United European Gastroenterology Journal最新文献

{"title":"Effectiveness and Treatment Persistence of Vedolizumab Compared to Anti-Tumour Necrosis Factor-α in Patients With Crohn's Disease: A Systematic Literature Review and Meta-Analysis.","authors":"Alessandro Armuzzi, Séverine Vermeire, María Chaparro, Patricia Biedermann, Rebecca Brown, Megan McStravick, Marlies Meyer, Stefan Schreiber","doi":"10.1002/ueg2.12705","DOIUrl":"10.1002/ueg2.12705","url":null,"abstract":"<p><strong>Background: </strong>Vedolizumab is approved for the treatment of moderately to severely active Crohn's disease (CD). Real-world evidence is essential for understanding the effectiveness and benefit-risk profile of vedolizumab outside clinical trial settings.</p><p><strong>Objective: </strong>To identify, systematically review and assess the real-world effectiveness and treatment persistence of vedolizumab in patients with CD, particularly over long-term follow-up periods and among populations with differing treatment experience, and to compare with the treatment persistence of anti-tumour necrosis factor (TNF)-α treatment.</p><p><strong>Methods: </strong>Literature searches were conducted to identify studies published from 2014 to 2022. Relevant congress searches were conducted (2015-2022) using Embase or by hand. Data on adults with CD treated with vedolizumab or anti-TNFα treatment in a real-world setting were extracted for meta-analysis.</p><p><strong>Results: </strong>Data from 73 studies, including 29,894 patients with CD, reported ≥ 1 outcome of interest for this analysis. Vedolizumab treatment persistence rate was 65.3% (95% confidence interval [CI] 60.2-70.1) at 1 year and 54.8% (95% CI 43.9-65.3) at 2 years. The treatment persistence rate with vedolizumab versus anti-TNFα treatment was 84.6% (95% CI 70.2-92.8) versus 75.3% (95% CI 69.7-80.2) at 1 year and 70.6% (95% CI 60.7-78.8) versus 64.6% (95% CI 56.7-71.8) at 2 years. The mucosal healing rate at 1 year was 40.6% (95% CI 34.2-47.3). Clinical remission rates were 39.4% (95% CI 33.9-45.1) at 1 year and 34.3% (95% CI 18.1-55.2) at 2 years. Corticosteroid-free clinical remission rates were 33.2% (95% CI 28.5-38.3) at 1 year and 20.4% (95% CI 12.5-31.5) at 2 years. All clinical outcome rates were higher in biologic-naive than in biologic-experienced patients.</p><p><strong>Conclusion: </strong>Real-world use of vedolizumab was associated with favourable long-term effectiveness and treatment persistence. Vedolizumab is a suitable first-line biological option for biologic-naive patients with CD.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"552-565"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872966","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":"Evolution of Eligibility Criteria in Inflammatory Bowel Disease Clinical Trials: A Clinical Trial Databank Analysis.","authors":"An Outtier, Rosanne Janssens, Liese Barbier, João Sabino, Bram Verstockt, Séverine Vermeire, Isabelle Huys, Marc Ferrante","doi":"10.1002/ueg2.12731","DOIUrl":"10.1002/ueg2.12731","url":null,"abstract":"<p><strong>Background: </strong>Eligibility criteria in clinical trials have been criticised for being overly restrictive without clinical justification.</p><p><strong>Objective: </strong>We aimed to investigate the types, evolution, and current status of eligibility criteria in clinical trials for inflammatory bowel diseases (IBD).</p><p><strong>Methods: </strong>We performed a clinical trial databank search on clinicaltrials.gov, and included all Phase 3 placebo-controlled randomised-controlled trials (RCTs) investigating biologics or small molecules as induction therapy for moderate-to-severe Crohn's disease (CD) and ulcerative colitis (UC). Eligibility criteria were analysed both quantitatively and qualitatively.</p><p><strong>Results: </strong>Fifty-nine RCTs were identified between the year 2000 and 2022 (30 for CD and 29 for UC). The median (interquartile range) number of eligibility criteria was 44 (38-49), and did not significantly change over the studied time period (p = 0.26). Qualitative analysis showed that common patient populations, such as older patients, therapy refractory patients, patients with comorbidities, prior malignancies, unclassified IBD type, ulcerative proctitis, stricturing and fistulizing CD, as well as patients with an ostomy, were often excluded. Heterogeneity in eligibility criteria across the different IBD clinical trials was found, such as for disease activity measurement, dosage of concomitant medication, wash-out period of advanced therapies, and laboratory tests.</p><p><strong>Conclusion: </strong>The median number of eligibility criteria for IBD RCTs did not significantly change over time. The eligibility criteria are however restrictive and complex, limiting the generalisability of efficacy and safety outcomes in daily practice when drugs are approved. Future research is needed to investigate the impact of broadening eligibility criteria to better encompass real-world practice.