Journal of clinical gastroenterology最新文献

{"title":"Metachronous Colorectal Neoplasia in Young Adults With Advanced Neoplasia Undergoing Colonoscopy: A Comparison of Risk by Age <45 Years Versus 45 to 49 Years.","authors":"Raj Jessica Thomas, Adel Hajj Ali, Jacquelyn Bolwell, Robert Butler, Carol A Burke, David Liska, Carole Macaron","doi":"10.1097/MCG.0000000000002072","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002072","url":null,"abstract":"<p><strong>Background: </strong>The risk of metachronous advanced colorectal neoplasia (mACRN) in young adults with advanced lesions at baseline colonoscopy is not well defined.</p><p><strong>Aims: </strong>To examine the risk for (mACRN) in adults <50 years old who had advanced neoplasia (AN) at baseline colonoscopy and determine factors associated with mACRN in these patients.</p><p><strong>Method: </strong>Patients 18 to 49 years of age with ≥1 AN [tubular adenoma (TA) ≥10 mm or with villous features or high-grade dysplasia (HGD), sessile serrated lesion (SSL) ≥10 mm or with dysplasia, traditional serrated adenoma (TSA)] on baseline colonoscopy between 2011 and 2021 who had surveillance colonoscopy >6 months after their baseline examination were included. Outcomes were assessed based on age at baseline colonoscopy, <45 years versus 45 to 49 years, and by follow-up colonoscopy findings: (1) normal, (2) nonadvanced neoplasia (NAN), and (3) AN.</p><p><strong>Results: </strong>Three hundred sixty-six patients with AN underwent ≥1 surveillance colonoscopy: 310 (84.7%) <45 years versus 56 (15.3%) 45 to 49 years. The mean follow-up time was longer for the <45-year-olds versus the 45 to 49-year-olds (43±26.4 vs. 28.4±12.8 mo respectively, P<0.001). The absolute risk of mACRN was 13.5% in the <45 age group versus 16.1% in the 45 to 49 age group, P=0.28. The 3-year cumulative incidence rates of mACRN were comparable for patients <45 and 45 to 49 years old: 10% (95% CI: 10% to 42%) versus 20% (95% CI: 7% to 15%), P=0.065. BMI was the only risk factor associated with mACRN OR 1.045 [95% CI (1.001 to 1.09)].</p><p><strong>Conclusions: </strong>In our cohort of patients <50 years old with AN at baseline, mACRN occurred at a similar rate to that reported by guidelines in 50 years and older, suggesting that current recommended post polypectomy surveillance is appropriate for this age group. BMI was independently associated with mACRN. Future studies should examine how weight management in patients with high BMI mitigates the recurrence of advanced neoplasia.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Sphingosine 1-Phosphate Receptor Modulators for Ulcerative Colitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Omar Mahmud, Asad Saulat Fatimi, Muhammad Umar Mahar, Arshia Jahangir, Aleena Kashif, Manzar Abbas, Akbar K Waljee, Jeffrey A Berinstein","doi":"10.1097/MCG.0000000000002027","DOIUrl":"10.1097/MCG.0000000000002027","url":null,"abstract":"<p><strong>Background and aims: </strong>Sphingosine 1-phosphate receptor modulators (S1PRMs) are an effective treatment for ulcerative colitis (UC). This review summarizes all available randomized trial data on the efficacy and safety of S1PRM therapy.</p><p><strong>Methods: </strong>Multiple publication databases were systematically searched for randomized control trials (RCTs) of adults with moderate to severe UC treated with S1PRMs. Random effects meta-analysis was performed. The risk of bias was assessed using the Cochrane Risk-of-Bias 2 tool, and the overall quality of evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>We identified 7 RCTs (1737 patients) involving the use of S1PRMs for moderate to severe UC. During induction, S1PRM therapy was efficacious when compared with placebo for clinical remission [RR: 2.65 (95% CI: 2.00, 3.53)], clinical response [RR: 1.68 (95% CI: 1.48, 1.91)], endoscopic improvement [RR: 2.17 (95% CI: 1.76, 2.68)], endoscopic normalization [RR: 2.56 (95% CI: 1.58, 3.83)], mucosal healing [RR: 2.88 (95% CI: 1.94, 4.26)], and histologic remission [RR: 2.42 (95% CI: 1.60, 3.66)]. Similar results were seen throughout the maintenance peroid, although fewer data were available to pool; notably, both sustained [RR: 3.57 (95% CI: 1.23, 10.35)] and steroid-free [RR: 2.92 (95% CI: 1.35, 6.33)] remission were significantly increased by S1PRM. There were no significant differences in adverse events [RR: 1.02 (95% CI: 0.90, 1.15)] and infections [RR: 1.15 (95% CI: 0.82, 1.60)] between S1PRM and placebo.