Gut and Liver最新文献

{"title":"Development and Validation of Predictive Models for Gastric Neoplasm Risk Stratification in Screening Esophagogastroduodenoscopy.","authors":"Seokho Myeong, Kyung-Han Song, Donghoon Kang, Yu Kyung Cho, Jae Myung Park","doi":"10.5009/gnl250018","DOIUrl":"https://doi.org/10.5009/gnl250018","url":null,"abstract":"<p><strong>Background/aims: </strong>Stratifying patients for gastric neoplasm risk before screening esophagogastroduodenoscopy (EGD) is challenging. The aim of this study was to develop a prediction model for assessing gastric neoplasm risk in a screening setting.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 21,586 EGD patients from Seoul St. Mary's Hospital, Korea (2009 to 2019). Logistic regression analyses identified risk factors, and score-based prediction models were developed on the basis of these risk factors. These models were evaluated using the area under the curve (AUC) and the Hosmer‒Lemeshow goodness of fit test. Internal validation was performed using bootstrapping (1,000 resamples) and a validation cohort.</p><p><strong>Results: </strong>The study included 10,414 patients in the derivation cohort and 11,172 in the validation cohort. Gastric dysplasia and cancer were identified in 49 (0.47%) and 35 (0.34%) patients, respectively. Four models were developed, with Model 4 including age, sex, pepsinogen I/II ratio, anti-<i>Helicobacter pylori</i> immunoglobulin G antibody, smoking, body mass index, alcohol use, and family history of gastric cancer. Model 4 had the highest AUC (0.827) in the derivation cohort, while Model 2 achieved the highest AUC (0.788) after risk scores were assigned. Observed prevalence rates were 0.24%, 1.05%, and 4.08% for low-, medium-, and high-risk groups, respectively (p<0.001). In internal validation, Model 3 demonstrated the highest AUC (0.802), with consistent performance in the validation cohort, and all models passed the Hosmer‒Lemeshow test (p>0.8).</p><p><strong>Conclusions: </strong>The predictive models achieved an AUC of approximately 0.8. Further improvements with additional stratification factors are needed for better diagnostic performance in prescreening.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Potassium-Competitive Acid Blocker-Based Triple Therapy with Tegoprazan versus Vonoprazan for <i>Helicobacter pylori</i> Eradication: A Randomized, Double-Blind, Active-Controlled Pilot Study.","authors":"Jae Yong Park, Il Ju Choi, Gwang Ha Kim, Su Jin Hong, Sung Kwan Shin, Seong Woo Jeon, Jae Gyu Kim","doi":"10.5009/gnl250067","DOIUrl":"https://doi.org/10.5009/gnl250067","url":null,"abstract":"<p><strong>Background/aims: </strong>Triple therapy with vonoprazan, a potassium-competitive acid blocker, has shown an acceptable eradication rate. The aim of this study was to evaluate the efficacy and safety of tegoprazan-based triple therapy compared with those of vonoprazan-based triple therapy for <i>Helicobacter pylori</i> eradication.</p><p><strong>Methods: </strong>This randomized, double-blind, active-controlled, multicenter pilot study included treatment-naive adults with <i>H. pylori</i> infection. Participants were randomized 1:1:1 to receive tegoprazan 50 mg (TAC 1), tegoprazan 100 mg (TAC 2), or vonoprazan 20 mg (VAC) with amoxicillin 1,000 mg plus clarithromycin 500 mg twice daily for 10 days. The primary outcome was the eradication rate.</p><p><strong>Results: </strong>Of the 102 enrolled participants, 97 completed the study. The eradication rates in the full analysis set were 60.61% (95% confidence interval [CI], 43.93% to 77.28%), 78.79% (95% CI, 64.84% to 92.74%), and 84.85% (95% CI, 72.62% to 97.08%) in TAC 1, TAC 2, and VAC, respectively. The eradication rates in the per-protocol set were 66.67% (95% CI, 49.80% to 83.54%), 86.67% (95% CI, 74.50% to 98.83%), and 87.50% (95% CI, 76.04% to 98.96%) in TAC 1, TAC 2, and VAC, respectively. In the full analysis set, the eradication rate differences were -6.06% (95% CI, -24.61% to 12.49%) between TAC 2 and VAC and -24.24% (95% CI, -44.92% to -3.56%) between TAC 1 and VAC. In the per-protocol set, the eradication rate differences were -0.83% (95% CI, -19.97% to 17.37%) between TAC 2 and VAC and -20.83% (95% CI, -41.23% to -0.44%) between TAC 1 and VAC. All therapies were well tolerated with no notable safety differences.</p><p><strong>Conclusions: </strong>After 10 days, tegoprazan 100 mg showed eradication rates comparable to those of vonoprazan 20 mg, while 50 mg may be insufficient. These findings support future research to optimize tegoprazan dosing in clinical practice (ClinicalTrials.gov; NCT04128917).