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"542-551"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855632","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":"Gut Microbiota as a Mediator Between Intestinal Fibrosis and Creeping Fat in Crohn's Disease.","authors":"Caiguang Liu, Rongchang Li, Jing Nie, Jinshen He, Zihao Lin, Xiaomin Wu, Jinyu Tan, Zishan Liu, Longyuan Zhou, Xiaozhi Li, Zhirong Zeng, Minhu Chen, Shixian Hu, Yijun Zhu, Ren Mao","doi":"10.1002/ueg2.70027","DOIUrl":"https://doi.org/10.1002/ueg2.70027","url":null,"abstract":"<p><p>Intestinal stricture remains one of the most challenging complications in Crohn's disease, and its underlying mechanisms are poorly understood. Accumulating evidence suggests that gut microbiota is significantly altered in stenotic intestines and may play a key role in the development of fibrogenesis in Crohn's disease. Additionally, the presence of hypertrophic mesenteric adipose tissue, also known as creeping fat, is closely correlated with intestinal stricture and fibrosis. Recent findings have revealed that bacterial translocation to creeping fat might exacerbate colitis and promote intestinal fibrosis. However, there is still a gap in determining whether gut microbiota links the formation of creeping fat to intestinal fibrosis. Hence, this review aims to summarize the known microbial influences on intestinal fibrosis, describes the microbial characteristics of creeping fat in Crohn's disease, and discusses the crosstalk between creeping fat-associated dysbiosis and the development of intestinal fibrosis.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062194","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":"Tofacitinib in chronic pouchitis: A step towards addressing an unmet need.","authors":"Jacob E Ollech","doi":"10.1002/ueg2.12691","DOIUrl":"10.1002/ueg2.12691","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"501-502"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606621","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":"Vedolizumab for Crohn's disease: Real-world efficacy through a meta-analytical lens.","authors":"Maria Manuela Estevinho, Virginia Solitano","doi":"10.1002/ueg2.12690","DOIUrl":"10.1002/ueg2.12690","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"503-504"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606624","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":"Secondary Prophylaxis of Cirrhotic Gastric Variceal Bleeding: Addition of Non-Selective Beta-Blockers to Endoscopic Combined Treatment.","authors":"Ling Wu, Xiaoquan Huang, Feng Li, Siyu Jiang, Liyuan Ni, Yingjie Ai, Detlef Schuppan, Shiyao Chen","doi":"10.1002/ueg2.12739","DOIUrl":"10.1002/ueg2.12739","url":null,"abstract":"<p><strong>Background: </strong>It remains unclear whether the addition of non-selective beta-blockers (NSBB) provides further benefit after combined use of tissue adhesive and endoscopic variceal ligation for bleeding gastroesophageal varices.</p><p><strong>Objective: </strong>This is the first cohort study comparing the secondary prophylactic efficacy of adding NSBB to combined endoscopic treatment in cirrhotic patients with gastric varices (without inclusion of isolated gastric varices [IGVs], which are rare in patients with cirrhosis without splanchnic thrombosis).</p><p><strong>Methods: </strong>We retrospectively analyzed two matched large cohorts of cirrhotic patients with gastric varices who received combined endoscopic treatment and were assigned to receive NSBB treatment or not as secondary prophylaxis. Further sub-analyses were performed. The 5-year overall survival and rebleeding rates were compared.</p><p><strong>Results: </strong>A total of 490 patients were enrolled, 130 of whom took NSBB. After propensity score matching (PSM), both groups comprised 130 patients. No significant difference between the NSBB and non-NSBB groups was observed regarding 5-year survival (87.40% vs. 83.64%, HR 0.62, 95% CI 0.33-1.17), while NSBB decreased the 5-year rebleeding rate from 45.7% to 30.64% (HR 0.57, 95% CI 0.39-0.82). The same was true when comparing the 2 groups after PSM. NSBB (HR 0.54, 95% CI 0.37-0.79) and splenectomy (HR 0.65, 95% CI 0.44-0.96) independently reduced rebleeding but did not affect survival. In patients without splenectomy, NSBB treatment improved survival (HR 0.43, 95% CI 0.21-0.89) and reduced rebleeding (HR 0.52, 95% CI 0.34-0.78).</p><p><strong>Conclusion: </strong>We show for the first time that adding NSBB to combined endoscopic therapy significantly reduced recurrent variceal bleeding in cirrhotic patients but did not improve overall survival, except for patients without splenectomy. The addition of NSBB for patients receiving combined endoscopic treatment of gastroesophageal varices provides benefits but does not prolong overall survival.