Gastroenterologia y hepatologia最新文献

{"title":"Predictors of early immunosuppression at ulcerative colitis onset in the biological era.","authors":"Gisela Piñero, Edgar Castillo, Carlos González-Muñoza, Anna Calm, Clàudia Pujol, Jordi Gordillo, Margalida Calafat, Federico Bertoletti, Esther Garcia-Planella, Míriam Mañosa, Eugeni Domènech","doi":"10.1016/j.gastrohep.2025.502533","DOIUrl":"10.1016/j.gastrohep.2025.502533","url":null,"abstract":"<p><strong>Background: </strong>Unlike Crohn's disease, ulcerative colitis (UC) lacks predictive factors of a bad prognosis. Therefore, immunosuppressant therapy is only considered in a step-up strategy when steroid refractoriness or dependency develops.</p><p><strong>Objective: </strong>To identify predictive factors for the early use of immunosuppressants, biological agents and colectomy in UC.</p><p><strong>Patients and methods: </strong>Retrospective, observational study of an incident cohort of UC at two referral centres over a 7-year period. Demographic, clinical, endoscopic and biologic variables at UC diagnosis were collected and early use (within five years) of immunosuppressants, biological agents and colectomy was assessed for a maximum of five years.</p><p><strong>Results: </strong>A total of 239 patients were included. At baseline, 32% presented with extensive colitis, 15% severe disease activity and 13% large ulcers at diagnostic endoscopy. At the end of follow-up, 24% were exposed to thiopurines, 18% to biologicals and 4% were colectomized. The need for thiopurines, biological agents or colectomy was independently associated with extensive UC at diagnosis (OR 5.3; IC95% 1.6-17.2), the need for corticosteroids at disease onset (OR 7.8; IC95% 2.6-23.9) and proximal progression during follow-up (OR 13; IC95% 2.3-73.4).</p><p><strong>Conclusions: </strong>Less than a third of patients with UC use thiopurines or biological agents within the first five years of disease course. Unfortunately, there are no predictive factors robust enough to allow for the early introduction of advanced therapies at disease onset.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502533"},"PeriodicalIF":1.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Healthcare Resource Utilization in Inflammatory Bowel Disease in Colombia between 2017-2021: A Retrospective Claims Database Study.","authors":"Fabián Juliao-Baños, Viviana Parra-Izquierdo, Tatiana Pacheco, Janeth Tatiana Acosta Leaño","doi":"10.1016/j.gastrohep.2025.502532","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502532","url":null,"abstract":"<p><strong>Background and aims: </strong>The incidence and prevalence of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are increasing across Latinamerica. IBD has an important impact on patients' quality of life and is associated with significant healthcare resource utilization (HCRU). This study aimed to describe the more recent epidemiological characteristics and HCRU patterns of IBD in Colombia.</p><p><strong>Methods: </strong>Retrospective study using real-world data from the national claims database SISPRO (Sistema de Información para la Protección Social) between 2017 and 2021. The data considered were sociodemographic (sex and age), epidemiological (incidence, prevalence, and mortality), and HCRU data.</p><p><strong>Results: </strong>We identified 54,961 cases of prevalent ulcerative colitis (UC) and 13,136 cases of Crohn's disease (CD). Between 2017 and 2019, the incidence rates for UC increased from 3.82 to 5.18 per 100,000 individuals, while the incidence for CD rose from 0.48 to 0.83 per 100,000. The prevalence of these conditions reached its highest point in 2019, with UC at 48.65 and CD at 15.41 per 100,000 population. Mortality data indicated 259 deaths registered with UC and 77 with CD. The utilization of biologic therapies saw a significant rise from 2020 to 2021, particularly with anti-TNF agents being the most frequently prescribed. The patterns observed in outpatient visits and hospital admissions followed similar trajectories, exhibiting a downturn during the COVID-19 pandemic.</p><p><strong>Conclusions: </strong>This study examined the epidemiology, HCRU, and costs of IBD in Colombia using SISPRO data. Despite a decrease during the COVID-19 pandemic, the incidence and prevalence of IBD have increased over time, accompanied by elevated HCRU and medication costs. These insights could contribute to informed decision-making and resource allocation for enhanced patient care in Colombia.