</p><p><strong>Conclusion: </strong>Pooling of RCT data confirms that S1PRM therapy is both effective and safe for patients with moderate to severe UC.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":"58 8","pages":"753-763"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Vedolizumab and Tumor Necrosis Factor Inhibitors in the Treatment of Steroid-refractory Microscopic Colitis: A Systematic Review and Meta-analysis.","authors":"Nabil El Hage Chehade, Sara Ghoneim, Sagar Shah, Darrell S Pardi, Francis A Farraye, Fadi F Francis, Jana G Hashash","doi":"10.1097/MCG.0000000000001914","DOIUrl":"10.1097/MCG.0000000000001914","url":null,"abstract":"<p><strong>Background: </strong>Tumor necrosis factor (TNF-α) inhibitors and the α4β7 integrin antagonist, vedolizumab, have been investigated as treatment options for patients with steroid-refractory microscopic colitis.</p><p><strong>Aims: </strong>To evaluate the benefit of vedolizumab and TNF-α inhibitors in patients with steroid-refractory microscopic colitis.</p><p><strong>Methods: </strong>Retrospective studies and case series involving patients with steroid-refractory MC who either received vedolizumab, adalimumab, or infliximab were eligible for inclusion. Pooled proportional meta-analyses were used to calculate the rate of clinical remission at induction, clinical response, maintenance of remission, histologic remission, and overall medication related adverse effects. Statistical analysis was performed in R using the metafor and meta packages.</p><p><strong>Results: </strong>A total of 14 studies involving 164 patients were included. Pooled analysis showed a clinical remission rate of 63.5% [95% CI (0.483; 0.776), I 2 =43% P =0.08], 57.8% [95% CI (0.3895; 0.7571), I 2 =0%, P =0.7541], and 39.3% [95% CI (0.0814; 0.7492), I 2 =66%, P =0.02] for vedolizumab, infliximab, and adalimumab, respectively. The maintenance of remission rates were 65.9% [95% CI (0.389; 0.889), I 2 =67%, P =0.02], 45.3% [95% CI (0.1479; 0.7747), I 2 =0%, P =0.36] and 32.5% [95% CI (0.000; 0.8508), I 2 =53%, P =0.14] in patients who received vedolizumab, infliximab, and adalimumab, respectively. Rate of biological-related adverse events warranting discontinuation of therapy was 12.2%, 32.9%, and 23.0% for the vedolizumab, infliximab, and adalimumab groups, respectively.</p><p><strong>Conclusion: </strong>Vedolizumab and anti-TNF-α agents demonstrated a clinical benefit in the treatment of steroid-refractory microscopic colitis and with a tolerable safety profile. Future randomized controlled trials are needed to compare vedolizumab with TNF-α inhibitors and examine treatment effect on patients' quality of life.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"789-799"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10155809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Pancreatic Cyst Clinical Practice Guidelines.","authors":"Jason J John, Wojciech Blonski, Tea Reljic, Ambuj Kumar","doi":"10.1097/MCG.0000000000001939","DOIUrl":"10.1097/MCG.0000000000001939","url":null,"abstract":"<p><strong>Background: </strong>There are various published clinical practice guidelines (CPGs) for the management of pancreatic cystic lesions. However, the quality of these guidelines has not been systematically appraised. This study aimed to evaluate the quality of CPGs published in the last 5 years for the management of pancreatic cysts.</p><p><strong>Methods: </strong>A systematic search of the PubMed database for eligible CPGs published between January 1, 2016 and November 17, 2021, using a sensitive filter. The quality of the CPGs was independently evaluated using the Appraisal of Guidelines for Research & Evaluation II instrument, with domain scores considered sufficient quality if >60% and good quality if >80%.</p><p><strong>Results: </strong>The search yielded 4 eligible CPGs out of 426 citations. The scores varied for different domains for each CPG, with the overall median score being 79% for scope and purpose, 26% for stakeholder involvement, 51% for rigor of development, 69% for clarity of presentation, 14% for applicability, and 75% for editorial independence.