Alimentary Pharmacology & Therapeutics最新文献

{"title":"Editorial: Prediction of Long‐Term Complications of Paediatric Liver Transplantation","authors":"S. Mahesh, J. P. Mann","doi":"10.1111/apt.71031","DOIUrl":"https://doi.org/10.1111/apt.71031","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"10 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130365","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: Beyond Positive or Negative—Unlocking Semi-Quantitative Information From a Rapid HBsAg Test","authors":"Rewhandamzi Boms, Yusuke Shimakawa","doi":"10.1111/apt.70940","DOIUrl":"10.1111/apt.70940","url":null,"abstract":"<p>Chronic hepatitis B (CHB) remains a major public health challenge, disproportionately affecting low and middle-income countries [<span>1</span>]. Although effective antiviral therapy is available, identifying individuals who require treatment remains challenging in many resource-constrained settings because assessment of viral replication, liver inflammation and fibrosis relies on laboratory tests that are often inaccessible because of cost, centralized laboratory infrastructure and limited availability [<span>2</span>]. Field-adapted alternatives are beginning to emerge, including a hepatitis B core-related antigen rapid diagnostic test (HBcrAg-RDT) developed to identify individuals with high HBV DNA levels at the point of care [<span>3</span>]. Quantitative hepatitis B surface antigen (qHBsAg) provides complementary information for characterizing the phase of CHB infection, but its measurement also requires dedicated laboratory platforms rarely available in resource-limited settings [<span>4</span>]. Asmamaw and colleagues investigate whether measuring the time-to-positivity of a rapid HBsAg test can serve as a practical surrogate for qHBsAg [<span>5</span>].</p><p>Using prospectively collected samples from Spain and Ethiopia, the investigators evaluated the relationship between the time-to-positivity of a commercially available rapid HBsAg test and HBsAg concentrations quantified by chemiluminescent immunoassay. In each cohort, an optimal time-to-positivity threshold for identifying samples with qHBsAg below 1000 IU/mL was selected separately using receiver operating characteristic curve analysis and Youden's index. In Spain, a threshold of 2.37 min yielded a sensitivity of 68.2% and specificity of 91.4%. In Ethiopia, the corresponding threshold was shorter, at 1.61 min, and showed a sensitivity of 64.3% and specificity of 60.0%. These findings provide proof of concept that a conventional rapid HBsAg test may provide clinically relevant semi-quantitative information beyond the binary detection of HBsAg.</p><p>The substantial difference in optimal time-to-positivity thresholds between the Spanish and Ethiopian cohorts for distinguishing HBsAg concentrations above or below 1000 IU/mL suggests that a single universal cut-off may not be applicable across settings. Before widespread use, the optimal threshold may therefore need to be established and validated in each intended population and context, potentially limiting the simplicity and scalability of the approach. Operational feasibility also warrants careful consideration. Measuring time to positivity requires a reader to remain beside the test and continuously observe it from sample application until the test line appears, which may take several minutes and prevent the reader from attending to other tasks. Digital readers may eventually reduce the need for continuous human observation, but their feasibility, cost, and performance require evaluation under routine conditions.</p><p>Time-to-po","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 9","pages":"1306-1307"},"PeriodicalIF":6.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70940","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808076","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":"Neighbourhood Deprivation Is Associated With Greater Mortality in Patients With Alcohol-Associated Liver Disease","authors":"Leith Ghani, Claire S. Faulkner, Majd B. Aboona, Pradhan Hariharan, Pooja Rangan, Amal Altaf, David O. Garcia, Vincent L. Chen, Donghee Kim, Juan Pablo Arab, Mazen Noureddin, Luis Antonio Díaz, Ani Kardashian, Michael B. Fallon, Karn Wijarnpreecha","doi":"10.1111/apt.70930","DOIUrl":"10.1111/apt.70930","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Significant health disparities persist in alcohol-associated liver disease (ALD), largely driven by social determinants of health (SDOH). However, the influence of neighbourhood-level SDOH on ALD outcomes remains underexplored. In