of our lipidomic findings for detecting higher alcohol consumption in steatotic liver disease (SLD) [<span>2</span>]. When looking at SLD on a population level, one key challenge is that MetALD remains so rare that it is likely underreported [<span>3</span>]. This raises concerns about misclassification, particularly in cohorts relying on self-reported alcohol intake [<span>4</span>]. Biomarkers such as carbohydrate-deficient transferrin (CDT) in serum or ethylglucuronid (ETG) may serve as objective measures of alcohol intake and could be particularly useful in individuals with advanced SLD [<span>5</span>], where accurate assessment of alcohol exposure is crucial for prognosis and management. While previous studies have demonstrated the utility of CDT in detecting chronic alcohol consumption, its role in distinguishing moderate drinkers from those with excessive intake in the setting of SLD remains uncertain [<span>6</span>].</p>\u0000<p>HDL might be a starting point to differentiate MASLD from MetALD but, while lipidomics has provided key discriminatory markers, the next logical step is integrating proteomics to refine the distinction between these subtypes further. Beyond biochemical markers, the interaction between alcohol intake in SLD and emerging pharmacological interventions remains an area of critical importance. With the advent of novel therapies for MASLD/MASH, including Resmetirom [<span>7</span>], GLP-1 receptor agonists [<span>8</span>] and agents targeting relevant metabolic pathways, for example, FGF21 [<span>9</span>], their potential interaction with alcohol metabolism warrants further scrutiny. Additionally, the interplay between lifestyle factors, genetic risk variants and alcohol consumption remains poorly understood. Given that alcohol intake is highly variable across populations, differs over time and is influenced by socioeconomic, cultural and behavioural factors, future studies should aim to integrate multiomic data, including lipidomics, proteomics and metabolomics, to dissect these complex interactions.</p>\u0000<p>Moving forward, a comprehensive approach combining lipidomics, proteomics and metabolomics will be essential to uncover non-linear relationships that may remain hidden when analysing a single omics layer. We propose developing a multi-omics-based score to differentiate MASLD and MetALD more effectively, ultimately aiding in personalised risk assessment and therapeutic decisions.</p>\u0000<p>Lastly, lipidomic differences between MASLD and MetALD further validate the new nomenclature's attempt to differentiate subgroups within SLD [<span>10</span>]. The distinct lipid profiles observed in MetALD—particularly the elevation of HDL-centric lipidomic markers and ketone body metabolites—suggest that these two entities are biologically distinct rather than merely reflecting a continuum of alcohol exposure. This supports the concept that the cl","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"4 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477833","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: Early Ileal Resection in Crohn's Disease Is Not Associated With Severe Long-Term Outcomes: The ERIC Study: Authors' Reply","authors":"Nathan Grellier, Julien Kirchgesner, Philippe Seksik","doi":"10.1111/apt.70052","DOIUrl":"https://doi.org/10.1111/apt.70052","url":null,"abstract":"<p>We thank Drs. Kelm and Flemming for their insightful letter [<span>1</span>] regarding our article [<span>2</span>]. We appreciate their remarks and would like to address their questions.</p>\u0000<p>First, we would like to clarify a crucial point regarding our findings in relation to the primary outcome. Contrary to what Drs. Kelm and Flemming suggested, we found no statistically significant difference between the early resection group (< 6 months) and the other groups (6 months–2 years and 2–5 years) for the risk of a second ileocecal resection. However, patients who underwent early ileocecal resection required fewer post-operative treatments and demonstrated less morphological recurrence, supporting early resection as an effective treatment to maintain remission.</p>\u0000<p>Second, accumulating evidence supports early ileocecal resection as a valuable approach for maintaining long-term remission in Crohn's disease isolated to the terminal ileum [<span>3</span>]. The challenge lies in identifying a safe approach that minimises recurrence risk while potentially reducing the need for subsequent immunosuppressive therapies. However, the key issue remains the stratification of recurrence risk and the selection of optimal surgical candidates.