United European Gastroenterology Journal最新文献

{"title":"Unexpected Marble-Like Lesions in Patient With Acute Upper Abdominal Pain.","authors":"Yoen Young Chuah, Keith Siau, Enrique de-Madaria","doi":"10.1002/ueg2.70040","DOIUrl":"10.1002/ueg2.70040","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1348-1349"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040768","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":"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":"1092-1106"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463723/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sphingosine-1-Phosphate Receptor Modulators for the Treatment of Ulcerative Colitis: A Narrative Review Focusing on Safety.","authors":"Massimo C Fantini, Diego Centonze, Giovanni Giacobazzi, Silvia Benemei, Emanuele Romeo","doi":"10.1002/ueg2.70026","DOIUrl":"10.1002/ueg2.70026","url":null,"abstract":"<p><p>Ulcerative colitis is a chronic immune-mediated inflammatory disease of the colon that causes considerable morbidity and increases the risk of colorectal cancer. Several targeted therapies have been developed for moderate-to-severe ulcerative colitis, significantly improving its management. Ozanimod and etrasimod, oral small-molecule drugs, are the latest addition. They belong to the class of sphingosine-1-phosphate receptor (S1PR) modulators and are the first members of this class to be granted approval for ulcerative colitis. They act by blocking lymphocyte trafficking from lymph nodes to inflamed tissues without impairing other immune system functions. This narrative review summarizes current knowledge of sphingosine-1-phosphate receptor modulators, focusing on safety. Safety data from the field of multiple sclerosis (MS) will be discussed because the first S1PR modulator to reach the market, fingolimod, was used extensively for relapsing-remitting MS. Indications for the safe use of ozanimod and etrasimod in ulcerative colitis patients will be provided.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1077-1091"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249823","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":"Patient and First-Degree Relatives Perceptions About Prediction and Prevention of Inflammatory Bowel Disease-A Multinational Survey.","authors":"Ana Catarina Bravo, Sara Godt Christensen, Mette Julsgaard, Iago Rodriguez-Lago, Lucía Exposito, Daniel Ginard, Pascal Juillerat, Heidi Gram Sørensen, Gionata Fiorino, Anthony Buisson, Nickolas Stemmer, Natalia Queiroz, Adriana Ribas, Vivíana Parra Izquierdo, Corey A Siegel, Kenneth Croitoiru, Elizabeth A Spencer, Inga Peter, Alan Moss, Luisa Avedano, Salvo Leone, Jean-Frederic Colombel, Manasi Agrawal, Ryan Ungaro, Catarina Fidalgo, Bárbara Morão, Joana Torres","doi":"10.1002/ueg2.70091","DOIUrl":"10.1002/ueg2.70091","url":null,"abstract":"<p><strong>Background and objective: </strong>While significant advances have been made in identifying biomarkers for predicting inflammatory bowel disease (IBD) onset, little is known about the willingness of at-risk individuals to undergo predictive testing and preventive interventions. This study aimed to assess acceptance of predictive tests and preventive interventions among individuals at risk of inflammatory bowel disease and identify factors influencing their decisions.</p><p><strong>Methods: </strong>An anonymized electronic survey was distributed to parents of children at risk of inflammatory bowel disease and first-degree relatives (FDRs) of IBD patients via clinicians and patient associations. The survey assessed acceptance of predictive tests, preventive interventions, and influencing variables.</p><p><strong>Results: </strong>A total of 1327 participants (74% women, mean age 42 ± 18 years) from 66 countries responded to the survey. Of these, 88% were parents of children at risk, and 12% were FDRs. Eighty-five percent were willing to embark in predictive testing, preferring blood analysis (91%), stool tests (89%), saliva tests (78%) or intestinal ultrasound (67%). Lower perceived IBD impact and higher disease knowledge reduced the odds of test acceptance. Preventive interventions were accepted by 98%, with dietary changes (85%), physical exercise (81%), and probiotics (71%) being the preferred. Acceptance of oral (38%) or intravenous/subcutaneous immunosuppressive treatments (32%) depended on their efficacy, difficulty, and risks.</p><p><strong>Conclusion: </strong>Most respondents preferred minimally invasive predictive tests and non-pharmacological preventive measures, although more than one-third would be willing to undergo immunosuppressive medications to prevent disease onset. Disease knowledge and quality-of-life perceptions influenced preferences. This data provides important information for the development of IBD prediction and prevention strategies.