Journal of Gastroenterology最新文献

{"title":"The external validation of Dallas Steatosis Index among Asian population: a useful tool for metabolic dysfunction-associated steatotic liver disease identification and prevention.","authors":"Mengyang Xia, Yixuan Lu, Feiyang Yin, Zhiqiang Cao, Ping Yao, Hongxia Li","doi":"10.1007/s00535-025-02220-4","DOIUrl":"10.1007/s00535-025-02220-4","url":null,"abstract":"<p><strong>Background: </strong>The Dallas Steatosis Index (DSI) is a non-invasive tool (NIT) developed to detect the risk of metabolic dysfunction-associated steatotic liver disease (MASLD) in multi-ethnic populations, external validation in Asians has yet to be conducted. Therefore, we evaluated the ability of the DSI with the BMI classification of WPRO (DSI_WPRO) to identify MASLD in the Chinese population. In addition, we investigated the associations between the DSI_WPRO and the risk of MASLD in a longitudinal study.</p><p><strong>Methods: </strong>Baseline data from the Dongfeng-Tongji cohort were collected to investigate the ability of the DSI_WPRO to identify MASLD patients by ROC analysis. Furthermore, multivariate logistic regressions were performed to investigate the associations of the DSI_WPRO and MASLD risks in a 5-year follow-up of the DFTJ cohort study.</p><p><strong>Results: </strong>Among a total of 9,376 MASLD participants and 25,974 non-MASLD participants, the area under the curve (AUC) of the DSI_WPRO reached 0.777 after adjusting BMI classification, which is higher than other NITs in this study. In addition, we redefined the risk category and the screening proposal of MASLD in Asians with the DSI_WPRO. We found that the cutoff point of 0 has the best ability to recognize the presence or absence of MASLD. Furthermore, compared with the low DSI_WPRO (DSI_WPRO < 0), OR (95% CIs) of higher DSI_WPRO (DSI_WPRO ≥ 0) was 3.048 (2.827 ~ 3.285) for MASLD.</p><p><strong>Conclusion: </strong>The DSI is a useful tool for MASLD identification and prevention. After more validation studies, DSI can be generalized in the Asian population.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"621-631"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492344","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":"Brain activity during a public-speaking situation in virtual reality in patients with irritable bowel syndrome and functional dyspepsia.","authors":"Ryo Katsumata, Takayuki Hosokawa, Noriaki Manabe, Hitoshi Mori, Kenta Wani, Minako Kimura, Shintaro Oda, Katsunori Ishii, Tomohiro Tanikawa, Noriyo Urata, Maki Ayaki, Ken Nishino, Takahisa Murao, Mitsuhiko Suehiro, Minoru Fujita, Miwa Kawanaka, Ken Haruma, Hirofumi Kawamoto, Toshihiro Takao, Tomoari Kamada","doi":"10.1007/s00535-025-02228-w","DOIUrl":"10.1007/s00535-025-02228-w","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial stress plays a central role in the pathophysiology of disorders of gut-brain interactions (DGBI), including functional dyspepsia (FD) and irritable bowel syndrome (IBS). Brain activity during psychosocial stress in patients with DGBI has not been adequately investigated. In this prospective study, we aimed to explore brain activity during psychosocial stress in patients with DGBI.</p><p><strong>Methods: </strong>Situations in an unmanned room, public space without attention, and public speaking were simulated in a virtual reality (VR) environment. Subjective stress, emotional state, and gastrointestinal (GI) symptoms were assessed using a visual analog scale, the State-Trait Anxiety Inventory, and the GI Symptom Rating Scale, respectively. Electrocardiograms were recorded to evaluate autonomic function. Activity in the prefrontal cortex (PFC) was examined using functional near-infrared spectroscopy (fNIRS).