</p>\u0000<p>The two centres involved in our study conduct weekly multidisciplinary IBD board meetings. Decisions regarding surgery for patients with IBD were always preceded by these discussions. Addressing the question regarding decision-making criteria for surgery versus advanced therapy is challenging in a retrospective setting. However, considering surgical indications, 95% of patients in the early resection group had complicated disease, compared to 82% in the late resection group. This suggests that patients who had early resection underwent surgery primarily out of necessity due to abscess or obstruction. These surgeries took place before the LIRIC trial, which later established laparoscopic ileocecal resection as a viable option for uncomplicated localised ileal Crohn's disease. In addition, the use of advanced therapies for complicated diseases was less standardised in the study period than it is today [<span>4, 5</span>].</p>\u0000<p>As pointed out, we did not report perioperative morbidity or the potential impact of surgery on quality of life and post-operative digestive symptoms. These limitations are due to the retrospective nature of our study. Data in the immediate post-operative period were not collected comprehensively, and quality of life was not assessed systematically, particularly for patients who underwent surgery in the early 2000s. We acknowledge that surgery should only be considered when it is safe and associated with minimal adverse outcomes [<span>6</span>]. The main challenge for future studies will be to identify predictors of optimal quality of life after ileocecal resection, and the timing of surgery may be an important factor to consider. It remains to be addressed which patients will benefi","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"35 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477869","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: Inverse Association Between Helicobacter pylori Infection and Eosinophilic Oesophagitis","authors":"Irene Spinelli, Serena Porcari, Chiara Esposito, William Fusco, Francesca Romana Ponziani, Cristiano Caruso, Edoardo Vincenzo Savarino, Antonio Gasbarrini, Giovanni Cammarota, Marcello Maida, Antonio Facciorusso, Gianluca Ianiro","doi":"10.1111/apt.70042","DOIUrl":"https://doi.org/10.1111/apt.70042","url":null,"abstract":"Exposure to <i>Helicobacter pylori</i> (<i>H. pylori</i>) has been associated with a decreased risk of eosinophilic oesophagitis (EoE).","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"25 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477837","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: Lipidomics in MASLD and MetALD","authors":"Rajalakshmi Govalan, Vincent L. Chen","doi":"10.1111/apt.70047","DOIUrl":"https://doi.org/10.1111/apt.70047","url":null,"abstract":"&lt;p&gt;Steatotic liver disease (SLD) includes the subtypes of metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD and increased alcohol intake (MetALD) [&lt;span&gt;1&lt;/span&gt;]. Differentiating MASLD from MetALD is crucial because of their distinct prognoses and management strategies [&lt;span&gt;2-4&lt;/span&gt;]. Advancements in the omics landscape—such as genomics, proteomics and metabolomics—may enhance our understanding of steatotic liver diseases [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;Schneider et al. explored lipidomic differences between MASLD and MetALD using the UK Biobank to identify lipidomic biomarkers to reliably distinguish these two steatotic liver disease phenotypes [&lt;span&gt;6&lt;/span&gt;]. They analysed data from 40,534 individuals with magnetic resonance imaging (MRI) liver scans, of whom 11,217 had SLD, as well as detailed data on alcohol consumption and cardiometabolic comorbidities. Among these participants, nuclear magnetic resonance spectroscopy lipidomic profiles were available for 6055 cases (5539 MASLD, 462 MetALD and 53 alcohol-related liver disease), and the authors examined 250 plasma lipidomic and metabolomic parameters. MetALD participants had significantly elevated high-density lipoprotein (HDL)-centric lipidomic markers compared with MASLD, and other top discriminatory metabolites include acetoacetate, 3-hydroxybutyrate, apolipoprotein A1 and phosphatidylcholines. These markers exhibited a stable association with alcohol consumption during their sensitivity analysis, and Mendelian randomisation identified a causal relationship between alcohol consumption and levels of several of these metabolites.