Alimentary Pharmacology & Therapeutics最新文献

{"title":"Editorial: Managing the Moving Target-Dose Adjustments in Inflammatory Bowel Disease.","authors":"Nicholas Clark,Daniel Tassone,Nik Sheng Ding","doi":"10.1111/apt.70340","DOIUrl":"https://doi.org/10.1111/apt.70340","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"13 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071772","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 ‘Long-Term Dynamic Changes of Alanine Aminotransferase Levels Are Associated With Liver-Related Events in Nucleos(t)ide Analogue-Treated Chronic Hepatitis B Patients in China’—Authors' Reply","authors":"Ning Yu, Rong Fan","doi":"10.1111/apt.70374","DOIUrl":"10.1111/apt.70374","url":null,"abstract":"<p>We sincerely appreciate the thoughtful comments and constructive feedback from Bilgin et al. [<span>1</span>] regarding our study on the prognostic significance of sex-specific alanine aminotransferase (ALT) thresholds in chronic hepatitis B (CHB) patients receiving nucleos(t)ide analogue (NA) therapy [<span>2</span>]. The robust design of our large-scale, dual-cohort study and the application of the latent class mixed modelling to characterise longitudinal ALT trajectories have been duly recognised. The correspondence also underscores clinically relevant implications, including the implementation of lower ALT targets and the integration of dynamic monitoring strategies, which align closely with the fundamental objectives of our investigation.</p><p>Second, we fully agree that ALT dynamics provide additional prognostic value beyond single time-point measurement. ALT levels can reflect viral replication or immune-mediated hepatocyte injury, both of which are linked to disease progression in CHB patients [<span>3-5</span>]. Although previous studies have shown that ALT levels at a single time-point are associated with patient outcomes [<span>6, 7</span>], our study further demonstrates that longitudinal ALT dynamics outperform baseline ALT levels in discriminating the risk of liver-related events (LRE). Notably, even among patients whose on-treatment ALT levels remained persistently below the conventional upper limit of normal (40 U/L), the 7-year cumulative incidence of LRE reached 8.1%. Accordingly, we proposed a pair of lower ALT thresholds (23 U/L for men and 16 U/L for women), which further stratified these patients into two risk groups, with 7-year LRE incidences of 5.5%–5.9% and 8.7%–10.8%, respectively [<span>2</span>]. We believe that incorporating ALT trajectories into routine monitoring may therefore enable clinicians to identify CHB patients who remain at elevated risk of LRE and facilitate more individualised follow-up and management strategies.</p><p>Third, we concur that ethnic and metabolic diversity, as well as unmeasured confounders such as alcohol use, hepatotoxic medications, and genetic predispositions, remain critical considerations for global implementation of these thresholds. ALT distributions vary significantly across populations and are influenced by sex, age, and the prevalence of metabolic syndrome prevalence [<span>8, 9</span>]. While our proposed cutoffs demonstrated robust prognostic value across subgroups, external validation in multiethnic cohorts and prospective designs is warranted.</p><p>In summary, we greatly appreciate the insightful interpretation of our findings and the emphasis on redefining ALT targets in CHB management by Bilgin et al. Adopting lower sex-specific ALT thresholds, together with dynamic monitoring, has the potential to refine the definition of biochemical response and enhance prognostic assessment during NA therapy. Future multi-centre, multiethnic studies will be essential to validate th","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 9","pages":"961-962"},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068622","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: Evaluating a Single 1600 mg Tablet Regimen of 5-Aminosalicylate for Ulcerative Colitis—The EASI Trial","authors":"Rie Louise Møller Nordestgaard,&nbsp;Bobby Lo,&nbsp;Rosalina Bergstrøm,&nbsp;Izabella Adzioski,&nbsp;Helene Skotte,&nbsp;Ida Marie Hawwa,&nbsp;Signe Krogsgaard Holme,&nbsp;Bermal Tiftikci,&nbsp;Katarzyna Majchrzak,&nbsp;Ida Vind,&nbsp;Flemming Bendtsen,&nbsp;Johan Burisch","doi":"10.1111/apt.70375","DOIUrl":"10.1111/apt.70375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>5-Aminosalicylate (5-ASA) is recommended for the treatment of mild-to-moderate ulcerative colitis (UC). However, adherence may be low; poor adherence is associated with an increased risk for flares.