</p><p><strong>Results: </strong>Overall, 15 healthy controls, 15 patients with IBS, and 15 patients with FD were included. In the public-speaking scenario, subjective stress scores significantly decreased (indicating more stress) and sympathetic nervous activity increased equally among the three groups compared with those in an unmanned scene. Patients with IBS had higher activity in the left ventrolateral prefrontal cortex (VLPFC) and lower activity in the dorsolateral PFC (DLPFC) than those with FD and healthy controls.</p><p><strong>Conclusions: </strong>Brain activity increased in the VLPFC and decreased in the DLPFC under stressful psychosocial situations created in the VR space in patients with IBS. Thus, the combination of VR and fNIRS is a viable option for evaluating brain activity under psychosocial stress in natural clinical settings.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"561-572"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492337","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 impact of epithelial types on postoperative outcomes for intraductal papillary mucinous neoplasms: a multicenter retrospective study.","authors":"Daiki Yamashige, Susumu Hijioka, Yasuhiro Shimizu, Akio Yanagisawa, Masafumi Nakamura, Kazuo Hara, Masayuki Kitano, Shinsuke Koshita, Tetsuya Takikawa, Toshifumi Kin, Mamoru Takenaka, Keiji Hanada, Toshiharu Ueki, Takao Itoi, Reiko Yamada, Takao Ohtsuka, Seiko Hirono, Atsushi Kanno, Yoshifumi Takeyama, Atsushi Masamune","doi":"10.1007/s00535-025-02225-z","DOIUrl":"10.1007/s00535-025-02225-z","url":null,"abstract":"<p><strong>Background: </strong>Intraductal papillary mucinous neoplasms (IPMNs) are classified into three epithelial types with distinct biological behaviors. However, their effects on the postoperative outcomes remain unclear.</p><p><strong>Methods: </strong>This multicenter retrospective study included 556 patients with IPMNs who underwent surgical resection. The epithelial types were categorized into the gastric (n = 323), intestinal (n = 160), and pancreatobiliary (n = 73) types. Their associations with the development of extrapancreatic lesions; remnant high-risk lesions (HRLs), including metachronous pancreatic ductal adenocarcinoma (PDAC); and disease-specific survival (DSS) were analyzed.</p><p><strong>Results: </strong>Fifty-one patients (9.2%) developed extrapancreatic lesions. The 10-year cumulative incidence rates for the gastric, intestinal, and pancreatobiliary types were 9.3%, 9.1%, and 32.0%, respectively (P < 0.001). Multivariate analysis identified invasive carcinoma, the gastric, and pancreatobiliary types as independent predictors. Among 516 patients who did not undergo total pancreatectomy, 40 (7.8%) and 13 (2.5%) developed HRLs and metachronous PDAC, respectively. The 10-year cumulative incidence rates of HRLs and metachronous PDAC for the gastric, intestinal, and pancreatobiliary types were 7.0%, 16.2%, and 37.2% and 1.8%, 3.7%, and 22.7%, respectively (P = 0.001 and P = 0.012). In multivariate analysis, the pancreatobiliary type was an independent predictor of metachronous PDAC. Five-year DSS rates for the gastric, intestinal, and pancreatobiliary types were 92.5%, 96.0%, and 76.1% (P < 0.001), respectively. Multivariate analysis identified invasive carcinoma, the gastric, and pancreatobiliary types as independent prognostic factors for DSS.</p><p><strong>Conclusions: </strong>IPMN epithelial type can independently affect postoperative outcomes. In particular, the pancreatobiliary type has significant impact on the development of metachronous PDAC. Therefore, postoperative surveillance should be tailored according to the epithelial type.