Hepatology International最新文献

{"title":"The dynamic patterns of metabolic-associated fatty liver disease and its severity and risk of cardiovascular disease.","authors":"Haozhe Cui, Yongliang Chen, Zhiming Zhao","doi":"10.1007/s12072-024-10745-8","DOIUrl":"https://doi.org/10.1007/s12072-024-10745-8","url":null,"abstract":"<p><strong>Background: </strong>While metabolic-associated fatty liver disease (MAFLD) is widely recognized as a risk factor for cardiovascular disease (CVD), the connection between the dynamic patterns of severity of hepatic steatosis and the associated CVD risk remains uncertain.</p><p><strong>Method: </strong>This study included 71,098 participants from the Kailuan Study without CVD or cancer who underwent two consecutive biennial health screenings between 2006 and 2008 and were followed up until 2022. MAFLD and its severity were assessed using ultrasound. Participants were categorized into four groups based on dynamic MAFLD patterns: MAFLD-free, MAFLD-progression, MAFLD-regression, and MAFLD-persistence. MAFLD-regression was further divided into regression from mild MAFLD and regression from moderate/severe MAFLD. Cox proportional hazard regression models analyzed the association between the progression and regression of MAFLD and CVD risk.</p><p><strong>Result: </strong>After a mean follow-up of 12.63 ± 3.16 years, 7838 individuals experienced incident CVD, 5374 had strokes, 1321 had myocardial infarctions, and 1819 developed heart failure. After adjusting for potential confounders, MAFLD-progression was associated with a higher CVD risk compared to MAFLD-free (HR 1.25, 95% CI 1.17-1.33), but this risk decreased with increasing age. Individuals with MAFLD-persistence had the highest CVD risk (HR 1.54, 95% CI 1.46-1.62). Compared to persistent MAFLD, regression from mild MAFLD was associated with a lower CVD risk (HR 0.83, 95% CI 0.76-0.91).</p><p><strong>Conclusion: </strong>The progression of MAFLD can increase the risk of CVD, while regression of MAFLD can decrease the risk of CVD. These findings suggest that the dynamic patterns of MAFLD significantly influence CVD risk.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of durvalumab rechallenge in advanced hepatocellular carcinoma patients refractory to prior anti-PD-1 therapy.","authors":"Kuan-Chang Lai, Yen-Hao Chen, Yi-Ping Hung, Nai-Jung Chiang, Ming-Huang Chen, San-Chi Chen","doi":"10.1007/s12072-024-10728-9","DOIUrl":"https://doi.org/10.1007/s12072-024-10728-9","url":null,"abstract":"<p><strong>Background/purpose: </strong>Recently, anti-programmed cell death protein-1 (anti-PD-1) and anti-PD-L1 therapies were approved for hepatocellular carcinoma (HCC). However, the effectiveness of rechallenging with one immune checkpoint inhibitor (ICI) after failure of another remains unclear. This study explores the efficacy and safety of anti-PD-L1 rechallenge in patients who failed anti-PD-1 therapy.</p><p><strong>Methods: </strong>From January 2016 to December 2023, 65 advanced HCC patients previously treated with anti-PD-1 therapy were retrospectively enrolled and rechallenged with durvalumab (480 mg IV every 2 weeks).</p><p><strong>Results: </strong>Overall, 86.2% of patients received nivolumab and 13.8% pembrolizumab as prior anti-PD-1 therapy. The overall response rate (ORR) to durvalumab was 13.8%. Patients who responded to prior anti-PD-1 had a higher ORR compared to non-responders (31.3% vs. 8.7%, p = 0.04). Patients with any grade of immune-related adverse events (irAEs) from durvalumab had a higher ORR than those without irAEs (35.3% vs. 6.7%, p = 0.01). The median PFS was 5.4 months, and the median OS was 9.6 months. Responders to prior anti-PD-1 showed longer OS (33.9 vs. 8.2 months, p < 0.01) and a trend toward longer PFS (13.8 vs. 4.9 months, p = 0.07) compared to non-responders. Multivariate analysis identified prior anti-PD-1 response (HR: 0.31) as the only protective factor for death. Common irAEs were skin toxicity (13.8%) and hepatitis (7.7%); no correlation was found between irAEs from prior anti-PD-1 and durvalumab treatment.</p><p><strong>Conclusion: </strong>This study provides the first, concrete evidence that durvalumab rechallenge is effective for HCC patients who are refractory to anti-PD-1 therapy, especially for those who previously responded to anti-PD-1 treatment.