&lt;/p&gt;\u0000&lt;p&gt;This study utilised a large cohort with well-characterised liver phenotypes and a comprehensive array of lipidomic and metabolomic biomarkers. Furthermore, Mendelian randomisation offers a robust approach to infer causal relationships, mitigating biases often seen in observational studies, lending credence to the argument that alcohol consumption distinctly alters lipid profiles. The study is not without limitations. There was a temporal disconnect between the lipidomic data collection and liver MRI scans. In UK Biobank, lipidomic specimens were nearly all collected in 2006–2010 (some were collected in 2012–2013), whereas MRI scans were done in 2014 or later. This potentially obscures the temporal dynamics of lipid changes. The authors attempted to mitigate this by performing a sensitivity analysis in the subset of participants with two metabolomic profiles to show that HDL profiles remained largely stable over time. Also, the study relies on self-reported alcohol consumption; alcohol biomarkers that distinguish MASLD and MetALD, as some of the authors of this study recently showed [&lt;span&gt;7&lt;/span&gt;], may serve as the basis for defining future MetALD cohorts. Finally, the cohort's predominantly European ancestry limits the generalisability of the findings to other populations.&lt;/p&gt;\u0000&lt;p&gt;The study highlights the complex link between alcohol","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"209 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477902","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 in Response to: ‘Early Ileal Resection in Crohn's Disease Is Not Associated With Severe Long-Term Outcomes: The ERIC Study’","authors":"Matthias Kelm, Sven Flemming","doi":"10.1111/apt.70013","DOIUrl":"https://doi.org/10.1111/apt.70013","url":null,"abstract":"&lt;p&gt;We read with interest the article by Grellier et al. [&lt;span&gt;1&lt;/span&gt;]. The authors clearly demonstrated that early surgical intervention is not only accompanied by significantly reduced rates of ileal re-resection, but also with reduced requirement for postoperative immunosuppressive therapy. In addition, the risk of morphological recurrence revealed by endoscopy or radiology was also significantly lower.&lt;/p&gt;\u0000&lt;p&gt;Based on these data, the study strongly strengthens the available evidence towards primary surgical therapy in patients suffering from complicated or uncomplicated (i.e., isolated) ileocecal Crohn's disease, in line with previously published prospective and retrospective data [&lt;span&gt;2-5&lt;/span&gt;]. Given this growing evidence, surgeons specialised in inflammatory bowel disease (IBD) need to advocate strongly for a primary surgical approach for patients with isolated ileocecal Crohn's disease. However, treatment strategies for patients with IBD are complex and include different specialties. Therefore, multidisciplinary IBD boards should always discuss individual treatment strategies. These boards comprising gastroenterologists, gastrointestinal surgeons, radiologists, pathologists and psychologists ensure that patients receive personalised and evidence-based therapy. It would be helpful if the authors could provide information about the use of IBD boards in the study before therapy was initiated and which criteria were used for decision-making to perform early or late resection. Furthermore, it would be interesting if there were any differences in short-term outcomes regarding postoperative morbidity.&lt;/p&gt;\u0000&lt;p&gt;From a surgical point of view, we would like to emphasise that all patients were operated on before 2012, where an open approach was more common than minimally invasive surgery. It can be presumed that, today, perioperative results of ileocecal resection would be even better with reduced morbidity, faster recovery and improved postoperative quality of life due to modern surgical and non-surgical approaches [&lt;span&gt;6&lt;/span&gt;]. In addition to these obvious therapeutic advantages for early surgery, evaluation of differences for therapeutic strategies regarding quality of life and healthcare-related costs should also be considered during short- and long-term follow-up. It would have been interesting to include patient aspects by collecting data about differences in quality of life since this is the most relevant patient-related outcome measure. Unfortunately, this very important issue is often neither the primary endpoint nor even reported in IBD-treatment studies.