{"title":"Duodenal Ablation Under the Spotlight of Science: A Promising Approach With Open Questions.","authors":"Mladen Maksic","doi":"10.1002/ueg2.70010","DOIUrl":"https://doi.org/10.1002/ueg2.70010","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558088","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-COVID-19 Disorders of Gut-Brain Interaction: A New Challenge for Gastroenterologists.","authors":"Mohamed G Shiha, Imran Aziz","doi":"10.1002/ueg2.70008","DOIUrl":"https://doi.org/10.1002/ueg2.70008","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568137","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}
Alberto Balduzzi, Francesco Maria Carrano, Yngve Falck-Ytter, Tarik Haluk Kani, Iris Levink, Yasuko Maeda, Irene Marafini, Adele Sayers
{"title":"What Constitutes a High-Quality Guideline: Exploring Consumers' Views.","authors":"Alberto Balduzzi, Francesco Maria Carrano, Yngve Falck-Ytter, Tarik Haluk Kani, Iris Levink, Yasuko Maeda, Irene Marafini, Adele Sayers","doi":"10.1002/ueg2.70000","DOIUrl":"https://doi.org/10.1002/ueg2.70000","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical guidelines are a cornerstone of evidence-based medicine. Little is known about clinicians' knowledge of guideline development and how they perceive guideline quality.</p><p><strong>Methods: </strong>A survey protocol was designed according to the CHERRIES (improving the quality of web surveys: the Checklist for Reporting Results of Internet E-Surveys) checklist. The survey explored three main aspects: high-quality markers of guidelines, knowledge of guideline development, and areas for improvement. The survey was conducted by contacting UEG and affiliated societies by email and via social media. All valid answers to each question were counted.</p><p><strong>Results: </strong>A total of 585 participants responded during the 3-month period. Some 65.8% were aged between 30 and 60 years, and 75.4% were doctors. The most important perceived quality indicators within a guideline were 'clear and actionable recommendations (97%)', followed by 'based on systematic literature review' (96%), and 'transparent methodology' (90%). 230 (39.3%) respondents were previously involved in clinical guideline development. However, the experience of working with a methodologist (18.8%) and using well-established guideline checklists (AGREE-II [21.0%]), RIGHT (Reporting Items for Practice guidelines in HealThcare) (9.9%) were limited. Just under half of the responders (289, 49.4%) were familiar with the GRADE methodology. Apps (78.5%), webinars (73.8%), and short videos (68.2%) were popular tools to access clinical guidelines. Over 90% of responders stated that the reputation of the journal (92%) and the name of the society involved in guideline development (91%) were important. Two-thirds of the responders preferred to see abridged versions of guidelines and 69.2% preferred freely accessible or open access guidelines.</p><p><strong>Conclusion: </strong>Consumers are keen to read clear and actionable guidelines that are developed transparently. There is a gap in guideline development knowledge. Initiatives by medical journals and professional societies are important to ensure the development of accessible and robust clinical guidelines.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523550","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}
Daniel Selin, John Maret-Ouda, Viktor Oskarsson, Mats Lindblad, Urban Arnelo, Bei Yang, Magnus Nilsson, Omid Sadr-Azodi
{"title":"Long-Term Mortality in Acute Pancreatitis-A Population-Based Cohort Study.","authors":"Daniel Selin, John Maret-Ouda, Viktor Oskarsson, Mats Lindblad, Urban Arnelo, Bei Yang, Magnus Nilsson, Omid Sadr-Azodi","doi":"10.1002/ueg2.12774","DOIUrl":"https://doi.org/10.1002/ueg2.12774","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis is a potentially life-threatening inflammation of the pancreas, with a rising incidence in most countries. Recent studies have suggested that acute pancreatitis is associated with increased long-term mortality. However, the extent to which this association is influenced by the development of chronic pancreatitis or comorbid conditions, such as malignant disease, remains unclear.</p><p><strong>Objective: </strong>To assess the association between acute pancreatitis and long-term all-cause mortality.</p><p><strong>Methods: </strong>The Swedish Pancreatitis Cohort (SwePan) was used, including all individuals with a first-time episode of acute pancreatitis in Sweden between 1990 and 2019 who survived the index hospital stay and 1:10 matched pancreatitis-free individuals from the general population. Multivariable conditional Cox proportional hazard models were used to compare mortality among individuals with acute pancreatitis compared with the matched pancreatitis-free control group.