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"586-598"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910917","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":"Confocal Endomicroscopy Intestinal Epithelial Barrier Abnormalities in Individuals Without Documented Gastro-Intestinal Disease.","authors":"Thanh-Hien Trieu, Sophie Vieujean, Nicolas Delhougne, Laurence Seidel, Edouard Louis, Jean-Philippe Loly","doi":"10.1002/ueg2.12756","DOIUrl":"10.1002/ueg2.12756","url":null,"abstract":"<p><strong>Background and aims: </strong>Probe-based confocal endomicroscopy (pCLE) allows real-time microscopic visualization of the intestinal mucosa surface layers. Despite remission achieved through anti-tumor necrosis factor or vedolizumab therapy, anomalies in the intestinal epithelial barrier are observed in inflammatory bowel disease (IBD) patients. Our study aimed to assess these abnormalities in non-IBD individuals and compare them with IBD patients in endoscopic remission to identify the associated factors.</p><p><strong>Methods: </strong>The study involved 84 patients, 40 with IBD under biologic therapy for over 6 months and in endoscopic remission, and 44 without IBD or irritable bowel syndrome (IBS) undergoing colorectal screening colonoscopy. White light endoscopy and probe-based confocal laser endomicroscopy were performed in the ileum, right colon, transverse colon, left colon, and rectum. Demographic, clinical, biological, and morphological factors were examined.</p><p><strong>Results: </strong>pCLE revealed abnormalities in both non-IBD individuals and those with IBD in endoscopic remission, such as fluorescein leakage, blood vessel dilatation, and hypervascularization across all segments, as well as epithelial gaps in the ileum, and crypt dilatation in the colon. Comparing the two groups, IBD patients exhibited slightly more gaps in the ileum, increased fluorescein leakage in the transverse colon, and fewer vessel dilatation in the transverse colon. Abnormalities were more frequent in cases of hypertension (p = 0.03), dyslipidemia (p = 0.02), female gender (p = 0.02), selective serotonin reuptake inhibitor (p = 0.03), and family history of IBD (p = 0.04) or colorectal cancer (p = 0.03).</p><p><strong>Conclusion: </strong>Confocal endomicroscopy abnormalities are present in both non-IBD individuals undergoing colorectal cancer screening colonoscopy as in those with IBD in endoscopic remission. Further research is needed to understand the pathophysiological mechanisms of these abnormalities and their clinical impact.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"576-585"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053594","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":"Gastroenterology Training and Career in Women: Challenges and Opportunities.","authors":"Eleni Manthopoulou, Ignacio Catalan-Serra, Maura Corsetti, Andrea Nowak, María Jesús Perugorria, Cem Simsek, Carolina Ciacci","doi":"10.1002/ueg2.12764","DOIUrl":"10.1002/ueg2.12764","url":null,"abstract":"<p><p>This review highlights gender gaps in training, career, and work-life balance in gastroenterology. Stereotypes and biases toward women's abilities and commitment to their careers can influence evaluations, advancement in gastroenterology training, and career progression. The findings indicate that lack of or limited access to mentorship and sponsorship, as well as support networks, can hinder the professional development of women. Moreover, results indicate that we must improve work-life balance measures, for example offering flexible working hours and compensation and support for women during pregnancy, after childbirth, and motherhood. However, reports on such equity measures are scarce, and we lack scientific evidence of their impact. This review concludes that to reduce gender gaps and make a positive impact, we need educational and promotional programs and monitoring of their outcomes.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"650-655"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415322","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":"Ascending the \"Hill\" of Artificial Intelligence in Upper Gastrointestinal Endoscopy.","authors":"Cem Simsek, Nasim Parsa, Lumir Kunovsky","doi":"10.1002/ueg2.12730","DOIUrl":"10.1002/ueg2.12730","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"510-511"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814203","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":"Modifying Our Environment to Improve Outcomes in Inflammatory Bowel Diseases?","authors":"Mathurin Fumery, Nicolas Richard","doi":"10.1002/ueg2.12734","DOIUrl":"10.1002/ueg2.12734","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"508-509"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814207","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}