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"658-670"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449334","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":"Aldh2 and the tumor suppressor Trp53 play important roles in alcohol-induced squamous field cancerization.","authors":"Yuki Kondo, Shinya Ohashi, Chikatoshi Katada, Yukie Nakai, Yoshihiro Yamamoto, Masashi Tamaoki, Osamu Kikuchi, Atsushi Yamada, Kenshiro Hirohashi, Yosuke Mitani, Shigeki Kataoka, Tomoki Saito, Trang H Nguyen Vu, Tomohiro Kondo, Yu Uneno, Tomohiko Sunami, Akira Yokoyama, Junichi Matsubara, Tomonari Matsuda, Seiji Naganuma, Kohei Oryu, Samuel Flashner, Masataka Shimonosono, Hiroshi Nakagawa, Manabu Muto","doi":"10.1007/s00535-024-02210-y","DOIUrl":"10.1007/s00535-024-02210-y","url":null,"abstract":"<p><strong>Background: </strong>Field cancerization defined by multiple development of squamous cell carcinomas (SCCs) in upper aerodigestive tract was explained by excessive alcohol intake. A dysfunctional mitochondrial aldehyde dehydrogenase 2 (Aldh2) delays the clearance of acetaldehyde, a genotoxic alcohol metabolite, and increases SCC risks. TP53 plays key roles in squamous carcinogenesis. However, the mechanism of alcohol-mediated squamous field cancerization has not been clearly elucidated.</p><p><strong>Methods: </strong>We developed a novel genetically engineered mouse strain KTPA^-/- (Krt5Cre^ERT2; Trp53^loxp/loxp; Aldh2^-/-) featuring Aldh2-loss concurrent with epithelial-specific Trp53 deletion. These mice were given 10%-EtOH, and we evaluated the development of squamous cell carcinogenesis histologically and genetically.</p><p><strong>Results: </strong>Widespread multifocal rete ridges (RRs), characterized by downward growth of proliferative preneoplastic cells, were found only in Aldh2^+/- and Aldh2^-/- mice with keratin5-specific Trp53 deletion (KTPA^+/- and KTPA^-/- mice, respectively), and alcohol drinking apparently increased RR formation rate. SCC occurred only in KTPA^-/- (Aldh2 loss/TP53 loss) mice with alcohol drinking (15/18: 83%). Total alcohol consumption volume was significantly higher in KTPA^-/- (Aldh2 loss/TP53 loss) mice with SCCs than those without SCCs. Further, target sequence revealed the occurrence of genetic abnormalities including Trp53 mutations in the esophageal epithelium of Aldh2^-/- mice with alcohol drinking, suggesting direct mutagenic effects of alcohol drinking to the esophageal epithelium.</p><p><strong>Conclusion: </strong>This study provides for the first time the evidence that alcohol drinking, Aldh2 dysfunction and Trp53 loss cooperate in squamous field cancerization. Alcohol consumption volume affects the SCCs development, even in the same genotype.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"546-560"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255802","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":"A clinicopathological study of IgG4-related autoimmune hepatitis and IgG4-hepatopathy.","authors":"Atsushi Tanaka, Kenji Notohara, Maki Tobari, Masanori Abe, Takeji Umemura, Atsushi Takahashi, Akemi Tsutsui, Takanori Ito, Kohichi Tsuneyama, Atsushi Masamune, Ken-Ichi Harada, Hiromasa Ohira, Mitsuhiro Kawano","doi":"10.1007/s00535-025-02221-3","DOIUrl":"10.1007/s00535-025-02221-3","url":null,"abstract":"<p><strong>Background and aim: </strong>Although IgG4-related autoimmune hepatitis (IgG4-AIH) and IgG4-hepatopathy have been proposed as hepatic phenotypes of IgG4-related disease (IgG4-RD), their definitions and concepts remain insufficiently established. This study aims to conduct a clinicopathological investigation of cases reported as potential IgG4-AIH or IgG4-hepatopathy.</p><p><strong>Methods: </strong>In previous nationwide epidemiological studies conducted in 2015 and 2018, we registered 1096 cases of IgG4-sclerosing cholangitis (IgG4-SC). Among these, 19 cases were identified as potential IgG4-AIH by the attending physicians, and other 20 cases as potential IgG4-hepatopathy with available liver histology were further evaluated using immunohistochemistry to assess the possibility of IgG4-AIH or IgG4-hepatopathy. For this purpose, we provisionally established diagnostic criteria for IgG4-AIH and IgG4-hepatopathy, primarily based on the comprehensive diagnostic criteria for IgG4-RD, which include IgG4 + cell count > 10/HPF and an IgG4 + /IgG ratio > 40%.