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502532"},"PeriodicalIF":2.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GETECCU POSITION PAPER ON FRAGILITY, ADVANCED AGE AND INFLAMMATORY BOWEL DISEASE.","authors":"Míriam Mañosa, Margalida Calafat, Esther Francia, Francesc Riba, Francisco Mesonero, Cristina Suárez, Santiago García-López, Francisco Losfablos, Xavier Calvet, Eugeni Domènech, Ana Gutiérrez, Ingrid Ordás, Luis Menchén, Francisco Rodríguez-Moranta, Yamile Zabana","doi":"10.1016/j.gastrohep.2025.502529","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502529","url":null,"abstract":"<p><p>Frailty is a state of vulnerability characterised by a decrease in physiological reserve and the ability to respond to stress, which increases the risk of complications, adverse effects of treatments and functional decline. Assessing frailty allows the biological age of patients to be determined, beyond their chronological age, providing a more accurate picture of their health status and care needs. The proportion of older adults with IBD is increasing in parallel with the ageing of the general population, and it is estimated that in the next decade, more than a third of IBD patients will be over 60 years of age. This population may suffer from complications arising from previously developed IBD and is particularly susceptible to developing side effects from treatment, making comprehensive assessment essential in order to identify those who are most vulnerable. Frailty is compounded by other geriatric syndromes such as comorbidity and polypharmacy, which can significantly interfere with the management and course of IBD, influencing the therapeutic strategy and prognosis. Objective: In this context, comprehensive geriatric assessment should be systematic in elderly patients with IBD, with the aim of detecting functional deficits and implementing specific interventions for nutritional support, functional rehabilitation and psychological care to optimise their progress. This position paper aims to establish recommendations in this regard based on the available evidence. Conclusions: The systematic incorporation of comprehensive geriatric assessment in the management of older people with IBD represents an essential strategy for improving clinical outcomes, adapting treatments to the patient's functional capacity and promoting a truly person-centred approach.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502529"},"PeriodicalIF":2.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVOLVE-IBERIA: Real-world evidence on vedolizumab and anti-tumor necrosis factor-α as first- or second-line biologic treatment among patients with ulcerative colitis.","authors":"Francesc Casellas, Ana Gutiérrez-Casbas, Cristina Rodríguez, Javier P Gisbert, Sabino Riestra, Claudia Herrera de Guise, Isabel Vera-Mendoza, M Pilar Martínez-Montiel, Sónia Bernardo, Isabel Medeiros, Jesús Aparicio, Ignacio Tagarro, Teresa Letosa Abián, Carmen Montoto, J Fernando Muñoz","doi":"10.1016/j.gastrohep.2025.502528","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2025.502528","url":null,"abstract":"<p><strong>Objective: </strong>Real-world evidence (RWE) on vedolizumab (VDZ), an anti-lymphocyte trafficking treatment that selectively targets the α4β7/MAdCAM-1 interaction on the gut, is mostly limited to patients who are repeatedly refractory to anti-tumor necrosis factor-alpha (anti-TNF-α), and other treatments. The EVOLVE-IBERIA study assessed VDZ or anti-TNF-α as first- or second-line biologic treatment, in patients with Crohn's disease or ulcerative colitis (UC); here we present the outcomes in patients with UC.</p><p><strong>Patients and methods: </strong>Medical records were retrospectively reviewed from 25 hospitals in Spain and Portugal. Eligible patients with UC were aged ≥18 years and had received treatment with first- or second-line VDZ or anti-TNF-α. Objectives were to evaluate clinical effectiveness, safety, and treatment patterns of VDZ and anti-TNF-α, and to characterize healthcare resource utilization. Baseline covariates were balanced in both cohorts by means of propensity scores, using the inverse probability of treatment weighting (PS-IPTW) method.