this study, we aimed to evaluate how neighbourhood-level SDOH are associated with disease burden, comorbid conditions, and mortality in individuals with ALD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study of patients with ALD in the Banner Health System, representing hospitals across Arizona, California, Nevada, Wyoming and Colorado, from January 2012 to October 2024 using ICD codes. Neighbourhood-level SDOH were quantified using the Social Deprivation Index (SDI). Patients were stratified into quartiles based on SDI score, with Quartile 4 representing the most socioeconomically disadvantaged neighbourhoods. Primary outcomes included incidence of mortality, cirrhosis, major adverse liver outcome (MALO), Type 2 diabetes mellitus, any cancer, and major adverse cardiovascular events (MACE). A multivariable competing risk analysis was performed adjusting for age, sex, race/ethnicity, insurance type, primary language, smoking status, Type 2 diabetes mellitus, hypertension, hyperlipidemia, aspirin use, statin use, alcohol use disorder and a composite mental-health/substance-use disorder variable encompassing depression, anxiety disorders, post-traumatic stress disorder, bipolar disorder, schizophrenia, and non-alcohol substance use disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 11,394 patients with ALD and available SDI data, 6747 had ≥ 365 days of follow-up. The average age was 51 years and 65.6% were female; 68.8% were non-Hispanic White, 19.7% Hispanic, 5.9% Native American/Alaskan Native (NA), 3.2% Black, and 0.4% Asian/Pacific Islanders. Patients residing in the most disadvantaged neighbourhoods (Quartile 4) were significantly younger, more likely to be female, had a higher median BMI, and more frequently reported a non-English primary language compared with those in the least disadvantaged areas (Quartile 1). Patients in the most deprived neighbourhoods were more likely to be Hispanic, Black, or Native American/Alaska Native and to be uninsured or on Medicaid, whereas those in the least disadvantaged neighbourhoods predominantly had private insurance. Individuals in Quartile 4 had increased mortality (adjusted hazard ratio [aHR]: 1.48, 95% Confidence Interval [CI]: 1.09–2.01) compared with individuals in Quartile 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this large and demographically di","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 9","pages":"1274-1287"},"PeriodicalIF":6.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754347","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: Interpreting Rule‐Out and Rule‐In Enhanced Liver Fibrosis Thresholds in Metabolic Dysfunction‐Associated Steatotic Liver Disease","authors":"Anastasios Koulaouzidis, Wojciech Marlicz","doi":"10.1111/apt.71020","DOIUrl":"https://doi.org/10.1111/apt.71020","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"87 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130348","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":"ALBI ‐6—A Novel Prognostic Score Combining ALBI and Interleukin‐6 in Patients With HCC Treated With Atezolizumab and Bevacizumab","authors":"Paula Bark, Lucas Wiesmann, Simon Johannes Gairing, Kateryna Shmanko, Lukas Müller, Maximilian Moos, Fabian Stöhr, Dirk Graafen, Tilman Emrich, Felix Hahn, Daniel Pinto dos Santos, Bernhard Scheiner, Victoria Berit Berger, Matthias Pinter, Valentina Zarka, Florian P. Reiter, Andreas Geier, Najib Ben Khaled, Alexander Philipp, Christoph Springfeld, Aurelie Tomczak, Michael T. Dill, Constantin Scholz, Jens Mittler, Hauke Lang, Beate Katharina Straub, Roman Kloeckner, Tobias Bäuerle, Christian Markus Lange, Arndt Weinmann, Peter Robert Galle, Friedrich Foerster","doi":"10.1111/apt.71012","DOIUrl":"https://doi.org/10.1111/apt.71012","url":null,"abstract":"Background/Aims Despite widespread use of combination immunotherapy in advanced liver cancer, reliable biomarkers for baseline risk stratification remain lacking. The inflammatory cytokine interleukin‐6 has established prognostic relevance in this cancer. We investigated the prognostic value of interleukin‐6 and developed a combined score (ALBI‐6) integrating interleukin‐6 with albumin–bilirubin grade, a marker of liver function. Methods In this multicentre retrospective cohort study, 216 patients with advanced hepatocellular carcinoma treated with first‐line atezolizumab plus bevacizumab were analysed. Interleukin‐6 was measured at baseline, first response, best response, and progression. The cohort was randomly divided into a training set ( <jats:italic>n</jats:italic> = 98) and a validation set ( <jats:italic>n</jats:italic> = 90). ALBI‐6 was derived using Cox regression and evaluated against several established prognostic scores. Results Elevated baseline interleukin‐6 was consistently associated with worse overall survival and remained independently prognostic after adjustment for tumour and clinical factors (extrahepatic spread, vascular invasion, alpha‐fetoprotein, performance status, liver function class). In the validation cohort, ALBI‐6 achieved a concordance index of 0.716 and separated patients into three risk groups with significantly different survival (log‐rank <jats:italic>p</jats:italic> = 0.002); ALBI‐6 was significantly more discriminative than one comparator score (modified albumin–bilirubin grade, <jats:italic>p</jats:italic> = 0.040), with numerically higher performance than the remaining comparators. In a separate analysis of the full cohort, ALBI‐6 significantly outperformed the CRAFITY score at all assessed time points. Bootstrap validation confirmed model stability. Conclusions ALBI‐6 integrates systemic inflammation and liver function into a simple composite index enabling meaningful risk stratification in patients with advanced hepatocellular carcinoma treated with immunotherapy. Prospective external validation is warranted.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"181 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130364","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":"Review Article: Fibrosis Reversal in Metabolic Dysfunction-Associated Steatohepatitis—The Promise of Emerging Therapeutics","authors":"Malek Ayoub,&nbsp;Tsubasa Tsutsumi,&nbsp;Mary E. Rinella","doi":"10.1111/apt.70921","DOIUrl":"10.1111/apt.70921","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatohepatitis (MASH) is a leading indication for liver transplantation, and fibrosis stage most strongly predicts clinical outcomes. Pharmacologic treatment is now available with resmetirom and semaglutide holding conditional approval.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To describe the therapeutic landscape for MASH with a focus on anti-fibrotic impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Narrative review of Phase 2 and 3 trials, meta-analyses, epidemiological data, and trial registries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Historically, drugs targeting downstream fibrogenic or inflammatory pathways have had limited success in advanced development, whereas those improving metabolic dysfunction have had fared better. Fibrosis improvement by at least one stage was seen with resmetirom in up to 26% versus 14% placebo after 52 weeks and with semaglutide in 37% versus 22% after 72 weeks. Several agents in development (e.g., fibroblast growth factor 21 analogues, as well as dual and triple incretin agonists, pan-peroxisome proliferator-activated receptor agonist) report encouraging Phase 2 results, with Phase 3 trials ongoing. Compensated cirrhosis requires a distinct approach related to its fibrosis heterogeneity and burden of portal hypertension. This requires a delicate balance between efficacy and event rates that is further complicated by current regulatory constraints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fibrosis improvement in MASH is attainable by available drugs with further promise from emerging therapies. The link between treatment induced histological improvement or improvement in noninvasive tests and reduction in clinical outcomes remains unproven. A rich therapeutic pipeline with the promise of combination regimens and increased focus non-invasive endpoints suggests that the future looks bright for patients living with fibrotic MASH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 9","pages":"1184-1196"},"PeriodicalIF":6.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754346","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":"Impact of Prior Biologic Mechanism of Action on Anti-TNF Effectiveness in Inflammatory Bowel Disease: An ENEIDA Registry Study","authors":"Carmen Yagüe Caballero,&nbsp;Santiago García López,&nbsp;Ana Royo Esteban,&nbsp;Laura Figueras Panillo,&nbsp;Pilar Nos,&nbsp;Luisa de Castro,&nbsp;M. Dolores Martín-Arranz,&nbsp;Manuel Barreiro-de Acosta,&nbsp;Elena Ricart,&nbsp;Ruth de Francisco,&nbsp;Eva Iglesias,&nbsp;Antonio Giordano,&nbsp;Pilar Varela,&nbsp;Iago Rodríguez-Lago,&nbsp;Montserrat Rivero,&nbsp;Beatriz Sicilia,&nbsp;Merce Navarro-Llavat,&nbsp;Isabel Vera,&nbsp;Carles Suria,&nbsp;Jordi Guardiola,&nbsp;Jesús Barrio,&nbsp;Margalida Calafat,&nbsp;Ana Gutiérrez,&nbsp;Xavier Calvet,&nbsp;David Rafael de la Cruz,&nbsp;Francisco