Hepatology International最新文献

{"title":"Hepatic irAEs, ICI continuation, and survival: methodological perspectives and future directions.","authors":"Huiying Yang, Xingxing Yao, Chan Chen","doi":"10.1007/s12072-025-11008-w","DOIUrl":"10.1007/s12072-025-11008-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1248-1249"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165073","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":"Assessing pricing and affordability of HBV treatment in Japan.","authors":"Maito Suoh, Saeed Esmaili, Mohammed Eslam, Jacob George","doi":"10.1007/s12072-026-11061-z","DOIUrl":"10.1007/s12072-026-11061-z","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1198-1201"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321517","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":"Tolvaptan for hyponatremia in patients with cirrhosis: a post hoc subgroup analysis of a multicenter, randomized, double-blind, placebo-controlled trial.","authors":"Yu Wang, Huifen Wang, Jun Cheng, Weijiang Ye, Huiguo Ding, Cunliang Deng, Guiqiang Wang, Haihang Zhu, Chengwei Chen, Guozhong Gong, Dazhi Zhang, Qing Xie, Mobin Wan, Xiong Cai, Jun Li, Qing Mao, Yongping Chen, Junqi Niu, Hao Wang, Yiming Mao, Yuwang Tian, Mingji Xian, Yuanyuan Kong, Hong Ma, Xiaojuan Ou, Jidong Jia","doi":"10.1007/s12072-026-11093-5","DOIUrl":"10.1007/s12072-026-11093-5","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to investigate the efficacy and safety of oral tolvaptan for hyponatremia in patients with cirrhosis in China.</p><p><strong>Patients and methods: </strong>In this post hoc subgroup analysis of a phase 2 clinical trial of oral tolvaptan for hyponatremia due to cirrhosis, heart failure, and syndrome of inappropriate antidiuretic hormone secretion in China, patients with hyponatremia due to cirrhosis received placebo or tolvaptan for 7 days (15 mg titrated to 30 or 60 mg/day). The primary endpoint was the average daily change in serum sodium level from baseline to days 4 and 7.</p><p><strong>Results: </strong>We enrolled 131 patients (90 males, 41 females) with cirrhosis mainly due to CHB (70.2%). Compared with placebo (N = 65), the tolvaptan group (N = 66) showed a significantly greater daily increase in serum sodium from baseline through day 4 (3.99 ± 2.70 vs. 0.32 ± 2.45 mmol/L; p < 0.0001) and 7 (4.72 ± 2.94 vs. 0.67 ± 3.05 mmol/L; p < 0.0001). The time to normalization of serum sodium levels was significantly shorter in the tolvaptan group (p < 0.0001). The serum sodium normalization rates on days 4 and 7 in the tolvaptan group were 59.09% and 68.18%, respectively, versus 18.46% and 24.62% in placebo (p < 0.0001). Seven days after tolvaptan cessation, the serum sodium levels were comparable to the placebo group. Tolvaptan was generally well tolerated, and the most common adverse events were dry mouth and thirst.</p><p><strong>Conclusions: </strong>This study demonstrates that short-term oral tolvaptan is effective and safe for hyponatremia in patients with cirrhosis in China.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1138-1149"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054352","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":"Clinical trial endpoints for metabolic dysfunction and alcohol associated steatotic liver disease.","authors":"Chencheng Xie, Mohamed A Elfeki, Winston Dunn, Ashwani K Singal","doi":"10.1007/s12072-026-11096-2","DOIUrl":"10.1007/s12072-026-11096-2","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction and alcohol-associated steatotic liver disease (MetALD) has emerged as a new subtype of steatotic liver disease, and presents a substantial challenge in clinical trial design due to a lack of data and consensus on endpoint selection.</p><p><strong>Objective: </strong>This review proposes patient selection, stratification, and optimization in Phase II and III clinical trial designs for MetALD and provides reasonable stage-specific clinical trial endpoints. It provides a comprehensive review of data on non-invasive tests (NITs) and trial endpoints in metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease, and extrapolates these data to MetALD.</p><p><strong>Results: </strong>The design of effective MetALD trials necessitates rigorous stratification by fibrosis stage and drinking patterns. In pre-cirrhotic MetALD, NITs, including vibration-controlled transient elastography, magnetic resonance elastography, and magnetic resonance imaging-proton density fat fraction, are reliable surrogate endpoints, with each modality-specific cut-off set to meet clinical improvement targets. For patients with compensated or decompensated cirrhosis, the emphasis shifts to hard clinical outcomes, such as transplant-free survival, overall survival, and prevention of major adverse liver events in phase III clinical trials. Additionally, integrating alcohol-reduction endpoints and comprehensive cardiometabolic endpoints is essential to capture the full impact of interventions in clinical trials.</p><p><strong>Conclusion: </strong>The MetALD clinical trials require strategic design, the adoption of the NITs shift concept, and stage- and phase-specific endpoints.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1020-1034"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972122","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":"Plasma metabolic signatures of healthy dietary patterns and risk of metabolic dysfunction-associated steatotic liver disease and cirrhosis.","authors":"Shijia Wang, Yingxin Liao, Zhijun Xue, Yuxiang Huang, Chao Yu, Xuechen Chen, Qiaoqiao Yang, Peiting Zhang, Mengyu Zhou, Yuqing Deng, Wenhua Ling, Xu Chen, Hongliang Xue","doi":"10.1007/s12072-026-11121-4","DOIUrl":"10.1007/s12072-026-11121-4","url":null,"abstract":"<p><strong>Background: </strong>The underlying mechanisms of the associations between dietary patterns and liver disease remain unclear. We aimed to identify metabolic signatures (MSs) reflecting adherence to ten healthy dietary patterns and to investigate their associations with metabolic dysfunction-associated steatotic liver disease (MASLD) and cirrhosis.