</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, Clinical Characteristics, and Treatment Status of Hepatitis C Virus Infection among People Who Use Drugs in South Korea: A Prospective Multicenter Study.","authors":"Gwang Hyeon Choi, Young-Hoon Chon, Do Hoon Kwon, Sung Nam Jo, Og-Jin Jang, Kyung-Ah Kim, Dahye Baik, Eun Sun Jang, Sook-Hyang Jeong","doi":"10.5009/gnl240451","DOIUrl":"https://doi.org/10.5009/gnl240451","url":null,"abstract":"<p><strong>Background/aims: </strong>Data on hepatitis C virus (HCV) infection among people who use drugs (PWUD) in South Korea is limited. This study investigated the prevalence, clinical characteristics, and treatment rates of HCV infection among PWUD.</p><p><strong>Methods: </strong>From August 2022 to May 2024, 342 PWUD were prospectively enrolled in four hospitals covering 95% of PWUD care in Korea. Blood tests and questionnaires were conducted. If the anti-HCV antibody test was positive, a reflex test for HCV RNA was performed. The clinical characteristics were compared according to anti-HCV or HCV RNA positivity.</p><p><strong>Results: </strong>Among these patients (median age, 46 years; men, 76%; injection drug user, 92%; syringe sharing, 56%), the prevalence of anti-HCV and HCV RNA was 31.3% and 10.5%, respectively. Abnormal aspartate aminotransferase or alanine aminotransferase levels were found in 24.6% of patients, and fibrosis-4 >3.25 was detected in 4.4% of patients. Anti-HCV positivity was independently associated with age (odds ratio [OR], 1.074), duration of injection drug use (OR, 1.060), sharing of syringes (OR, 3.510), and very low monthly income (OR, 2.598). Among anti-HCV positive patients, the treatment rate was significantly higher in the HCV RNA negative group (71.8%) than in the RNA positive group (16.7%). The only independent factor related to treatment uptake was having Medical Aid, which reimbursed 100% of the antiviral treatment (OR, 10.912; 95% confidence interval, 2.024 to 58.848; p=0.005).</p><p><strong>Conclusions: </strong>Among PWUD in South Korea, the anti-HCV and HCV RNA prevalence rates were 31.3% and 10.5%, respectively. Only half of the anti-HCV positive PWUD received antiviral treatment. Treatment uptake was related to direct-acting antiviral affordability, suggesting a need for public support.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Serum Pepsinogen Tests in Detection of Gastric Atrophy, Intestinal Metaplasia, Gastric Adenoma, and Gastric Cancer in South Korea.","authors":"Yonghoon Choi, Nayoung Kim, Ji Hyun Park, Jeong Hwan Lee, Yeejin Kim, Ho-Kyoung Lee, Yu Kyung Jun, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee","doi":"10.5009/gnl250055","DOIUrl":"https://doi.org/10.5009/gnl250055","url":null,"abstract":"<p><strong>Background/aims: </strong>The aim of this study was to evaluate the efficacy of serum pepsinogen (sPG) tests for gastritis, gastric adenoma (GA), and gastric cancer (GC) using the enzyme‑linked immunosorbent assay-based GastroPanel kit and to investigate the correlation between Gastro-Panel- and Latex-enhanced Turbidimetric Immunoassay (L-TIA)-derived sPG results.</p><p><strong>Methods: </strong>sPG I and II levels and PG I/II ratios were measured using both kits in 2,204 participants, including 1,109 controls, 316 GA, and 779 GC patients.</p><p><strong>Results: </strong>The GastroPanel- and L-TIA-derived sPG results showed high concordance. An sPG I concentration of 70 ng/mL and a PG I/II ratio of 3 measured with the L-TIA kit corresponded to 100 ng/mL and 5.3 with the GastroPanel kit. sPG I decreased in the GA and GC groups, whereas sPG II was lower in the GA group, but higher in the GC group than that in control group. The PG I/II ratios significantly decreased in the GA and GC groups, especially for the intestinal type. The sensitivity and specificity of PG I/II ratio ≤5.3 using the GastroPanel kit for the detection of GA or GC were 51%-59% and 61%-66%, respectively, which were slightly higher than 51%-58% and 58%-63% using the L-TIA kit. The group with a PG I/II ratio ≤5.3 and <i>Helicobacter pylori</i>-negative status had the highest risk with an adjusted odds ratio of 3.36 for GA and 2.25 for GC, with more prominent increase in diffuse-type compared to intestinal-type.</p><p><strong>Conclusions: </strong>The GastroPanel kit showed non-inferiority compared to the L-TIA kit.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early versus Late Eradication of <i>Helicobacter pylori</i> after Endoscopic Submucosal Dissection of Gastric Neoplasms: A Prospective, Multicenter, Randomized, Controlled Study.","authors":"Cheal Wung Huh, Da Hyun Jung, Jie-Hyun Kim, Hyojin Park, Young Hoon Youn","doi":"10.5009/gnl250004","DOIUrl":"https://doi.org/10.5009/gnl250004","url":null,"abstract":"<p><strong>Background/aims: </strong><i>Helicobacter pylori</i> is a well-known gastric carcinogen, and its eradication is an important therapeutic strategy to prevent the development of metachronous lesions following endoscopic submucosal dissection (ESD). However, the optimal timing for <i>H. pylori</i> eradication following ESD remains unclear.