Mesonero,&nbsp;Cristina Martínez Pascual,&nbsp;Javier P. Gisbert,&nbsp;Carla J. Gargallo-Puyuelo,&nbsp;David Monfort i Miquel,&nbsp;Mónica Sierra,&nbsp;Laura Arranz,&nbsp;Cristina Rodríguez-Gutiérrez,&nbsp;Rufo Lorente,&nbsp;Fernando Bermejo,&nbsp;Lucía Márquez-Mosquera,&nbsp;Gisela Torres Vicente,&nbsp;José Lázaro Pérez-Calle,&nbsp;José M. Huguet,&nbsp;Laura Ramos,&nbsp;Ángel Ponferrada-Díaz,&nbsp;Daniel Ceballos,&nbsp;Mª. Teresa Diz-Lois Palomares,&nbsp;Eva Sesé Abizanda,&nbsp;Pablo Vega,&nbsp;Ramón Pajares,&nbsp;Javier Santos Fernández,&nbsp;Elena Betoré,&nbsp;David Busquets,&nbsp;Olga Merino,&nbsp;Carlos Martínez-Flores,&nbsp;Yamile Zabana,&nbsp;Manuela Josefa Sampedro González,&nbsp;Jone Ortiz de Zarate,&nbsp;Ana Fuentes Coronel,&nbsp;Empar Sainz Arnau,&nbsp;Daniel Carpio,&nbsp;Nuria Jiménez,&nbsp;Ignacio Marín-Jiménez,&nbsp;Luis Bujanda,&nbsp;Raquel Camargo Camero,&nbsp;Martín Irabien,&nbsp;María Abanades Tercero,&nbsp;Benito Velayos Jiménez,&nbsp;Pilar Robledo Andres,&nbsp;Ana María Trapero,&nbsp;Pedro G. Delgado-Guillena,&nbsp;Luís Hernández Villalba,&nbsp;Margarita Menacho,&nbsp;Nuria Rull Murillo,&nbsp;Carles Leal,&nbsp;Cristina Alba,&nbsp;Rosa Gómez Espín,&nbsp;Alfredo J. Lucendo,&nbsp;Manuel Van Domselaar,&nbsp;Laura García Alles,&nbsp;Eduardo Iyo Miyashiro,&nbsp;Ana Crespo Catalá,&nbsp;Pau Gilabert,&nbsp;Daniel Martín Rodríguez,&nbsp;Víctor Manuel Navas-López,&nbsp;María Calvo Iñiguez,&nbsp;Daniel Ginard,&nbsp;Teresa Martínez Pérez,&nbsp;Eugeni Domènech,&nbsp;Diego Casas Deza","doi":"10.1111/apt.70904","DOIUrl":"10.1111/apt.70904","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The expanding use of targeted therapies in inflammatory bowel disease has made treatment sequencing increasingly relevant, yet evidence on anti-TNF effectiveness after prior biologics with different mechanisms of action (MOA) remains limited. Our objective is to evaluate the durability of anti-TNF treatment in this scenario.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multicentre study based on data from the ENEIDA registry. Patients who received second-line anti-TNF therapy after a first biologic with a different MOA for active luminal disease were identified. Using propensity score matching, each case was matched with three controls from two cohorts: patients treated with second-line anti-TNF after another anti-TNF and patients receiving first-line anti-TNF therapy. Treatment durability and short- and long-term clinical effectiveness were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-six Crohn's disease patients and 117 UC patients receiving anti-TNF after other MOA were included. In CD, second-line anti-TNF therapy after a different MOA (62% ustekinumab) was associated with a higher risk of treatment discontinuation compared with first-line anti-TNF therapy (HR 1.55; 95% CI, 1.05–2.30), without significant differences in short- or long-term clinical effectiveness. In UC, anti-TNF therapy after a different MOA (90% vedolizumab) was associated with lower treatment durability compared with first-line anti-TNF therapy (HR 1.69; 95% CI, 1.31–2.19) and with anti-TNF after another anti-TNF agent (HR 1.91; 95% CI, 1.48–2.48), its remission rates significantly lower at both short- and long-term follow-up (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Anti-TNF therapy used after a different MOA is associated with reduced effectiveness and durability compared with its use as first-line therapy or after another anti-TNF agent, especially in UC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 9","pages":"1234-1247"},"PeriodicalIF":6.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70904","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709474","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: Anti-Integrin αvβ6 Autoantibodies for Distinguishing Ulcerative Colitis From Crohn's Disease","authors":"Yuya Muramoto,&nbsp;Takeshi Kuwada,&nbsp;Masahiro Shiokawa","doi":"10.1111/apt.70947","DOIUrl":"10.1111/apt.70947","url":null,"abstract":"&lt;p&gt;Distinguishing ulcerative colitis (UC) from Crohn's disease (CD) depends on the combined interpretation of clinical, endoscopic and histological findings. Serological markers such as ANCA and ASCA are used as adjuncts, but their accuracy in separating UC from CD is limited [&lt;span&gt;1&lt;/span&gt;]. Anti-integrin αvβ6 autoantibodies were first reported in UC in 2021 [&lt;span&gt;2&lt;/span&gt;]. Subsequent studies have confirmed their diagnostic value in independent cohorts [&lt;span&gt;3-5&lt;/span&gt;], and anti-integrin αvβ6 autoantibodies have also been detected before