</p><p><strong>Results: </strong>In total, 89,465 individuals discharged from hospital with acute pancreatitis and 890,837 matched pancreatitis-free individuals were followed up for 10,155,039 person-years (mean 10.0 years). There were 33,764 (37.7%) deaths among individuals with acute pancreatitis and 265,403 (29.8%) deaths among controls. In multivariable adjusted models, mortality was increased in individuals with acute pancreatitis throughout the follow-up period, particularly among those with severe and non-gallstone-related acute pancreatitis as compared to the matched controls. These results remained statistically significant after censoring the follow-up time for recurrent acute pancreatitis or a diagnosis of chronic pancreatitis.</p><p><strong>Conclusions: </strong>Acute pancreatitis was associated with increased long-term mortality, even after adjusting for comorbidities, including cancer, and censoring for recurrent acute pancreatitis or chronic pancreatitis. Future research should assess causes of death and focus on understanding long-term morbidity to facilitate prevention through tailored follow-up strategies.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524513","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}
Viktorie Kovarova, Ivana Lankova, Evzen Machytka, Katerina Knotkova, Helena Kratochvílová, Marek Beneš, Julius Spicak, Adam Vasura, Eran Goldin, Gavriel Munter, Tomas Zima, Milos Mraz, Hila Dagan, Brian Levy, Martin Haluzik, Jan Kral
{"title":"Duodenal Laser Ablation for Treatment of Type 2 Diabetes: Results of First in Human Study.","authors":"Viktorie Kovarova, Ivana Lankova, Evzen Machytka, Katerina Knotkova, Helena Kratochvílová, Marek Beneš, Julius Spicak, Adam Vasura, Eran Goldin, Gavriel Munter, Tomas Zima, Milos Mraz, Hila Dagan, Brian Levy, Martin Haluzik, Jan Kral","doi":"10.1002/ueg2.12762","DOIUrl":"https://doi.org/10.1002/ueg2.12762","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) significantly impacts global health and economies. Despite various therapies, managing DM remains challenging. Bariatric surgery has shown efficacy in obese patients with type 2 diabetes mellitus (T2DM), but its utilization remains low. Innovative, less invasive endoscopic approaches such as duodenal mucosal resurfacing show potential in treating T2DM. This article presents the results of a First in Human (FIH) study using a duodenal submucosal laser ablation investigational device for T2DM treatment.</p><p><strong>Methods: </strong>A prospective, single-arm, open-label study evaluated the safety and efficacy of the Digma System Endoscopic procedure for duodenal submucosal laser ablation in consecutive enrolled T2DM patients.</p><p><strong>Results: </strong>The study was conducted from July 2017 to December 2020 and enrolled 31 patients for the Digma System Endoscopic procedure. The Dose Escalation Cohort (DEC) used sub-therapeutic laser doses for training and safety. The Treatment Cohort (TC) of 25 patients received therapeutic doses, resulting in HbA1c reductions of -0.6% at 6 months (p = 0.014) and -0.4% at 12 months (p = 0.062). Fasting glucose dropped 17.3 mg/dL (p = 0.173) at 6 months and 28 mg/dL (p = 0.022) at 12 months. Post-prandial glucose improvements were also observed. HOMA-IR improved at 3 and 6 months. PAGI-SYM and PAGI-QOL showed stable to slightly improved GI symptoms and quality of life. Two severe adverse events were unrelated to the procedure.</p><p><strong>Conclusion: </strong>The study demonstrates the safety, feasibility, and potential efficacy of the Digma System Endoscopic procedure. Evidence suggests improvements in HbA1c, fasting and post-prandial glucose, and HOMA-IR levels could be attributed to the Digma System Endoscopic procedure.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459779","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}
Swati Venkat, Joshua Rusbuldt, Dylan Richards, Thomas Freeman, Camilla Richmond, Joachim Hog Mortensen, Jakob Benedict Seidelin, Anja Poulsen, Brad McRae, Darren Ruane
{"title":"Serum Collagen Biomarkers Are Reflective of Tissue Specific Fibroblasts Associated With Ulcerative Colitis Activity and Treatment Response to Ustekinumab.","authors":"Swati Venkat, Joshua Rusbuldt, Dylan Richards, Thomas Freeman, Camilla Richmond, Joachim Hog Mortensen, Jakob Benedict Seidelin, Anja Poulsen, Brad McRae, Darren Ruane","doi":"10.1002/ueg2.70002","DOIUrl":"https://doi.org/10.1002/ueg2.70002","url":null,"abstract":"<p><strong>Background: </strong>There is a need to identify peripheral biomarkers reflective of defined disease associated fibroblasts in Ulcerative Colitis (UC), with the aim of enabling clinical development approaches for novel-stromal-targeted therapeutics for individuals at risk for fibrostenotic complications. Additionally, longitudinal non-invasive biomarkers of tissue remodelling, fibroblast biology and pharmacodynamic measurements are needed in the clinic to facilitate risk stratification.</p><p><strong>Aim: </strong>To identify novel blood protein biomarkers associated with defined fibroblast subsets, tissue remodelling and treatment response/non-response in UC.