</p><p><strong>Conclusions: </strong>The study revealed that the quality of the CPGs for pancreatic cyst management in adults remains moderate at best. Patient representatives were not involved in any of the CPG development process. There is a significant scope for improvement in methodological rigor and clarity of presentation.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"836-839"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diverticulosis, Adenomas, and Cancer in the Colon: A Systematic Review and Meta-Analysis of Endoscopic Studies.","authors":"Alessandro Del Forno, Angelo Zullo, Clelia Marmo, Riccardo Marmo, Raffaele Manta, Vincenzo De Francesco, Giulia Fiorini, Matteo Pavoni, Dino Vaira","doi":"10.1097/MCG.0000000000002046","DOIUrl":"10.1097/MCG.0000000000002046","url":null,"abstract":"<p><strong>Goals: </strong>To perform a systematic review and meta-analysis of endoscopic studies to evaluate an association between diverticulosis and neoplastic lesions in the colon.</p><p><strong>Background: </strong>Some epidemiological observations suggest an association between diverticulosis and adenoma/cancer in the colon. However, an increased risk of colon neoplastic lesions in diverticulosis subjects was found to be increased in some studies, but not in others, puzzling data interpretation.</p><p><strong>Study: </strong>From the retrieved studies, prevalence of adenomas, advanced adenomas, cancer or neoplasia (advanced adenoma or cancer) was compared between subjects with or without diverticulosis, and comparisons in subgroups were also performed.</p><p><strong>Results: </strong>Data of 26 studies with a total of 419,623 patients were eventually considered, including 27,092 patients with diverticulosis. Data analysis found a statistically significant association between diverticulosis and adenomas (OR: 1.88; 95% CI: 1.50-2.25), advanced adenomas (OR: 1.49; 95% CI: 1.02-2.16), and neoplasia (OR: 1.50; 95% CI: 1.11-2.02), but not with cancer alone (OR: 1.01; 95% CI: 0.70-1.47). These associations were confirmed in the subgroup analyses, by considering Caucasian and Asian populations, prospective and retrospective studies, screening or symptoms settings, and between good or fair quality studies.</p><p><strong>Conclusions: </strong>A statistically significant association between diverticulosis and adenomas, advanced adenomas and neoplasia, but not with cancer alone was found. However, the strength of association seems to be insufficient to impact on clinical practice.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"764-768"},"PeriodicalIF":2.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Colorectal Cancer Screening Reach Among United States Veterans: Analyzing Clinical, Sociodemographic, and Social Determinants of Health-Based Patient Factors Across Screening Methods: Analyzing Clinical, Sociodemographic, and Social Determinants of Health-based Patient Factors Across Screening Methods.","authors":"Kanika Malani, Kirsten Loscalzo, Yousef Elfanagely, Kittichai Promrat","doi":"10.1097/MCG.0000000000002065","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002065","url":null,"abstract":"<p><strong>Introduction: </strong>Mailed fecal immunochemical testing (mFIT), in-clinic FIT (cFIT), and colonoscopy are believed to reach distinct patient populations. This study aims to evaluate this belief.</p><p><strong>Methods: </strong>Sociodemographic, clinical, and social determinants of health (SDOH) characteristics of 201 patients completing mFIT, 203 patients completing cFIT, and 74 patients completing colonoscopy at a Northeastern United States Veterans Affairs center from August 2023 to January 2024 were compared using descriptive statistics, χ2, and ANOVA tests.</p><p><strong>Results: </strong>Patients completing mFIT (P=0.003) and cFIT (P=0.001) were older than those completing colonoscopy. mFIT patients had more private health insurance as compared with cFIT (P<0.0001) patients. Patients completing colonoscopy had higher average disability ratings as compared with cFIT patients (P<0.0001). mFIT (P<0.0001) and colonoscopy (P<0.0001) patients had more time elapsed since their last primary care visit as compared with cFIT patients. mFIT patients had lower rates of mental health disorders as compared with colonoscopy (P<0.0001) and cFIT (P<0.0001) patients. cFIT patients had higher rates of past stool test use as compared with mFIT (P<0.0001) and colonoscopy (P<0.0001) patients. mFIT patients had lower rates of past colonoscopy completion as compared with cFIT (P<0.0001) and colonoscopy (P<0.0001) patients. There were no significant differences in SDOH domains among patients completing each of the screening methods.