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate whether a regimen of a single 1600 mg tablet of 5-ASA improves adherence with preserved remission rates compared to a conventional regimen of three 800 mg tablets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 178 patients with UC (89 per group) in this open-label randomised controlled phase IV trial. Patients had to have stable remission on 5-ASA for at least 2 months and no concomitant diseases that could affect compliance. We randomised patients (1:1) to either receive Asacol 1600 mg single tablet or Asacol 2400 mg (three tablets of 800 mg once daily) for 12 months. Patients were assessed five times during the 12 months, where medicine was delivered and received, blood and stool samples were collected and symptom scores were determined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-two patients taking a single tablet and 78 taking three tablets were adherent (<i>p</i> = 0.32). Fewer patients in the 1600 mg group missed doses (24.5 vs. 26.5). There was no difference in the number of relapses or proportions experiencing relapse. Neither adherence nor treatment group was a significant predictor of relapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The single-tablet lower dose treatment could be a feasible alternative to the conventional three-tablet regimen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The study was registered at Clinicaltrials.gov (ID NCT04133194) and approved by The Danish Medicine Agency and The National Committee on Health Research Ethics (EudraCT 2019-002070-31)</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 9","pages":"877-886"},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068380","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 on “Long-Term Dynamic Changes of Alanine Aminotransferase Levels Are Associated With Liver-Related Events in Nucleos(t)ide Analogue-Treated Chronic Hepatitis B Patients in China”","authors":"Ersel Bilgin,&nbsp;Bilger Çavuş,&nbsp;Sabahattin Kaymakoğlu","doi":"10.1111/apt.70354","DOIUrl":"10.1111/apt.70354","url":null,"abstract":"&lt;p&gt;Editors,&lt;/p&gt;&lt;p&gt;We read with great interest the study by Fan et al. [&lt;span&gt;1&lt;/span&gt;], which examined the significance of alanine aminotransferase (ALT) changes in chronic hepatitis B (CHB) patients treated with nucleos(t)ide analogues (NAs) from mainland China and Hong Kong. Using latent-class mixed modelling (LCMM), the authors found sex-specific optimal ALT thresholds (≤ 23 U/L for men, ≤ 16 U/L for women) that were linked to a much lower risk of liver-related events (LRE). These results challenge the traditional upper limit of normal (ULN) of 40 U/L, which comes from healthy populations and may not be the best for assessing risk in CHB [&lt;span&gt;9&lt;/span&gt;] (Table 1).&lt;/p&gt;&lt;p&gt;This study stands out for its large sample size (&lt;i&gt;n&lt;/i&gt; = 18,129), long median follow-up (53.3 months), and dual-cohort design, allowing for strong external validation. The use of LCMM to track ALT changes over time is a methodological strength, revealing different risk levels even within the “normal” ALT range. Importantly, the significant impact of the proposed thresholds persisted in high-risk groups, including patients with cirrhosis or elevated aMAP scores, and in those without fatty liver disease, highlighting the wide relevance of these findings.&lt;/p&gt;&lt;p&gt;The results support the growing agreement that ALT ULN values should be redefined using disease-specific and population-specific data [&lt;span&gt;3-6&lt;/span&gt;]. Previous studies have shown that normalising ALT within 12 months of NA therapy is associated with better outcomes [&lt;span&gt;7&lt;/span&gt;,&lt;span&gt;8&lt;/span&gt;], and that persistently normal ALT after HBeAg seroclearance lowers the risk of hepatocellular carcinoma (HCC) [&lt;span&gt;9&lt;/span&gt;]. However, these earlier studies often relied on single-time-point or short-term ALT measurements, while Fan et al. show the added value of long-term ALT changes.