the diagnosis of UC [&lt;span&gt;6&lt;/span&gt;]. In this issue of &lt;i&gt;Alimentary Pharmacology &amp; Therapeutics&lt;/i&gt;, Truniger et al. prospectively studied 224 patients with established UC or CD [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Anti-integrin αvβ6 autoantibodies had an AUC of 0.897 (sensitivity 85.8%, specificity 87.1%), compared with 0.736 for the p/aANCA-positive/ASCA IgG-negative profile and 0.704 for the p/aANCA-positive/ASCA IgA-negative profile [&lt;span&gt;7&lt;/span&gt;]. In this first direct comparison using the same serum samples, adding conventional ANCA/ASCA profiles provided little additional diagnostic information beyond anti-integrin αvβ6 autoantibodies, indicating that anti-integrin αvβ6 is a better serological discriminator between UC and CD than conventional testing.&lt;/p&gt;&lt;p&gt;The findings within CD are also informative. Positivity was 7.9% in ileal CD and 8.1% in ileocolonic CD, but 43.8% in colonic CD [&lt;span&gt;7&lt;/span&gt;]. Because colonic CD is the phenotype in which separation from UC can be particularly difficult [&lt;span&gt;8&lt;/span&gt;], this relatively high positivity may reduce the discriminatory value of anti-integrin αvβ6 in the subgroup in which it would be most clinically useful. It may also have biological implications, as integrin αvβ6 is induced in injured epithelium and contributes to transforming growth factor-β activation during mucosal repair [&lt;span&gt;2&lt;/span&gt;]. The higher positivity in colonic CD may therefore reflect a shared colonic inflammatory pathway rather than simply false-positive results. Whether this has biological significance remains uncertain.&lt;/p&gt;&lt;p&gt;Whether anti-integrin αvβ6 autoantibodies are useful when the diagnosis is uncertain remains to be determined. In the present study, all patients had an established diagnosis of UC or CD, and those with indeterminate colitis were excluded. The performance of the assay in newly presenting patients, particularly those with colon-limited or unclassified disease, remains an important question.&lt;/p&gt;&lt;p&gt;In a direct, same-sample comparison, Truniger et al. show that anti-integrin αvβ6 autoantibodies are a better serological discriminator than ANCA and ASCA in established UC and CD. Whether this advantage extends to the diagnostically uncertain cases where it would be most valuable is the question that now warrants prospective study.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Yuya Muramoto:&lt;/b&gt; conceptualization, writing – original draft, writing – review and editing. &lt;b&gt;Takeshi Kuwada:&lt;/b&gt; writing – review","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 9","pages":"1308-1309"},"PeriodicalIF":6.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70947","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808046","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":"The Prevalence of Frailty in Elderly Inflammatory Bowel Disease Patients Varies Depending on the Scale Used","authors":"Lorena Carballo-Folgoso,&nbsp;José María Duque Alcorta,&nbsp;Pilar Varela,&nbsp;Ruth de Francisco,&nbsp;Edisa Armesto,&nbsp;Alejo Mancebo Mata,&nbsp;Isabel Pérez-Martínez,&nbsp;Pelayo Rodríguez López,&nbsp;Miguel Ángel de Jorge Turrión,&nbsp;Andrés Castaño-García,&nbsp;Cristina García-Pérez,&nbsp;Gonzalo Martínez Martín,&nbsp;Emilia Fernández-González,&nbsp;Pablo Flórez-Díez,&nbsp;Daniel Muiño-Domínguez,&nbsp;Ana Díaz-Simal,&nbsp;Valentina Chiminazzo,&nbsp;Adolfo Suárez,&nbsp;Sabino Riestra","doi":"10.1111/apt.70895","DOIUrl":"10.1111/apt.70895","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Frailty is an important predictor of adverse outcomes in inflammatory bowel diseases (IBD); however, it has not been established which is the best way to measure frailty in IBD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare four frailty scales in elderly IBD patients and identify factors associated with this condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multicentre cohort study in IBD outpatients ≥ 60 years old using four frailty scales: Fried Frailty Phenotype (FFP), FRAIL scale, Clinical Frailty Score (CFS) and SHARE-FI. Clinical-demographic data and comorbidity indices (Charlson and CIRS-G) were obtained. The agreement between scales was evaluated, and logistic regression analysis was conducted to assess the factors associated with frailty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six hundred and twelve patients (56.4% Crohn's disease) were enrolled from March to June 2024. Prevalence of frailty varied from 4.4% (FRAIL), 