</p><p><strong>Methods: </strong>This cohort study included 82,259 participants with detailed dietary and metabolomic data. MSs for each dietary pattern were derived using elastic-net regression. Cox proportional hazards regression, Mendelian randomization, and mediation analyses were employed to explore potential associations and mechanisms.</p><p><strong>Results: </strong>MSs for ten healthy dietary patterns were derived from 31 to 116 metabolites, primarily comprising fatty acids, lipids, and lipoprotein subclasses. Across all patterns, MSs were consistently associated with a lower risk of MASLD, with hazard ratios (HRs) ranging from 0.59 to 0.76. Notably, MSs for MIND, HPDI, rE-DII, and HLCD were associated with reduced cirrhosis risk (HRs: 0.56 to 0.63). Mendelian randomization analysis supported a potential causal relationship between MSs of MED, MIND, HPDI, and EAT-Lancet diets and liver diseases. Mediation analysis revealed that specific MSs accounted for 20.1% to 29.4% of the association between dietary patterns and MASLD, and 25.7% to 27.4% of that with cirrhosis. Metabolites from fatty acid metabolism and lipoprotein subclasses were significantly linked to liver diseases, and substantial mediated effects were observed across these metabolic pathways.</p><p><strong>Conclusions: </strong>Specific MSs linked to healthy dietary patterns are associated with reduced risk of liver disease, potentially underlying the diet's protective mechanism against MASLD and guiding future dietary guidelines in preventing progressive liver disease.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1058-1072"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing risk attribution in diabetes-associated mortality among patients with alcohol-related ACLF.","authors":"Hui-Chin Chang, Shuo-Yan Gau","doi":"10.1007/s12072-025-10985-2","DOIUrl":"10.1007/s12072-025-10985-2","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1213-1214"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707938","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":"Comments on \"Three‑year overall survival in unresectable hepatocellular carcinoma treated with atezolizumab plus bevacizumab\".","authors":"Qiang Zhang, Gang Tian","doi":"10.1007/s12072-025-10991-4","DOIUrl":"10.1007/s12072-025-10991-4","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1196-1197"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714042","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":"Comment on \"Diabetes mellitus is linked to higher mortality in alcohol‑related acute‑on‑chronic liver failure\".","authors":"Zhiqiang Zhu, Chunlei Zhang","doi":"10.1007/s12072-025-11003-1","DOIUrl":"10.1007/s12072-025-11003-1","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1223-1224"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804283","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":"Revisiting MASLD-based pregnancy risk stratification: a critical appraisal of Jung et al.'s nationwide cohort study.","authors":"Jianfeng Luo","doi":"10.1007/s12072-025-11006-y","DOIUrl":"10.1007/s12072-025-11006-y","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1244-1245"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896490","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 of tirzepatide versus SGLT2 inhibitors in metabolic dysfunction-associated steatotic liver disease (MASLD): a multicenter propensity-matched real-world study.","authors":"Ibrahim Khalil, Pallab Sarker, Nabila Nur, Md Imran Hossain, Aizaz Anwar Khalid, Sajjad Ghanim Al-Badri, Mst Mahmuda Akter, Manisha Das, Mohd Turzo Rahman","doi":"10.1007/s12072-026-11122-3","DOIUrl":"10.1007/s12072-026-11122-3","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent condition with significant cardiometabolic and hepatic risks. Tirzepatide, a dual GLP-1/GIP receptor agonist, shows promise in MASLD, but real-world comparative data against sodium-glucose cotransporter-2 inhibitors (SGLT2is) are lacking.</p><p><strong>Methods: </strong>In this multicenter, retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Network, we compared outcomes in 43,743 new tirzepatide initiators versus 43,743 matched SGLT2i users with MASLD and ≥ 1 metabolic comorbidity. Propensity Score Matching (1:1, caliper 0.1) balanced > 50 covariates. Primary outcomes included all-cause mortality, hospitalization, major adverse cardiovascular events (MACE), major adverse liver outcomes (MALO), and major adverse kidney events (MAKE) at 1- and 3-year follow-up, analyzed via Kaplan-Meier estimation and Cox proportional hazards models.</p><p><strong>Results: </strong>Tirzepatide was associated with significantly lower risks versus SGLT2is. At 1-year follow-up (n = 43,743 per group), all-cause mortality events were 144 (cumulative incidence 0.48%, KM event-free survival 99.52%) with tirzepatide versus 533 (1.38%, 98.62%) with SGLT2i (HR 0.328, 95% CI 0.272-0.394; log-rank p < 0.0001). All-cause hospitalization occurred in 3033 versus 7143 (HR 0.460, 95% CI 0.441-0.480). MACE events were 1064 versus 2376 (HR 0.506, 95%CI 0.471-0.544). MALO events were 149 versus 465 (HR 0.379, 95% CI 0.315-0.456). Hepatic failure and ascites also favored tirzepatide, while MAKE, varices, and hepatic encephalopathy showed no significant differences. Benefits persisted at 3 years (n = 39,838 per group): mortality 208 versus 963 (HR 0.374, 95% CI 0.321-0.436); hospitalization 3723 versus 9548 (HR 0.528, 95%CI 0.508-0.549); MACE 1260 versus 3282 (HR 0.545, 95%CI 0.510-0.582); and MALO 220 versus 726 (HR 0.478, 95%CI 0.410-0.558).</p><p><strong>Conclusions: </strong>In this large real-world MASLD cohort, tirzepatide was associated with substantial reductions in mortality, hospitalizations, cardiovascular, and liver-related events compared to SGLT2is. These observational findings suggest potential advantages of tirzepatide and warrant prospective validation in randomized trials.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1095-1115"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375310","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}