&lt;/p&gt;&lt;p&gt;Two main clinical implications arise. First, clinicians should think about adopting lower ALT targets in CHB treatment, adjusted by sex, as part of monitoring. Second, assessing ALT over time instead of depending on single readings may improve prognostic accuracy and help determine more personalised follow-up intervals. Incorporating these thresholds into treatment guidelines could improve how we define “biochemical response” in NA therapy.&lt;/p&gt;&lt;p&gt;However, there are several factors to consider before worldwide adoption. ALT distributions and metabolic conditions differ across populations, so multiethnic validation is essential. Additionally, unmeasured elements such as alcohol use, hepatotoxic drugs, and genetic factors may affect ALT levels and LRE risk. Finally, although the study primarily involved patients receiving entecavir, it is important to evaluate how applicable these thresholds are to other NAs.&lt;/p&gt;&lt;p&gt;In conclusion, Fan et al. [&lt;span&gt;1&lt;/span&gt;] provide strong evidence that lower sex-specific ALT thresholds during NA therapy are linked to a reduced LRE risk in CHB. Adopting these thresholds, along with dynamic ALT monitoring, ","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 9","pages":"959-960"},"PeriodicalIF":6.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068598","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":"IL23 Receptor Polymorphism Is a Predictor of Anti-Tumour Necrosis Factor-α-Induced Paradoxical Psoriasis in Inflammatory Bowel Disease.","authors":"Navneet Natt,Monica Gindi,Gio R Dela Cruz,Terry Ponich,James C Gregor,Nilesh Chande,Melanie D Beaton,Keith McIntosh,Michael Sey,Reena Khanna,Richard B Kim,Aze Wilson","doi":"10.1111/apt.70377","DOIUrl":"https://doi.org/10.1111/apt.70377","url":null,"abstract":"BACKGROUNDParadoxical psoriasis (PP) is an adverse drug reaction associated with anti-tumour necrosis factor (TNF)-α therapy leading to disfiguring skin lesions that may impact an individual's quality of life and affect their inflammatory bowel disease (IBD) care. To date, there are no tools to identify individuals at risk for PP. IL-23 receptor (IL23R) gene polymorphisms have been linked to psoriasis and may be implicated in PP.AIMSTo evaluate the association between the IL23R1142G>A single nucleotide variant and the occurrence of PP in an anti-TNFα-treated IBD population and assess other clinical variables associated with PP development.METHODSIn a retrospective cohort study conducted in anti-TNFα-exposed adult patients with IBD, participants were screened for the IL23R1142G>A variant genotype and the occurrence of PP was assessed. Participants were additionally assessed for clinical variables associated with PP development and for the impact of PP on IBD treatment.RESULTSAmong 499 patients, the incidence of PP was 5.1% (29/570) with 570 unique anti-TNFα exposures. Most patients had severe PP (69.0%) and required treatment cessation (69.0%), which resulted in complete resolution of PP. An IL23R1142G>A variant genotype was highly associated with PP development (46.2% vs. 5.1%, OR = 17.8, 95% CI 7.8-40.0; p < 0.0001). No other clinical variables were associated with the occurrence of PP.CONCLUSIONSVariation in the IL23R gene may identify those at risk of anti-TNFα-induced PP, beyond clinical variables. Further validation of this finding may promote its utility as a clinically actionable tool for the safe delivery of IBD medical therapy.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"71 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071863","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: Ulcerative Colitis Management in the Biologic Era—Data From the English Healthcare Databases","authors":"Guillaume Le Cosquer, David Laharie","doi":"10.1111/apt.70346","DOIUrl":"https://doi.org/10.1111/apt.70346","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"25 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035226","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":"Prediction of Hepatocellular Carcinoma and Other Liver-Related Events in Chronic Hepatitis B Patients With Metabolic