4.6% (CFS), 12.4% (SHARE-FI) up to 16.8% (FFP). The agreement between all the scales used was Fleiss' Kappa 0.25. Frailty was independently associated with polypharmacy and CIRS-G ≥ 3 on multivariate analysis of the four scales. Other factors, such as higher age, female gender, poor family support, disease duration of IBD, and clinical IBD activity were statistically associated with higher risk of frailty according to three of the four scales used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of frailty in elderly IBD patients varies depending on the scale used. Polypharmacy and CIRS-G ≥ 3 are associated with a higher risk of frailty, regardless of the frailty assessment tool used. Further prospective studies are needed to identify the impact of frailty in elderly IBD patients and improve treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 9","pages":"1207-1218"},"PeriodicalIF":6.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623926","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: Beyond the Withdrawal—Why the POISE Long-Term Data Still Matter","authors":"Marco Carbone,&nbsp;Adriaan J. van der Meer","doi":"10.1111/apt.70910","DOIUrl":"10.1111/apt.70910","url":null,"abstract":"&lt;p&gt;Few drugs in hepatology have shaped a field as profoundly—and generated as much regulatory controversy—as obeticholic acid (OCA) [&lt;span&gt;1, 2&lt;/span&gt;]. The POISE open-label extension (OLE) study by Bowlus et al. [&lt;span&gt;3&lt;/span&gt;] provides the longest prospective follow-up available for a second-line therapy in primary biliary cholangitis (PBC), with up to 6 years of OCA exposure. It appears at a unique and somewhat paradoxical moment: after OCA withdrawal from the European and US markets, while remaining available in countries including the UK and Canada. OCA therefore continues to influence the evolving concept of disease modification in PBC.&lt;/p&gt;&lt;p&gt;The POISE OLE is among the few long-term studies exploring whether sustained biochemical response translates into stabilization of fibrosis and reduced disease progression. The investigators report durable reductions in alkaline phosphatase (ALP), bilirubin, aminotransferases, inflammatory markers, and immunoglobulins, with approximately 60% of patients maintaining the composite POISE response (ALP &lt; 1.67× upper limit of normal, ≥ 15% reduction from baseline, and normal bilirubin) through month 72. Particularly noteworthy is the reported overall stability of liver stiffness, whereas its increasing in some is associated with poorer prognosis, consistent with large retrospective studies [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;These findings are clinically relevant because PBC is a chronic, progressive fibrosing cholangiopathy in which irreversible bile duct injury often persists despite ursodeoxycholic acid (UDCA). Without curative therapy, slowing disease progression may be as meaningful as reversing it. Preventing hepatic fibrogenesis is therefore a realistic therapeutic goal, particularly in patients with incomplete biochemical response to UDCA. The sustained stability of liver stiffness further supports incorporating non-invasive fibrosis assessment alongside biochemical response in future PBC trials and in the broader definition of disease modification [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Interpretation nevertheless requires caution. The uncontrolled OLE design is inherently susceptible to survivor and selection bias, since patients benefiting from treatment are more likely to remain in follow-up. Furthermore, most participants were enrolled before the 2021 prescribing restrictions that contraindicated OCA in patients with portal hypertension or decompensated cirrhosis. The findings should therefore be interpreted within the context of contemporary patient selection.&lt;/p&gt;&lt;p&gt;As expected, pruritus remained the predominant adverse event, although treatment discontinuation rates were relatively modest. Importantly, the authors openly acknowledge the evolving regulatory landscape, including post-marketing safety concerns and the inconclusive COBALT study. This transparency strengthens, rather than weakens, the value of the report.&lt;/p&gt;&lt;p&gt;Long-term datasets remain essential for defining the place of this FXR agonist compound within","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"64 9","pages":"1304-1305"},"PeriodicalIF":6.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70910","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726374","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}