&lt;/p&gt;\u0000&lt;p&gt;In conclusion, we congratulate Grellier et al. for their study since the results improve our current evidence about primary treatment options in ileocecal Crohn's disease. However, despite growing evidence, there is still a great need for prospective, randomised studies respecting patient-centred outcome measures to ensure that all requirements of the complexity and heterog","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"31 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477834","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: Association of Antibiotic Exposure With Microscopic Colitis","authors":"June Tome, Darrell S. Pardi","doi":"10.1111/apt.70043","DOIUrl":"https://doi.org/10.1111/apt.70043","url":null,"abstract":"&lt;p&gt;Soon after microscopic colitis (MC) was first described, reports emerged of cases that appeared to be due to the use of certain medications. As case reports accumulated, the topic gained further attention. At one point, a sophisticated imputation score was created in an attempt to assess the likelihood of causality of a particular drug or drug class as a cause of MC with the conclusion that eight drugs or drug classes had a high likelihood of inducing MC and seven had an intermediate risk [&lt;span&gt;1&lt;/span&gt;]. Combinations of these drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs) together with proton pump inhibitors (PPIs), may exacerbate the risk [&lt;span&gt;2-4&lt;/span&gt;]. In addition to drug-induced MC scoring systems, various other clinical predictive models have been proposed to identify patients unlikely to have MC and in whom colon biopsies can potentially be avoided. More recently, immune checkpoint inhibitors used in oncology have also been associated with the development of MC [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;\u0000&lt;p&gt;A meta-analysis of 12 case–control studies demonstrated modest odds ratios suggesting that exposure to NSAIDs, PPIs, SSRIs and aspirin was associated with the incidence of MC [&lt;span&gt;6&lt;/span&gt;]. However, several studies evaluating this association demonstrated that the risk was significantly mitigated when controls with diarrhoea—rather than healthy subjects—were used for comparison [&lt;span&gt;7, 8&lt;/span&gt;] indicating that the association with some of these medications was not causative but, rather, due to the medications exacerbating diarrhoea and thereby bringing milder cases to medical attention.&lt;/p&gt;\u0000&lt;p&gt;Szilcz and colleagues have reported a modest association with antibiotic use and the development of MC in a large national case–control study of older adults in Sweden [&lt;span&gt;9&lt;/span&gt;]. To control for detection bias, they also performed an analysis of the association between antibiotic use and normal colon biopsies. In this control group, the association with antibiotic exposure was even stronger indicating that the observed association with MC was probably due to detection bias. Similar to the studies discussed above, these results reinforce the need to consider the control group when studying associations between drug exposure and the development of MC.&lt;/p&gt;\u0000&lt;p&gt;Therefore, accumulating evidence linking medication use to the development of MC indicates that the association for many drugs may be more confounded than causal [&lt;span&gt;10&lt;/span&gt;]. This observation has important implications for understanding the underlying pathophysiological mechanisms underpinning the development of MC. However, the implications for clinicians caring for these patients are less clear. Specifically, if a patient is being evaluated for diarrhoea, whether they have biopsy-proven MC or not, a careful review of their medication list, including over-the-counter medications, is essential. If any drug might be temporally associated with the onset of diarrhoea, considerati","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"50 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470475","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":"Risk of Incident Type 2 Diabetes and Prediabetes in Patients With Direct Acting Antiviral-Induced Cure of Hepatitis C Virus Infection","authors":"Yu-Ping Chang, Ji-Yuh Lee, Chi-Yi Chen, Wei-Yu Kao, Chih-Lin Lin, Sheng-Shun Yang, Yu-Lueng Shih, Cheng-Yuan Peng, Fu-Jen Lee, Ming-Chang Tsai, Shang-Chin Huang, Tung-Hung Su, Tai-Chung Tseng, Chun-Jen Liu, Pei-Jer Chen, Jia-Horng Kao, Chen-Hua Liu","doi":"10.1111/apt.70029","DOIUrl":"https://doi.org/10.1111/apt.70029","url":null,"abstract":"Data regarding the risk of incident type 2 diabetes (T2D) and prediabetes among patients with hepatitis C virus (HCV) achieving direct-acting antivirals (DAAs)-induced sustained virologic response (SVR₁₂) remains limited.