Dysfunction or Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Lesley A Patmore,Ivana Carey,Jordan J Feld,Willem P Brouwer,Keyur Patel,Maria Buti,Pieter Honkoop,Douwe F Postma,Hans Blokzijl,Özgur M Koc,Eva van Oorschot,Kosh Agarwal,Marc van der Valk,Faydra I Lieveld,Mai Kilany,Matthijs Kramer,Joep de Bruijne,Mark A A Claassen,Bettina E Hansen,Robert A de Man,Harry L A Janssen,R Bart Takkenberg,Milan J Sonneveld","doi":"10.1111/apt.70360","DOIUrl":"https://doi.org/10.1111/apt.70360","url":null,"abstract":"INTRODUCTIONMetabolic dysfunction and metabolic dysfunction-associated steatotic liver disease (MASLD) are associated with an increased risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to study risk factors for HCC and to assess the performance of the PAGE-B score in this population.METHODSWe included CHB patients with ≥ 1 metabolic comorbidity from nine centres. Steatosis was diagnosed by ultrasound, CAP, or histology. Risk factors were analysed by Cox regression, and the performance of the PAGE-B score was assessed in the overall population and across relevant subgroups.RESULTSWe included 1922 patients. 1730 (90.0%) were overweight, 434 (22.6%) had hypertension, 254 (13.2%) dyslipidemia, 230 (12.0%) diabetes and 732 (38.1%) MASLD. Presence of cirrhosis, older age, lower platelets and lower albumin were independent risk factors for HCC. The 5-year HCC risk was 0.1%/2.0%/12.4% patients with low/intermediate/high PAGE-B scores (p < 0.001). Consistent results were obtained in patients with MASLD (0/2.8/11.1% for low, intermediate and high PAGE-B scores (p < 0.001)). PAGE-B stratified risk in patients without cirrhosis (0% vs. 1.2% and 1.8%, p < 0.001). Among the subset of patients with cirrhosis, risks were 4.2% (low), 6.9% (intermediate) and 27.3% (high) (p < 0.001).CONCLUSIONSCHB patients with metabolic dysfunction and/or MASLD are at significant risk of HCC. The PAGE-B score can be used to stratify HCC risk in this population, with negligible 5-year HCC incidence in those without cirrhosis and low PAGE-B scores. However, caution should be exercised in patients with cirrhosis in whom HCC risk remains significant even among those with a low PAGE-B score.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"47 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017747","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: Multidisciplinary Approach for Inflammatory Bowel Disease to Promote Value-Based Care","authors":"Manavjot Singh,&nbsp;Madhusudan Grover,&nbsp;Megan Petrik","doi":"10.1111/apt.70369","DOIUrl":"10.1111/apt.70369","url":null,"abstract":"&lt;p&gt;We read with great interest the article by Kochar et al. [&lt;span&gt;1&lt;/span&gt;] reporting that antidepressant medication use was associated with a lower rate of inflammatory bowel disease (IBD)-related Emergency Room (ER) visits, but higher rates of IBD-related hospitalisations, corticosteroid use, and surgery. This has drawn much-needed attention to the topic of behavioural health care in IBD, which warrants further dialogue.&lt;/p&gt;&lt;p&gt;Prior research on antidepressant medications (ADM) in IBD has been mixed. While some studies reported poor outcomes in patients with IBD on ADM, others suggested that these medications may provide benefits from treating comorbid mental health conditions, pain, and sleep issues [&lt;span&gt;2, 3&lt;/span&gt;]. The safety of ADM use has been questioned by Coates et al. [&lt;span&gt;4&lt;/span&gt;] who also opined that the methodological design of the study prevented any causal conclusions.&lt;/p&gt;&lt;p&gt;An alternative interpretation of the findings of Kochar et al. is that, when patients with IBD are engaged in mental health treatment, they may display differential behaviours when utilising healthcare. Patients initiated on ADM are often more closely connected to their care teams due to the follow-up associated with these medications. The ADM prescription itself may serve as a proxy for higher disease severity for the clinical team, thereby prompting closer monitoring. This familiarity may make providers more vigilant and encourage patients to communicate their concerns early. This may lead to an increased likelihood of planned medical admissions to stabilise IBD-related concerns rather than urgent, unplanned care-seeking in emergency departments. ADM use may also stabilise emotional functioning and support effective coping, leading to proactive communication with the outpatient care team rather than relying on ER settings to reactively manage urgent issues.