</p><p><strong>Results: </strong>Of the 19 cases, 2 were diagnosed as IgG4-AIH, with IgG4 + cell counts/HPF of 25.3 and 18.7, and IgG4 + /IgG ratios of 310.2% and 53.4%, respectively. Neither storiform fibrosis nor obliterative phlebitis was observed in the liver of these cases, and both responded excellently to corticosteroid treatment. In addition, from other 20 cases, we diagnosed 8 cases as IgG4-hepatopathy, with IgG4-SC and autoimmune pancreatitis being present in 7 and 2 cases, respectively.</p><p><strong>Conclusion: </strong>This study identified two cases of IgG4-AIH and eight cases of IgG4-hepatopathy. Further studies are necessary to explore the occurrence of IgG4-AIH using these diagnostic criteria in the AIH cohort. The presence of IgG4-hepatopathy may facilitate the diagnosis of IgG4-SC.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"632-640"},"PeriodicalIF":6.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374147","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":"Letter to \"The potential of an artificial intelligence for diagnosing MRI images in rectal cancer: multicenter collaborative trial\".","authors":"Haoxun Mao, Sheng Li","doi":"10.1007/s00535-025-02255-7","DOIUrl":"https://doi.org/10.1007/s00535-025-02255-7","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029544","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":"Identification of novel plasma proteins as promising noninvasive biomarker for early diagnosis and surveillance of pancreatic ductal adenocarcinoma.","authors":"Shuang Liu, Jiachun Su, Hongzhe Zhao, Ruihong Bai, Lingxing Zeng, Chunling Xue, Shuang Deng, Shaoqiu Liu, Ziming Chen, Zilan Xu, Yifan Zhou, Sihan Zhao, Xiaoyu Wu, Xinyi Peng, Jialiang Zhang, Xudong Huang, Jian Zheng, Chongyu Zhao, Lu Zheng","doi":"10.1007/s00535-025-02252-w","DOIUrl":"https://doi.org/10.1007/s00535-025-02252-w","url":null,"abstract":"<p><strong>Background: </strong>Although cancer antigen 19-9 (CA 19-9) is the only FDA-approved biomarker for pancreatic ductal adenocarcinoma (PDAC), its diagnostic effectiveness is limited, as it may not be elevated in 15-25% of patients. This study aims to explore novel plasma proteins associated with PDAC as potential biomarkers for early diagnosis and clinical surveillance.</p><p><strong>Methods: </strong>Novel plasma protein biomarkers potentially causally associated with PDAC were identified using Mendelian randomization (MR). These biomarkers were validated in a multicenter study encompassing 230 tissue and 1,011 plasma samples to establish a diagnostic model for PDAC. Furthermore, their pre- and post-operative levels were compared to evaluate their potential as clinical surveillance biomarkers.</p><p><strong>Results: </strong>Genetically predicted expression of seven proteins potentially causally associated with an increased risk of PDAC. In a multicenter, large-scale study, Keratin 5 (KRT5) and Versican (VCAN) were identified as promising biomarkers for PDAC, with an area under the curve (AUC) of 0.90, and a combined panel including CA 19-9 achieved an AUC of 0.95. Additionally, plasma KRT5 and VCAN demonstrated superior diagnostic performance for early-stage PDAC with CA 19-9 levels below 37 U/mL (Stage I, AUC 0.85; Stage II, AUC 0.85). The specificity of plasma KRT5 and VCAN for PDAC was further validated by comparing their expression levels across various digestive cancers. Moreover, a significant decrease in plasma KRT5 and VCAN levels was observed post-surgery (P < 0.05), supporting their potential as biomarkers for clinical surveillance of PDAC.</p><p><strong>Conclusions: </strong>Plasma KRT5 and VCAN proteins may serve as promising valuable biomarkers for the early diagnosis and clinical surveillance of PDAC.