</p><p><strong>Methods: </strong>In this multicenter, prospective, randomized trial, 191 patients undergoing ESD for gastric neoplasms were randomly assigned to either an early (3 to 5 days) or late (8 to 9 weeks) eradication group after ESD. The primary outcome was the rate of successful <i>H. pylori</i> eradication. Secondary outcomes included the tolerability and side effects of eradication therapy in both groups.</p><p><strong>Results: </strong>A total of 149 patients were included in the per-protocol analysis (75 in the early eradication group and 74 in the late eradication group) after excluding patients who required surgery or were lost to follow-up. The early eradication group showed a significantly higher eradication rate compared to the late eradication group (early 80.0%, late 64.9%; p=0.045). However, the tolerability and side effects of the eradication therapy did not differ between the groups. In multivariate analysis, early initiation of eradication therapy after ESD was an independent predictor of successful eradication (odds ratio, 2.30; 95% confidence interval, 1.04 to 5.05; p=0.038).</p><p><strong>Conclusions: </strong>Early attempts to eradicate <i>H. pylori</i> following ESD significantly increased eradication success rates without increasing the incidence of side effects. Therefore, early attempts to eradicate <i>H. pylori</i> after ESD may be the best option for successful eradication. (ClinicalTrials.gov identifier NCT02921399).</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of <i>Helicobacter pylori</i> Eradication on Metabolic Parameters and Body Composition including Skeletal Muscle Mass: A Matched Case-Control Study.","authors":"Suh Eun Bae, Kee Don Choi, Jaewon Choe, Min Jung Lee, Seonok Kim, Ji Young Choi, Hana Park, Jaeil Kim, Hye Won Park, Hye-Sook Chang, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Jeong Hoon Lee, Do Hoon Kim, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung","doi":"10.5009/gnl240494","DOIUrl":"10.5009/gnl240494","url":null,"abstract":"<p><strong>Background/aims: </strong>Findings on the impact of <i>Helicobacter pylori</i> eradication on metabolic parameters are inconsistent. This study aimed to evaluate the effects of <i>H. pylori</i> eradication on metabolic parameters and body composition, including body fat mass and skeletal muscle mass.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of asymptomatic patients who underwent health screenings, including bioelectrical impedance analysis, before and after <i>H. pylori</i> eradication between 2005 and 2021. After matching individuals based on key factors, we compared lipid profiles, metabolic parameters, and body composition between 823 patients from the eradicated group and 823 patients from the non-eradicated groups.</p><p><strong>Results: </strong>Blood pressure, erythrocyte sedimentation rate, and glycated hemoglobin values were significantly lower in the eradicated group than in the non-eradicated group. However, changes in body mass index (BMI), body fat mass, appendicular skeletal muscle mass (ASM), waist circumference, and lipid profiles were not significantly different between the two groups. In a subgroup analysis of individuals aged >45 years, blood pressure, erythrocyte sedimentation rate, and glycated hemoglobin changes were significantly lower in the eradicated group than in the non-eradicated group. BMI values were significantly higher in the eradicated group than in the non-eradicated group; however, no significant differences were observed between the two groups regarding changes in body weight, body fat mass, ASM, or waist circumference. Total cholesterol and low-density lipoprotein cholesterol levels were significantly lower in the eradicated group than in non-eradicated group.</p><p><strong>Conclusions: </strong><i>H. pylori</i> eradication significantly reduced blood pressure, glucose levels, and systemic inflammation and improved lipid profiles in patients aged >45 years. BMI, body fat mass, ASM, and waist circumference did not significantly differ between patients in the eradicated group and those in the non-eradicated group.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"346-354"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Disorders and Inflammatory Bowel Diseases.","authors":"Hye Kyung Hyun, Jae Hee Cheon","doi":"10.5009/gnl240316","DOIUrl":"10.5009/gnl240316","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is characterized by chronic immune-mediated intestinal inflammation, presenting with a spectrum of metabolic disorders as well as intestinal and extraintestinal manifestations. Lifestyle factors, genetic predisposition, immune dysfunction, and gut bacteria composition contribute to the development of IBD. Several comorbidities, including cardiovascular diseases, thrombosis, and metabolic disorders, have been associated with IBD. Therefore, metabolic disorders, including nonalcoholic fatty liver disease, type 2 diabetes mellitus, and obesity have become the focus of attention in patients with IBD. Identifying and managing these conditions can significantly influence patient outcomes and enhance overall management. Therefore, this review aimed to elucidate the current understanding of relevant and emerging metabolic comorbidities and extraintestinal manifestations associated with IBD and their clinical significance.