</p><p><strong>Results: </strong>A total of 199 patients with UC were included (median follow-up:24.0 months). At Week 52, clinical response rates were 75.6% and 73.2% (p=0.72) and clinical remission rates were 56.6% and 62.0% (p=0.49), in the VDZ cohort and anti-TNF-α cohort, respectively. Treatment-related adverse event rates per 100 patient-years were 0.23 in the VDZ cohort and 1.1 in the anti-TNF-α cohort (p=0.037).</p><p><strong>Conclusion: </strong>The similar long-term effectiveness and lower incidence of adverse events of VDZ compared with anti-TNF-α in the real-world setting, confirm the favorable benefit:risk ratio of VDZ as first- or second-line biologic treatment for UC.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502528"},"PeriodicalIF":2.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Spanish National Strategic Plan for Hepatitis C: A legacy of success","authors":"Javier Crespo ,&nbsp;Agustín Albillos ,&nbsp;María Buti","doi":"10.1016/j.gastrohep.2025.502457","DOIUrl":"10.1016/j.gastrohep.2025.502457","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"48 7","pages":"Article 502457"},"PeriodicalIF":2.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the hidden risk: Herbal and dietary supplement consumption in liver disease patients.","authors":"Elia Canga, Anna Pocurull, Montserrat Rodriguez-Reyes, Cristina Collazos, Laura Martín, Zoe Mariño, Sabela Lens, Xavier Forns","doi":"10.1016/j.gastrohep.2025.502520","DOIUrl":"10.1016/j.gastrohep.2025.502520","url":null,"abstract":"<p><strong>Introduction: </strong>The use of herbal products and dietary supplements (HDS) carries a potential risk of liver toxicity. Data on HDS consumption among patients attending liver disease clinics remain unexplored.</p><p><strong>Objective: </strong>To determine the frequency, types and reasons for HDS consumption in patients attending a specialized liver disease outpatient clinic.</p><p><strong>Methods: </strong>Prospective study including consecutive patients attending the hepatology outpatient clinic at the Hospital Clínic of Barcelona from June 2023 to October 2023. Following a standard medical visit, a trained nurse conducted a structured interview to assess HDS consumption.</p><p><strong>Results: </strong>A total of 150 patients were included, with a median age of 59 (IQR: 49-67) and male predominance (56%, n=84). Only 12 patients (8%) reported HDS consumption during a standard medical interview, while the number increased to 92 (61%) after nurse-led structured interview. The primary reasons for dietary supplements use included vitamin supplementation (43%), fitness improvement (10.5%) and hair/nail health (10.5%). For herbal products, the most common reason for use was pleasure (73%). Reported HDS products with potential hepatotoxicity (levels A and B) were green tea (n=16), turmeric with black pepper (n=11), aloe (n=2), greater celandine (n=1) and black cohosh (n=1).</p><p><strong>Conclusion: </strong>HDS use is highly prevalent among patients with liver disease, but a structured interview is crucial to detect their consumption, as they usually forget spontaneous reporting. Importantly, a significant proportion of these products carry a risk of hepatic toxicity, underscoring the need for increased patient education and clinical vigilance.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502520"},"PeriodicalIF":2.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital readmissions after liver transplantation worsen mental health depression: A cohort study.","authors":"Victor Fernandez-Alonso, Leticia Lopez-Pedraza, Ana Maria Hernandez-Matias, Ana Fernandez-Alonso, Manuela Perez-Gomez, Maria Nieves Moro-Tejedor","doi":"10.1016/j.gastrohep.2025.502521","DOIUrl":"10.1016/j.gastrohep.2025.502521","url":null,"abstract":"<p><strong>Introduction: </strong>Liver transplantation continues to be the most effective treatment of choice for patients with end-stage liver disease. Patients who go through that process experienced emotional stress and transplanted patients have a high rate of readmission.</p><p><strong>Aims: </strong>This study aims to analyze the relation between mental health and hospital readmissions during the first year after liver transplantation.</p><p><strong>Method: </strong>A prospective study was conducted in a cohort of liver transplant patients in a tertiary hospital. Sociodemographic and clinical variables were collected. A descriptive analysis of the data and a multivariate study using a mixed linear model were performed.