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986338","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":"Endoscopic liquid biopsy of bile: superior diagnostic and prognostic performance of bile-derived exosomal miR-21-5p for biliary tract cancers.","authors":"Michihiro Yoshida, Tadashi Toyohara, Yasuki Hori, Akihisa Kato, Hidenori Sahashi, Kayoko Kuno, Akihisa Adachi, Yusuke Kito, Kenji Urakabe, Kazuki Hayashi, Itaru Naitoh, Fumihiro Okumura, Hiromu Kondo, Makoto Natsume, Naruomi Jinno, Kenta Kachi, Hiromi Kataoka, Yasuhito Tanaka","doi":"10.1007/s00535-025-02250-y","DOIUrl":"https://doi.org/10.1007/s00535-025-02250-y","url":null,"abstract":"<p><strong>Background: </strong>Compared to peripheral blood, bile as a microenvironment within the biliary tract is expected to contain a higher concentration of tumor-associated factors secreted directly by primary biliary tumors, making it a promising source for tumor analysis. This study explores the diagnostic and prognostic utility of exosomal miR-21-5p in bile and serum for biliary tract cancers (BTCs).</p><p><strong>Methods: </strong>miR-21-5p expression was analyzed in 110 bile samples (55 BTC, 55 controls) collected during endoscopic retrograde cholangiopancreatography using qRT-PCR. The diagnostic and prognostic performances of miR-21-5p levels in bile and serum were evaluated. To enhance clinical applicability, we also developed a novel diagnostic parameter termed \"miR-21-5p bile/serum (B/S) ratio\", calculated by determining the ratio of bile to serum miR-21-5p within individuals.</p><p><strong>Results: </strong>miR-21-5p expression was significantly elevated in both the bile and serum of patients with BTC. Bile miR-21-5p showed superior diagnostic performance (AUC: 0.913) over serum miR-21-5p (AUC: 0.628) and CA19-9 (AUC: 0.793). Prognostically, a higher bile miR-21-5p was associated with poorer overall survival and was identified as an independent predictor (HR: 2.446, p = 0.002), whereas serum miR-21-5p lacked significant prognostic value. B/S ratio also showed high diagnostic accuracy when ≥ 2 (AUC: 0.870), and a B/S ratio ≥ 13 was associated with significantly poorer overall survival and found as an independent prognostic predictor (HR: 2.554, p = 0.008).</p><p><strong>Conclusions: </strong>Bile miR-21-5p and miR-21-5p B/S ratio are promising biomarkers for BTC diagnosis and prognosis that outperform traditional markers, highlighting the potential of bile-derived miRNAs for clinical use.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026500","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":"Post-marketing surveillance of tofacitinib in patients with ulcerative colitis in Japan: a final report of safety and effectiveness data.","authors":"Katsuyoshi Matsuoka, Satoshi Motoya, Takayuki Yamamoto, Minoru Matsuura, Toshimitsu Fujii, Shinichiro Shinzaki, Yohei Mikami, Shoko Arai, Junichi Oshima, Yutaka Endo, Hirotoshi Yuasa, Masato Hoshi, Keiko Sato, Tadakazu Hisamatsu","doi":"10.1007/s00535-025-02249-5","DOIUrl":"https://doi.org/10.1007/s00535-025-02249-5","url":null,"abstract":"<p><strong>Background: </strong>We present the final analysis of a tofacitinib post-marketing surveillance (PMS) study in Japanese patients with ulcerative colitis (UC).</p><p><strong>Methods: </strong>Safety/effectiveness data were evaluated (through Sept/30/2022). All patients with UC in Japan receiving tofacitinib were registered (60-week observation period). Adverse events (AEs) were recorded. Per protocol, several AEs were identified as clinically important/potential risks; all treatment-period data were used to calculate incidence rates (IRs; unique patients with events/100 patient-years [PY] of exposure). Effectiveness was assessed (partial/total Mayo score), with last observation carried forward for imputation of missing data.