Gut and Liver最新文献

{"title":"Comparing the Efficacy and Safety of Fexuprazan and Lansoprazole for the Prevention of Nonsteroidal Anti-inflammatory Drug-Induced Peptic Ulcer.","authors":"Seokchan Hong, Ji Hyeon Ju, Sang-Heon Lee, Seung-Jae Hong, Sang-Hyon Kim, Ga Young Ahn, Jae Hyun Jung, Jin-Wuk Hur, You-Jung Ha, Jin Kyun Park, Hyun-Sook Kim, Sung Won Lee, Yong-Beom Park, Mie Jin Lim, Yun Sung Kim, Jung Soo Song, Chan-Bum Choi, Seong-Ho Kim, In Ah Choi, Kee Don Choi, Tae Hee Lee, Young Sin Cho, Yong Chan Lee, Kye Sook Kwon, Hyejung Lee, Mihee Park, Junga Heo, Song Baek, Chang-Keun Lee","doi":"10.5009/gnl250019","DOIUrl":"https://doi.org/10.5009/gnl250019","url":null,"abstract":"<p><strong>Background/aims: </strong>To compare the efficacy and safety of fexuprazan and lansoprazole for preventing peptic ulcers (PUs) induced by nonsteroidal anti-inflammatory drugs (NSAIDs).</p><p><strong>Methods: </strong>This multicenter, double-blind, randomized, active-controlled study was conducted across 32 hospitals in South Korea. Patients with musculoskeletal disease requiring long-term treatment with celecoxib, naproxen, or meloxicam were randomized to receive either fexuprazan 20 mg/day (n=212) or lansoprazole 15 mg/day (n=211) for 24 weeks. The primary endpoint was the occurrence of PUs, which were confirmed via esophagogastroduodenoscopy (EGD), with a non-inferiority margin of 8.3%. Only ulcers that developed during the treatment period were examined in the analysis. The occurrence of gastroduodenal bleeding was also monitored via EGD, and symptoms were assessed by using the Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM). Adverse events were recorded during the study.</p><p><strong>Results: </strong>The incidence rate of EGD-confirmed PUs at week 24 was 1.16% in the fexuprazan group and 2.76% in the lansoprazole group, with a between-group difference of -1.64% (95% confidence interval, -4.52% to 1.25%), demonstrating non-inferiority. No patients presented with gastroduodenal bleeding. No significant between-group differences were found in the PAGI-SYM scores (leastsquare mean difference in the total score at week 24, -0.42; 95% confidence interval, -2.48 to 1.64; p=0.69). There were low rates of adverse drug reactions in the fexuprazan and lansoprazole groups (8.57% vs 4.78%, respectively p=0.12).</p><p><strong>Conclusions: </strong>Given its non-inferiority to lansoprazole and similar safety profile, fexuprazan is a promising alternative for the prevention of NSAID-induced PUs (ClinicalTrials.gov identifier NCT04784910).</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495887","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":"Surveillance and Surgical Salvage Treatment for Endoscopically Removed T1 Colorectal Cancers.","authors":"Hiroyuki Takamaru, Cynthia Tsay, Yutaka Saito","doi":"10.5009/gnl240460","DOIUrl":"10.5009/gnl240460","url":null,"abstract":"<p><p>Endoscopic submucosal dissection (ESD) enables en-bloc resection of large lesions more than 20 mm in size. Therefore, the use of ESD has gained broader acceptance for clinical applications globally. Previous reports on long-term outcomes after ESD, when followed by additional surgery, have also reported favorable results, positioning ESD as a crucial tool in providing minimally invasive treatment for T1 colorectal cancer (CRC). However, a lack of clear evidence regarding optimal surveillance strategies for T1 CRC following endoscopic treatments such as ESD remains. In some cases of T1 CRC, the need for additional surgery to address the risk of lymph node metastasis (LNM) remains a significant concern in daily practice. This narrative review aimed to examine the evidence on surveillance and additional surgery following the endoscopic treatment of T1 CRC by evaluating the criteria for intervention and associated risk factors. In cases where there are no unfavorable pathological features or risk factors for LNM, the risk of LNM is extremely low, and endoscopic techniques alone are typically sufficient in achieving curative resection for these patients. However, when risk factors for LNM are present, additional surgery should be considered. Several current guidelines recommend determining whether to pursue additional surgery or surveillance based on these risk factors, which must be carefully assessed according to individual patient conditions. Further studies are required to clarify the long-term prognosis, risk of lymph node or distant metastasis, and appropriate surveillance strategies, which may include salvage treatment such as additional surgery.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333009","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":"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}