&lt;/p&gt;&lt;p&gt;While these proposed mechanisms may explain the findings of Kochar et al. the safety and outcomes of ADM on gastrointestinal symptoms remain inadequately understood; management of mental disorders in IBD often involves ad hoc clinical strategies. A consensus statement has emphasised the identification of mental health disorders and referral to treatment as an integral part of IBD care. Although anxiety and depression screening is typically considered routine for patients with IBD, the identification of subclinical mood symptoms and other IBD-specific psychosocial concerns is often overlooked [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In recognition of these needs, IBD care is evolving toward a holistic, patient-centred, multidisciplinary collaborative approach that also encourages value-based care [&lt;span&gt;6&lt;/span&gt;]. Coordinated care involving gastroenterologists, GI psychologists, psychiatrists, dietitians, nurse practitioners, and social workers is encouraged to address the biological and psychosocial aspects of IBD, with the potential to reduce IBD-related ER visits and hospitalisations.&lt;/p&gt;&lt;p&gt;Longitudinal asses","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 8","pages":"857-858"},"PeriodicalIF":6.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017748","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: Ulcerative Colitis Management in the Biologic Era-Data From the English Healthcare Databases. Authors' Reply.","authors":"J Couch,K Thomas,T R Card,D J Humes","doi":"10.1111/apt.70362","DOIUrl":"https://doi.org/10.1111/apt.70362","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"16 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017743","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":"Comparative Risk of Hepatitis B Virus Reactivation in Patients Receiving Immune Checkpoint Inhibitors or Tyrosine Kinase Inhibitors for Liver Cancer","authors":"Dorothy Cheuk‐Yan Yiu, Jimmy Che‐To Lai, Landon Long Chan, Grace Lai‐Hung Wong, Mandy Sze‐Man Lai, Vincent Wai‐Sun Wong, Yee‐Kit Tse, Henry Lik‐Yuen Chan, Stephen Lam Chan, Terry Cheuk‐Fung Yip","doi":"10.1111/apt.70367","DOIUrl":"https://doi.org/10.1111/apt.70367","url":null,"abstract":"BackgroundCurrent and past hepatitis B virus (HBV) infection remains the leading cause of liver cancer in endemic areas.AimTo examine the risk of HBV reactivation (HBVr) in patients receiving immune checkpoint inhibitors (ICI) for liver cancer.MethodsPatients with current or past HBV infection receiving systemic treatments for liver cancer from March 2015 to March 2023 were identified using a territory‐wide electronic database in Hong Kong. The primary outcome was HBVr in ICI compared to tyrosine kinase inhibitor (TKI) use, defined according to the American Association for the Study of Liver Diseases criteria. The secondary outcome was HBVr in different types of ICI.ResultsOne thousand five hundred and ninty‐six patients with current or past HBV infection (222 first received ICI; 1374 first received TKI) were included. 205 patients (12.8%) had past HBV infection, and 93.2% of the cohort were on HBV antiviral prophylaxis at baseline. At a median of 10.7 months (IQR: 3.7–12.0), 25 (1.6%) patients had HBVr, among whom 5 were exposed to ICI. The 12‐month cumulative incidence (95% CI) of HBVr of the 1596 patients was 1.7% (1.1%–2.4%). The proportion of patients experiencing HBVr with and without antiviral prophylaxis was 1.4% and 3.7%, respectively. In multivariable analysis, ICI use was not associated with a higher risk of HBVr than TKI use, and the use of different ICI did not impact the risk of HBVr.ConclusionWith adequate antiviral prophylaxis, the absolute risk of HBVr is low in advanced HBV‐related liver cancer patients receiving ICI, regardless of current or past HBV infection.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"113 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003152","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}