</p><p><strong>Results: </strong>Overall, 2043 patients were enrolled (safety analysis set: n = 1982/effectiveness analysis set: n = 1969). Data were excluded for 13 patients from two hospitals from which consent was not obtained for publication and which, therefore, were not permitted for publication. AEs and serious AEs were observed in 33.4% and 5.2% of patients, respectively; one death occurred (intestinal abscess). Herpes zoster (HZ; non-serious and serious) was the most reported infection (n = 92 [IR 5.93/100 PY, 95% confidence interval 4.78, 7.27]). Serious infection, malignancy, cardiovascular and venous thromboembolic events IRs were 1.51/100 PY, 0.62/100 PY, 0.13/100 PY, and 0.31/100 PY, respectively. Overall, 52.4% of patients discontinued treatment, mostly due to inadequate clinical response (48.9%). At Week 60, 1151/1969 patients (58.5%) achieved partial Mayo score remission.</p><p><strong>Conclusion: </strong>The overall safety profile was generally comparable with tofacitinib data from PMS reports from Japan, worldwide and the tofacitinib UC clinical program. However, HZ IR was higher than in the tofacitinib UC clinical program. Tofacitinib effectiveness was consistent with data from the tofacitinib UC clinical program.</p><p><strong>Clinicaltrials: </strong>GOV: NCT03643211.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969795","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":"Educational interventions to enhance support for balancing work and treatment in inflammatory bowel disease patients.","authors":"Nobuhiro Ueno, Aki Sakatani, Katsuyoshi Ando, Seisuke Saito, Kojiro Sugimura, Kazuyuki Tanaka, Shinya Serikawa, Chisato Ishikawa, Momotaro Muto, Yuhei Inaba, Kentaro Moriichi, Mikihiro Fujiya","doi":"10.1007/s00535-025-02248-6","DOIUrl":"https://doi.org/10.1007/s00535-025-02248-6","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) significantly impacts employment and work productivity, necessitating support for balancing work and treatment (SBWT). While SBWT systems have been formalized in Japan, awareness among healthcare professionals remains low. This study aimed to evaluate the effectiveness of an educational program on SBWT for healthcare professionals in Hokkaido, Japan.</p><p><strong>Methods: </strong>A 2-year questionnaire-based study was conducted across eight medical facilities in Hokkaido, Japan, from November 2022 to November 2024. The educational program, comprising lecture-based and self-directed learning formats, addressed six key components of SBWT. Pre- and post-program surveys assessed changes in awareness, interest, and behaviors related to SBWT.</p><p><strong>Results: </strong>Pre-program awareness of SBWT was low (36.7% among doctors, 28.2% among medical staff). Post-program, awareness increased significantly to 81.3% and 58.3%, respectively (p < 0.01). Interest in SBWT improved across several categories for both groups, with greater gains among medical staff. Behavioral changes, such as detailed employment-related consultations with IBD patients and improved reporting practices from medical staff to doctors, were observed but not statistically significant. Lecture-based learning was more effective than self-directed methods, in increasing awareness, interest, and engagement with SBWT, particularly for medical staff.</p><p><strong>Conclusions: </strong>The educational program successfully enhanced awareness and interest in SBWT, with lecture-based methods proving more effective for medical staff. These findings emphasize the need for tailored educational strategies based on baseline knowledge. Future initiatives should focus on sustaining knowledge acquisition, expanding programs nationwide, and assessing long-term impacts on healthcare practices and patient outcomes.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995799","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}