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"APASL clinical practice guidelines on systemic therapy for hepatocellular carcinoma-2024.","authors":"George Lau, Shuntaro Obi, Jian Zhou, Ryosuke Tateishi, Shukui Qin, Haitao Zhao, Motoyuki Otsuka, Sadahisa Ogasawara, Jacob George, Pierce K H Chow, Jianqiang Cai, Shuichiro Shiina, Naoya Kato, Osamu Yokosuka, Kyoko Oura, Thomas Yau, Stephen L Chan, Ming Kuang, Yoshiyuki Ueno, Minshan Chen, Ann-Lii Cheng, Gregory Cheng, Wan-Long Chuang, Oidov Baatarkhuu, Feng Bi, Yock Young Dan, Rino A Gani, Atsushi Tanaka, Wasim Jafri, Ji-Dong Jia, Jia-Horng Kao, Kiyoshi Hasegawa, Patrick Lau, Jeong Min Lee, Jun Liang, Zhenwen Liu, Yinying Lu, Hongming Pan, Diana A Payawal, Salimur Rahman, Jinsil Seong, Feng Shen, Gamal Shiha, Tianqiang Song, Hui-Chuan Sun, Tsutomu Masaki, Ekaphop Sirachainan, Lai Wei, Jin Mo Yang, Jose D Sallano, Yanqiao Zhang, Tawesak Tanwandee, AKadir Dokmeci, Shu-Sen Zheng, Jia Fan, Sheung-Tat Fan, Shiv Kumar Sarin, Masao Omata","doi":"10.1007/s12072-024-10732-z","DOIUrl":"https://doi.org/10.1007/s12072-024-10732-z","url":null,"abstract":"<p><p>In Asia-Pacific region, hepatocellular carcinoma is a serious health threat attributing to over 600,000 deaths each year and account for over 70% of global cases. Clinically, the major unmet needs are recurrence after curative-intent surgery, liver transplantation or local ablation and disease progression in those with hepatocellular carcinoma not eligible for resection or failed locoregional therapy. In the recent few years, new targeted therapy and immune-checkpoint inhibitors have been registered as systemic therapy to address these issues. Notably, new forms of systemic therapy, either as first-line or second-line therapy for unresectable hepatocellular or those not eligible for locoregional therapy, are now available. New data is also emerging with the use of systemic therapy to prevent hepatocellular carcinoma recurrence after curative-intent resection or local ablation therapy and to retard disease progression after locoregional therapy. In the future, further implementation of immune-checkpoint inhibitors and other forms of immunotherapy are expected to bring a new paradigm to the management of hepatocellular carcinoma. New insight related to immune-related adverse events with the use of immunotherapy has allso enabled optimization of the therapeutic approach to patients with hepatocellular carcinoma. The purpose of this clinical practice guideline is to provide an up-to-date recommendation based on clinical evidence and experience from expert Asia-Pacific key opinion leaders in the field of hepatocellular carcinoma. Three key questions will be addressed, namely: (1) Which patients with hepatocellular carcinoma should be considered for systemic therapy? (2) Which systemic therapy should be used? (3) How should a patient planned for immune checkpoint-based systemic therapy be managed and monitored?</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rechallenge with immune checkpoint inhibitors therapy for patients with HCC-lot more to learn.","authors":"George Lau","doi":"10.1007/s12072-024-10751-w","DOIUrl":"https://doi.org/10.1007/s12072-024-10751-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-cirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and management.","authors":"Akash Shukla, Don C Rockey, Patrick S Kamath, David E Kleiner, Ankita Singh, Arun Vaidya, Abraham Koshy, Ashish Goel, A Kadir Dökmeci, Babulal Meena, Cyriac Abby Philips, Chhagan Bihari Sharma, Diana A Payawal, Dong Joon Kim, Gin-Ho Lo, Guohong Han, Huma Qureshi, Ian R Wanless, Jidong Jia, Jose D Sollano, Mamun Al Mahtab, Mark Dhinesh Muthiah, Mark W Sonderup, Mendez Sanchez Nahum, Mohamed Ismail Bin Merican, Necati Ormeci, Norifumi Kawada, Rajender Reddy, R K Dhiman, Rino Gani, Saeed S Hameed, Sidharth Harindranath, Wasim Jafri, Xiaolong Qi, Yogesh Kumar Chawla, Yoshihiro Furuichi, Ming-Hua Zheng, Shiv Kumar Sarin","doi":"10.1007/s12072-024-10739-6","DOIUrl":"https://doi.org/10.1007/s12072-024-10739-6","url":null,"abstract":"<p><p>Since the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy. An international working group with extensive expertise in portal hypertension was assigned with formulating consensus guidelines to clarify the definition, diagnosis, histological features, natural history, and management of NCPF/IPH, especially in the context of PSVD. The guidelines were prepared based on evidence from existing published literature. Whenever there was paucity of evidence, expert opinion was included after detailed deliberation. The goal of this manuscript, therefore, is to enhance the current understanding and help create global consensus on the issues surrounding NCPF/IPH.