</p><p><strong>Results: </strong>Liver transplant patients improve their mental health within the first year. Hospital admissions during the first-year impact negatively increasing anxiety and depression in liver transplant patients, especially in women.</p><p><strong>Conclusion: </strong>The nurse must carry out a continuous psychological evaluation during the process and manage the necessary care, coordinating interdisciplinary care with the appropriate professionals to provide the emotional and psychological care. A multidisciplinary and interdisciplinary team should focus on the prevention of hospital admissions, controlling and managing cardiovascular risk, adherence to immunosuppressive treatment, adherence to the clinical follow-up prescribed by physicians, prevention of infections and promotion of healthy habits.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502521"},"PeriodicalIF":2.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brunner gland hamartoma causing an upper gastrointestinal bleeding.","authors":"Ana Sánchez Martínez, Elena Romera Barba, Alberto Sánchez Espinosa","doi":"10.1016/j.gastrohep.2025.502519","DOIUrl":"10.1016/j.gastrohep.2025.502519","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502519"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and prognosis of cirrhotic cardiomyopathy in hospitalized patients with decompensated cirrhosis.","authors":"Judith Cortada, Francesca Castaldo, Jordi Sánchez-Delgado, José Ferrusquía-Acosta, Meritxell Casas, Mireia Miquel, Mario Sutil-Vega, Mercedes Vergara, Cristina Solé","doi":"10.1016/j.gastrohep.2025.502518","DOIUrl":"10.1016/j.gastrohep.2025.502518","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502518"},"PeriodicalIF":2.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of early Lille score in patients with severe alcohol-associated hepatitis.","authors":"Ana Suárez-Saro Fernández, Mónica Barreales Valbuena, Cristina Martín-Arriscado Arroba, Elena Gómez Domínguez, Álvaro Hidalgo Romero, Inmaculada Fernández Vázquez","doi":"10.1016/j.gastrohep.2025.502517","DOIUrl":"10.1016/j.gastrohep.2025.502517","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of the Lille Index (LI) on day 2 (LI2) and day 4 (LI4) in predicting short-term mortality in patients with severe alcohol-associated hepatitis (SAH) and to assess its concordance compared to the Lille Index on day 7 (LI7).</p><p><strong>Patients and methods: </strong>This retrospective, observational, single-center study included SAH patients admitted between 2016 and 2023. SAH was defined as a Maddrey score ≥32 and/or a MELD score ≥21. The predictive ability of LI2, LI4, and LI7 for 28-, 90-, and 180-day mortality was analyzed using AUC, Cox regression (Hazar Ratio (HR)), and Kaplan-Meier curves.</p><p><strong>Results: </strong>Among 65 SAH patients, 62 received corticosteroids. Median follow-up was 722 days. LI2 was associated with a 28-day mortality HR of 33.1 (95% CI: 3.8-287.3), similar to LI7 (HR: 13.2; 95% CI: 2.2-81.2). AUCs for 28-day mortality were 0.818 for LI2, 0.794 for LI4, and 0.809 for LI7 (P>.05). The proportion of patients classified by prognosis was similar for LI2 vs. LI7 (68.33% vs. 70.97%, P=.752) and LI4 vs. LI7 (73.33% vs. 70.97%, P=.771). Concordance between LI2 and LI7 was 85%, and between LI4 and LI7 was 93.33%.</p><p><strong>Results: </strong>Among 65 SAH patients, 62 received corticosteroids. The median follow-up was 722 days. LI2 was associated with a 28-day mortality HR of 33.1 (95% CI: 3.8-287.3), similar to LI7 (HR: 13.2; 95% CI: 2.2-81.2). AUCs for 28-day mortality were 0.818 for LI2, 0.794 for LI4, and 0.809 for LI7 (P>.05). The proportion of patients classified by prognosis was similar for LI2 vs. LI7 (P=.752) and LI4 vs. LI7 (P=.771). Concordance between LI2 and LI7 was 85%, and between LI4 and LI7, 93.33%.</p><p><strong>Conclusions: </strong>LI2 and LI4 were comparable to LI7 in predicting short-term mortality in SAH. Earlier calculation, particularly LI2, could anticipate clinical decisions in poor prognosis patients, such as corticosteroid discontinuation or evaluation for liver transplantation in selected cases.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502517"},"PeriodicalIF":1.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}