</p><p><strong>Conclusion: </strong>While each of the screening methods reaches a different patient population, mFIT does not reach a substantially more vulnerable population compared with cFIT and colonoscopy, highlighting the need for improvements in mFIT outreach.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between the Inflammatory Potential of Diet and Constipation Among Adults in the United States: A Cross-sectional Study.","authors":"Wang Feng Lu, Lei Liu, Yong Hong Zhang, Huanxian Liu","doi":"10.1097/MCG.0000000000002060","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002060","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential association between Dietary Inflammatory Index (DII) scores and constipation among a sample of adults in the United States.</p><p><strong>Methods: </strong>This cross-sectional study used data from adult participants in the 2005 to 2010 National Health and Nutrition Examination Survey (ie, \"NHANES\"). Self-reported information was used to identify cases of constipation. The DII was used to assess inflammatory potential of the diet. Odds ratios (ORs) and corresponding 95% CIs for the association between the DII and constipation were determined using multivariate logistic regression modeling. Stratified analyses explored whether there was effect modification to influence the relationship between DII and constipation.</p><p><strong>Results: </strong>Of 8272 subjects, 759 reported constipation, and 7513 did not, corresponding to a prevalence of 9.2%. After adjusting for age, gender, race/ethnicity, marital status, education level, smoking status, alcohol consumption, physical activity, body mass index (BMI), cardiovascular diseases (CVD), hypertension, stroke, diabetes, energy intake, carbohydrate intake, and selective serotonin reuptake inhibitor (SSRI) use. Compared with lower DII scores group T1 (-5.28 to ≤0.72), the adjusted OR values for DII scores and constipation in T2 (>0.72 to ≤2.50) and T3 (>2.50 to 5.24) were 1.27 (95% CI: 1.02-1.58, P=0.029) and 1.43(95% CI: 1.14-1.8, P=0.002). Subgroup analyses showed that there were effect modification of gender and physical activity factors on DII scores and constipation.</p><p><strong>Conclusions: </strong>Results of this cross-sectional study suggest that a higher dietary inflammatory index score was associated with increased risk of constipation after adjustment for confounding in a multivariable analysis. gender and physical activity were found to be an effect modifier of this relationship.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Dysfunction-associated Steatotic Liver Disease is Becoming the Leading Driver of the Burden of Cirrhosis in China: Results From the Global Burden of Disease Study 2019.","authors":"Rui Li, Hang Li, Xujun Ye, Juanjuan Qin","doi":"10.1097/MCG.0000000000002055","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002055","url":null,"abstract":"<p><strong>Objective: </strong>Cirrhosis and other chronic liver diseases (generally referred to as cirrhosis in this article) are major causes of morbidity and mortality in China. The disease pattern of cirrhosis caused by different etiologies has been changing due to economic development and changes in lifestyle.</p><p><strong>Methods: </strong>Prevalence, incidence, disability-adjusted life-years, and mortality data were retrieved from the Global Burden of Disease study, 2019. Estimated annual percentage change was used to quantify the trends in the age-standardized prevalence rate and prevalence number of cirrhosis from 1990 to 2019. We presented the results for five causes of cirrhosis, and for different age and sex groups.</p><p><strong>Results: </strong>Nationwide, we found that the prevalence number of liver cirrhosis increased steadily (from 3025.3×105 to 4279.8×105) from 1990 to 2019. Notably, the age-standardized prevalence rate of cirrhosis caused by metabolic dysfunction-associated steatotic liver disease (MASLD) increased throughout the study period, and MASLD has exceeded the hepatitis B virus and become the leading cause of liver cirrhosis since 1992. The highest prevalence number of MASLD occurred in the young population aged between 15 to 49 years.