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"307-317"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population Pharmacokinetic Model for the Use of Intravenous or Subcutaneous Infliximab in Patients with Inflammatory Bowel Disease: Real-World Data from a Prospective Cohort Study.","authors":"Joo Hye Song, Sung Noh Hong, Myeong Gyu Kim, Minjung Kim, Seong Kyung Kim, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim","doi":"10.5009/gnl240503","DOIUrl":"10.5009/gnl240503","url":null,"abstract":"<p><strong>Background/aims: </strong>Infliximab treatment failure in patients with inflammatory bowel disease may result from sub-optimal infliximab trough level. An understanding of pharmacokinetics (PKs) is important to maintain an optimal trough level. PK studies of the switch to subcutaneous (SC) infliximab from intravenous (IV) infliximab using real-world data are lacking. We aimed to develop a population PK model of IV and SC infliximab to predict individual infliximab exposure during maintenance therapy.</p><p><strong>Methods: </strong>We used data from prospectively collected data on IV and SC infliximab concentrations in patients with inflammatory bowel disease receiving maintenance treatment from February 2020 to December 2022 at Samsung Medical Center. Population PK analysis was conducted by using a two-compartment model with first-order absorption and first-order elimination. Goodness-of-fit plots and visual predictive check were used to evaluate the PK model.</p><p><strong>Results: </strong>A total of 2,132 samples from 181 patients (149 Crohn's disease and 32 ulcerative colitis) were analyzed. We developed an infliximab population PK model using body mass index, albumin, C-reactive protein level, and the anti-drug antibody level and validated its predictive performance.</p><p><strong>Conclusions: </strong>It may be possible to predict the infliximab trough level of both IV and SC infliximab in patients with inflammatory bowel disease during maintenance treatment by using our model in real-world practice.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"376-387"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Mortality and Cirrhosis-Related Complications with MELD3.0: A Multicenter Cohort Analysis.","authors":"Jihye Lim, Ji Hoon Kim, Ahlim Lee, Ji Won Han, Soon Kyu Lee, Hyun Yang, Heechul Nam, Hae Lim Lee, Do Seon Song, Sung Won Lee, Hee Yeon Kim, Jung Hyun Kwon, Chang Wook Kim, U Im Chang, Soon Woo Nam, Seok-Hwan Kim, Pil Soo Sung, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon, Myeong Jun Song","doi":"10.5009/gnl240584","DOIUrl":"10.5009/gnl240584","url":null,"abstract":"<p><strong>Background: </strong>/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score.</p><p><strong>Methods: </strong>We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score.</p><p><strong>Results: </strong>A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0 had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0 score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10-20 points was 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase in the MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites.</p><p><strong>Conclusions: </strong>The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"427-437"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean Registry on the Current Management of <i>Helicobacter pylori</i> (K-Hp-Reg): Interim Analysis of Adherence to the Revised Evidence-Based Guidelines for First-Line Treatment.","authors":"Hyo-Joon Yang, Joon Sung Kim, Ji Yong Ahn, Ok-Jae Lee, Gwang Ha Kim, Chang Seok Bang, Moo In Park, Jae Yong Park, Sun Moon Kim, Su Jin Hong, Joon Hyun Cho, Shin Hee Kim, Hyun Joo Song, Jin Woong Cho, Sam Ryong Jee, Hyun Lim, Yong Hwan Kwon, Ju Yup Lee, Seong Woo Jeon, Seon-Young Park, Younghee Choe, Moon Kyung Joo, Dae-Hyun Kim, Jae Myung Park, Beom Jin Kim, Jong Yeul Lee, Tae Hoon Oh, Jae Gyu Kim","doi":"10.5009/gnl240489","DOIUrl":"10.5009/gnl240489","url":null,"abstract":"<p><strong>Background/aims: </strong>The Korean guidelines for <i>Helicobacter pylori</i> treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of <i>H. pylori</i> infection in Korea.</p><p><strong>Methods: </strong>This interim report describes the adherence to the revised guidelines and their impact on first-line eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form.</p><p><strong>Results: </strong>A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed. The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001).</p><p><strong>Conclusions: </strong>The revised guidelines for the treatment of <i>H. pylori</i> infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"19 3","pages":"364-375"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}