</p><p><strong>Methods: </strong>We performed data analysis on matched serum and tissue transcriptomics from the UNIFI trial at weeks 0 and 8 in clinical responders and non-responders. Detailed gene correlation analysis was performed on 97 colonic biopsies from 50 patients pre- and post-treatment, to construct detailed cell-type mapping associated with clinical parameters. Detailed serum-based proteomics analysis was performed using matched serum and tissue sample sets to evaluate specific correlations between defined tissue cellular subsets and unique peripheral proteins, reflective of defined tissue transcriptional subsets and clinical parameters.</p><p><strong>Results: </strong>Evaluation of the UNIFI clinical study, revealed a significant association between intestinal-inflammatory activated fibroblasts (IIAF) and various clinical parameters, including Geboes scores. These findings were unique to IIAFs and were confirmed using spatial tissue transcriptomics. Evaluation of novel peripheral proteomics revealed a significant correlation between selective serum collagen biomarkers, including Pro-Collagen 22, Collagen 1M, CTX-III, ELP-3, and the IIAF tissue module. These serum collagen biomarkers were unique to IIAFs, as other broad proteomics methodologies failed to demonstrate significant correlations with known UC serum markers. Ustekinumab endoscopic responders had a significant decrease in IIAFs, which was associated with decreases in these IIAF associated serum proteins. Furthermore, C1M and ELP-3 demonstrated predictive value to enable characterisation of UC patients with IIAF driven disease.</p><p><strong>Conclusions: </strong>These serum biomarkers were correlated with tissue levels of IIAFs, identifying unique peripheral markers of tissue associated cell types correlated with fibrosis. Given the association of IIAFs and treatment response, this highlights the utility of these triaged collagen biomarkers for anti-stromal therapeutic development and patient stratification in UC and beyond.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450224","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":"Gastrointestinal Bleeding due to Small Intestinal Metastases From Choriocarcinoma.","authors":"Huipeng Zhang, Jing Zhang, Yanbo Yu, Xin Long","doi":"10.1002/ueg2.70007","DOIUrl":"https://doi.org/10.1002/ueg2.70007","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450057","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}
Ilaria Lodola, Giuseppe Dell'Anna, Gianpaolo Balzano, Silvio Danese
{"title":"Is It Anorexia? Congenital Duodenal Web.","authors":"Ilaria Lodola, Giuseppe Dell'Anna, Gianpaolo Balzano, Silvio Danese","doi":"10.1002/ueg2.70006","DOIUrl":"https://doi.org/10.1002/ueg2.70006","url":null,"abstract":"<p><p>Congenital duodenal web (CDW) is a rare cause of intestinal obstruction in adults, making diagnosis challenging. We present the case of a 26-year-old woman with chronic epigastric symptoms who recently developed vomiting and significant weight loss. Prolonged compensatory duodenal dilation obscured typical radiological signs and delayed preoperative identification. The diagnosis was confirmed intraoperatively and managed surgically. This case highlights the need to consider CDW in adults with unexplained proximal gastrointestinal obstruction.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450063","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}
Ferdinando D'Amico, Sarah Bencardino, André Gonçalves, Mariangela Allocca, Federica Furfaro, Alessandra Zilli, Tommaso Lorenzo Parigi, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese
{"title":"Unlocking hope: The future of ustekinumab biosimilars in Crohn's disease treatment.","authors":"Ferdinando D'Amico, Sarah Bencardino, André Gonçalves, Mariangela Allocca, Federica Furfaro, Alessandra Zilli, Tommaso Lorenzo Parigi, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese","doi":"10.1002/ueg2.12682","DOIUrl":"https://doi.org/10.1002/ueg2.12682","url":null,"abstract":"<p><p>Biologic therapies have revolutionized Crohn's disease (CD) management, but their high costs pose a significant barrier to access. Biosimilars can provide increased access to treatment because of significant cost-savings. Ustekinumab is a biological drug against interleukin 12-23 that is employed in treating moderate-to-severe CD. As the patent of the reference product (RP) is expiring, ustekinumab biosimilars have been developed and are currently becoming available for patients. Available data demonstrate that ustekinumab biosimilars exhibit comparable efficacy, pharmacokinetics, safety and immunogenicity as the RP. Ustekinumab biosimilars have been approved for CD based on extrapolation and there is no real-world data available yet for this indication. While biosimilars of ustekinumab promise cost savings in treating moderate-to-severe CD, it is not yet known whether their availability will change the treatment algorithm in CD. This review focuses on the available data on ustekinumab biosimilars, focusing on their pros and cons for their forthcoming role in treating moderate to severe CD.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450232","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}