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"89 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463042","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":"Clinical Trial: A Phase 2b Study to Evaluate the Efficacy and Safety of MK-3655 in Individuals With Pre-Cirrhotic MASH","authors":"Annaswamy Raji, Ira Gantz, Michael Crutchlow, Heather Flynn, Lianzhe Xu, Anthony J. Rodgers, Radha Krishnan, Matthew L. Rizk, Shuai Hu, Keith D. Kaufman, Samuel S. Engel","doi":"10.1111/apt.70038","DOIUrl":"https://doi.org/10.1111/apt.70038","url":null,"abstract":"Fibroblast growth factor 21 (FGF21) is a metabolic regulator with demonstrated efficacy for the treatment of metabolic dysfunction-associated steatohepatitis (MASH). FGF21 signals through ‘c’ isoforms of the FGF receptors (FGFR) 1–3 and the co-receptor β-klotho.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"23 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470466","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":"Addressing the High and Rising Global Burden of Metabolic Dysfunction‐Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction‐Associated Steatohepatitis (MASH): From the Growing Prevalence to Payors' Perspective","authors":"Zobair M. Younossi, Homie Razavi, Michael Sherman, Alina M. Allen, Quentin M. Anstee, Kenneth Cusi, Scott L. Friedman, Eric Lawitz, Jeffrey V. Lazarus, Detlef Schuppan, Manuel Romero‐Gómez, Jörn M. Schattenberg, Miriam B. Vos, Vincent Wai‐Sun Wong, Vlad Ratziu, Marcus Hompesch, Arun J. Sanyal, Rohit Loomba","doi":"10.1111/apt.70020","DOIUrl":"https://doi.org/10.1111/apt.70020","url":null,"abstract":"BackgroundThe continuum of metabolic syndrome encompasses a spectrum of dysfunctions impacting obesity‐linked insulin resistance, glucose homeostasis, lipid metabolism and pro‐inflammatory immune responses. The global prevalence of metabolic diseases, including diabetes, chronic liver disease, cardiometabolic disease and kidney disease, has surged in recent decades, contributing significantly to population mortality. Metabolic dysfunction‐associated steatotic liver disease (MASLD), formerly known as non‐alcoholic fatty liver disease, is a leading cause of liver disease worldwide. MASLD poses a significant global health challenge with its rising prevalence, placing a substantial burden on healthcare systems, impacts patient well‐being and incurs significant economic costs. Addressing MASLD requires a comprehensive understanding of its interconnected factors, including its prevalence, healthcare burden and economic implications. Lack of awareness, imprecise non‐invasive diagnostic methods and ineffective preventive interventions are core components of the MASLD‐related problem.AimThe aim of this article was to summarise the global burden of MASLD from the payer's perspective.MethodsWe carried out a review of the global comprehensive burden of MASLD. These topics led to discussions and insights by an expert panel during the 7th Metabolic Continuum Roundtable meeting, which took place in November 2023. This meeting focused on the burden, patient‐reported outcomes and health economics, from payor and societal perspectives, and aimed to identify opportunities for improving patient care, optimise resource allocation and mitigate the overall impact on individuals and society related to MASLD. During the roundtable, an emphasis emerged on the need for greater awareness and strategic deployment of diagnostic, therapeutic and preventative measures to address MASLD effectively.ConclusionThe global burden of MASLD is high and growing. Prioritising the prevention of metabolic dysregulation and timely therapeutic interventions can yield a holistic strategy to combat MASLD, its progression and potentially lower disease costs.Trial Registration: NCT06309992","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"13 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443352","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}