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In response to \"Key considerations in portal vein thrombosis management\".","authors":"Patrick Northup, Abraham Cheloff, Luke Bonanni, Joshua Kirschenbaum, Naveena Luke, Jenny Engelman, Joshua Ross, Gabriel Fuligni","doi":"10.1007/s12072-024-10747-6","DOIUrl":"https://doi.org/10.1007/s12072-024-10747-6","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive genomic profiling for advanced hepatocellular carcinoma in clinical practice.","authors":"Takeshi Terashima, Tatsuya Yamashita, Kuniaki Arai, Noboru Takata, Tomoyuki Hayashi, Akihiro Seki, Hidetoshi Nakagawa, Kouki Nio, Noriho Iida, Shinya Yamada, Tetsuro Shimakami, Hajime Takatori, Kunihiro Tsuji, Hajime Sunagozaka, Eishiro Mizukoshi, Masao Honda, Shinji Takeuchi, Taro Yamashita","doi":"10.1007/s12072-024-10741-y","DOIUrl":"https://doi.org/10.1007/s12072-024-10741-y","url":null,"abstract":"<p><strong>Aim: </strong>Although several therapeutic agents show efficacy in advanced hepatocellular carcinoma (HCC), biomarkers such as comprehensive genomic profiling (CGP) for the selection of second-line treatments after immunotherapy have not been established. We evaluated the value of CGP for the treatment decision in patients with HCC.</p><p><strong>Methods: </strong>We retrospectively studied 52 patients with advanced HCC who received CGP tests at three tertiary hospitals between February 2022 and November 2023. Genomic profiles were obtained using one of three CGP tests; 49 and 3 patients were evaluated using tissue-based and blood-based assay, respectively. The impact of CGP results on subsequent treatment selection in clinical practice and correlations between representative gene alterations and patient characteristics or responses to immunotherapy were evaluated.</p><p><strong>Results: </strong>The most frequently observed variants were TERT mutations, followed by CTNNB1, TP53, ARID1A, and MYC mutations. Potentially druggable gene alterations were observed in 45 patients (87%), and 34 patients (65%) were recommended to receive treatments based on specific gene alterations by a molecular tumor board. Treatments were covered by health insurance in 13 patients (25%). Five patients (10%) received the recommended treatment by the date of data cut-off. There were no differences in the efficacy of immunotherapy with respect to mutation status in hTERT, CTNNB1, TP53, ARID1A, and MYC.</p><p><strong>Conclusions: </strong>The results of the present study suggested that druggable gene alterations may provide useful information not only in proposing alternative treatment after standard of care but also in selecting second-line targeted treatments after immunotherapy for patients with advanced HCC.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key considerations in portal vein thrombosis management.","authors":"Jianyu Lv, Chengfei Du, Junbin Yan","doi":"10.1007/s12072-024-10746-7","DOIUrl":"https://doi.org/10.1007/s12072-024-10746-7","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the evaluation and management of MAFLD: a call for comprehensive assessments and social work integration.","authors":"Han Wang, Huanhuan Feng, Wenchao Zhou","doi":"10.1007/s12072-024-10735-w","DOIUrl":"https://doi.org/10.1007/s12072-024-10735-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal threshold of portal pressure gradient for patients with ascites after covered TIPS: a multicentre cohort study.","authors":"Yifu Xia, Jun Tie, Guangchuan Wang, Hao Wu, Yuzheng Zhuge, Xulong Yuan, Guangjun Huang, Zhen Li, Linhao Zhang, Zihao Cai, Chengwei Tang, Chunqing Zhang","doi":"10.1007/s12072-024-10742-x","DOIUrl":"https://doi.org/10.1007/s12072-024-10742-x","url":null,"abstract":"<p><strong>Background: </strong>Transjugular intrahepatic portosystemic shunt (TIPS) is recommended for treating recurrent and refractory ascites. However, determining the target portal pressure gradient (PPG) has been inconclusive. This multicentre cohort study explored the post-TIPS PPG potential range associated with improving survival.</p><p><strong>Methods: </strong>The study enrolled 276 patients, all of whom underwent covered TIPS for ascites treatment across four medical centers. The cumulative incidences of clinical outcomes were compared among groups categorized by potential PPG thresholds.</p><p><strong>Results: </strong>During the whole follow-up period with a medium follow-up of 21.6 (7.5, 41.6) months, 122 (44.2%) experienced liver-related death, and 73 (26.4%) patients experienced a recurrence of ascites. Multivariable analysis revealed PPG < 7 mmHg (p = 0.007) and the recurrence of ascites (p = 0.033) are independent risk factors for survival, while the PPG ≥ 11 mmHg was an independent risk factor for the recurrence of ascites (p = 0.012). Patients with ≥ 7 mmHg had a lower rate of liver-related death than patients with post-TIPS PPG < 7 mmHg (51.0% vs 66.6%, p = 0.004), while those with post-TIPS PPG ≥ 11 mmHg exhibited a higher cumulative incidence of ascites compared to those with post-TIPS PPG < 11 mmHg (44.6% vs 33.7%, p = 0.023). The robustness of the results was confirmed.</p><p><strong>Conclusion: </strong>Our study highlighted the existence of an optimal post-TIPS PPG range in patients with recurrent and refractory ascites. Patients may experience improved survival and ascites control with a post-TIPS PPG of 7-11 mmHg.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}