</p><p><strong>Conclusion: </strong>The prevalence of liver cirrhosis caused by hepatitis B virus decreased, whereas the prevalence of liver cirrhosis caused by MASLD increased. MASLD has become the leading cause of liver cirrhosis in China. The prevalence of liver cirrhosis increased most significantly in the young age group compared with the other age group. Preventive strategies targeting MASLD would be necessary to reduce the disease burden of cirrhosis in China, especially in the young aged generation.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world Clinical Effectiveness and Safety of Vedolizumab and Adalimumab in Biologic-naive Patients With Crohn's Disease: Results From the EVOLVE Study.","authors":"Andres J Yarur, Brian Bressler, Neil R Brett, Marielle Bassel, Shashi Adsul, Pravin Kamble, Gerassimos J Mantzaris","doi":"10.1097/MCG.0000000000002056","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002056","url":null,"abstract":"<p><strong>Goals: </strong>This study evaluated the real-world effectiveness and safety of vedolizumab versus adalimumab over 12 months of treatment in biologic-naive patients with Crohn's disease (CD), using data from the EVOLVE study.</p><p><strong>Background: </strong>A comparison of vedolizumab and adalimumab may help to better position them in the therapeutic algorithm for moderate-to-severe CD.</p><p><strong>Study: </strong>Data were collected from medical records of patients with CD aged ≥18 years initiating treatment with adalimumab or vedolizumab between May 2014 and July 2017. Adjusted analyses were performed using inverse probability weighting to account for differences in baseline characteristics. Cumulative rates for clinical effectiveness outcomes and treatment persistence were estimated using Kaplan-Meier analyses. Disease-related exacerbations, serious adverse events (SAEs), and serious infections (SIs) were also assessed.</p><p><strong>Results: </strong>Data from 218 vedolizumab- and 144 adalimumab-treated patients were analyzed. Adjusted cumulative rates of clinical remission were greater with vedolizumab than with adalimumab (66.3% vs. 46.4%; P=0.006). Probability of treatment persistence was higher with vedolizumab (89.3% vs. 77.5%; P=0.024); probabilities of clinical response (68.5% vs. 61.1%; P=0.586) and mucosal healing (67.7% vs. 56.0%; P=0.562) were similar. SAEs were less likely to occur with vedolizumab [hazard ratio, 0.45 (95% confidence interval, 0.22-0.93)]; however, the likelihood of SIs [0.27 (0.06-1.20)], CD exacerbations [0.91 (0.56-1.47)], and CD-related surgeries [1.55 (0.21-11.15)] was comparable between the 2 groups.</p><p><strong>Conclusions: </strong>In a real-world setting, biologic-naive patients with CD treated with vedolizumab demonstrated a greater likelihood of drug persistence and achieving clinical remission, with equivalent rates of response and mucosal healing versus adalimumab-treated patients.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Stool-based Testing for Colorectal Lesions Among Average-risk Individuals: A Real-world Evidence Study.","authors":"Catherine Cheney, Alice Parish, Donna Niedzwiecki, Chukwuemeka Oko, Christy Walters, Brian A Sullivan","doi":"10.1097/MCG.0000000000002053","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002053","url":null,"abstract":"<p><strong>Objective: </strong>We assessed the real-world performance of stool-based tests (SBTs) for colorectal cancer screening.</p><p><strong>Materials and methods: </strong>Retrospective review of average-risk individuals with positive SBT for advanced neoplasia (adenocarcinoma, advanced adenoma, and/or advanced serrated lesions) detection at follow-up colonoscopy.</p><p><strong>Results: </strong>There was no statistical difference in the detection of advanced neoplasia (P= 0.16) between SBTs [30.7% for multitargeted stool DNA (mt-sDNA) vs 22.8% for fecal immunochemical test]. However, there was a significant difference in the detection of advanced serrated lesions (11.3% for mt-sDNA vs 1.8% for fecal immunochemical test, P< 0.001).</p><p><strong>Conclusion: </strong>There was no difference between SBTs for advanced neoplasia detection, though mt-sDNA detected significantly more advanced serrated lesions.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}