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1226-1238"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875422","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":"How \"Sure\" Are We About Precision Medicine in IBD?","authors":"Florian Tran, Konrad Aden","doi":"10.1002/ueg2.70048","DOIUrl":"10.1002/ueg2.70048","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1046-1047"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095034","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":"Key Predictors of Relevant Weight Loss in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Nicola Pugliese, Ivan Arcari, Federica Cerini, Rosa Lombardi, Federica Turati, Grazia Pennisi, Matteo Soleri, Simone Rocchetto, Diletta De Deo, Michele Sagasta, Chiara Masetti, Anna Ludovica Fracanzani, Salvatore Petta, Carlo La Vecchia, Mauro Viganò, Alessio Aghemo","doi":"10.1002/ueg2.70055","DOIUrl":"10.1002/ueg2.70055","url":null,"abstract":"<p><strong>Background and aims: </strong>Weight loss is an effective therapeutic strategy for patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to identify factors that predict relevant weight loss, defined as at least 7% of initial body weight, in MASLD outpatients.</p><p><strong>Method: </strong>We retrospectively included all MASLD patients referred to four Italian tertiary centers between January 2019 and December 2021. Patients received lifestyle modification advice according to current guidelines, with reassessment of anthropometric measures after 18-24 months.</p><p><strong>Results: </strong>A total of 897 patients were included. The majority were male (57%) with a mean age of 61.6 ± 13.3 years and a mean baseline body mass index (BMI) of 30.3 ± 4.5 kg/m². Comorbidities included type 2 diabetes (T2D; 36%), arterial hypertension (54.7%) and dyslipidemia (55.2%). Over a median observation period of 21 months, 164 (18.3%) patients achieved relevant weight loss. Multiple adjusted regression analysis identified baseline BMI between 30 and 34.9 kg/m² (odds ratio, OR = 1.95, 95% confidence interval, CI: 1.30-2.95) or ≥ 35 kg/m² (OR = 2.08, 95% CI: 1.21-3.57), use of GLP-1 agonists for T2D (OR 1.85, 95% CI: 1.19-3.80), bilirubin levels ≥ 1.2 mg/dL (OR 2.12, 95% CI: 1.29-3.51) nutritionist support (OR 2.04, 95% CI: 1.12-3.71) and liver stiffness measurement (LSM) ≥ 10 kPa (OR 1.70, 95% CI: 1.07-2.70) as independent predictors of relevant weight loss.</p><p><strong>Conclusions: </strong>Baseline BMI ≥ 30 kg/m², use of GLP-1 agonists, elevated bilirubin levels, support from a nutritionist and LSM ≥ 10 kPa are significant predictors of relevant weight loss in MASLD patients. These findings underscore the importance of personalized interventions in MASLD management.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1205-1216"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226798","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":"The Rising Global Burden of MASLD and Other Metabolic Diseases (2000-2021).","authors":"Pojsakorn Danpanichkul, Kanokphong Suparan, Luis Antonio Diaz, Michael B Fallon, Vincent L Chen, Kornnatthanai Namsathimaphorn, Krittameth Rakwong, Torlap Inkongngam, Chuthathip Kaeosri, Markos Kalligeros, Phuuwadith Wattanachayakul, Cheng Han Ng, Hirokazu Takahashi, Daniel Q Huang, Mark D Muthiah, Juan Pablo Arab, Donghee Kim, Trenton M White, Mazen Noureddin, Elisabetta Bugianesi, Peter Jepsen, Vincent W S Wong, Jeffrey V Lazarus, Karn Wijarnpreecha","doi":"10.1002/ueg2.70072","DOIUrl":"10.1002/ueg2.70072","url":null,"abstract":"<p><strong>Background: </strong>Metabolic diseases are a public health threat to diverse populations worldwide. This study aims to update the epidemiological trends of metabolic diseases across regions and sociodemographic stratifications using the Global Burden of Diseases Study 2021.</p><p><strong>Methods: </strong>This study focused on metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) along with obesity, hypertension, and dyslipidemia. The prevalence and disability-adjusted life years (DALYs) with their age-standardised prevalence rate and DALYs (ASPR and ASDALYs) and uncertainty intervals (UIs) were estimated and stratified by sex, geography, and the Sociodemographic Index (SDI). Epidemiological trends were analysed using the Joinpoint Regression method, which calculated the annual percent change (APC) and confidence intervals (CIs) of age-standardised rates (ASRs) from 2000 to 2021.</p><p><strong>Results: </strong>In 2021, MASLD had a prevalence of 1.27 billion people (ASPR: 15,018.07, 95% UI: 13,756.47 to 16,361.44; ASDALYs: 42.40, 95% UI: 33.60 to 53.31), while T2DM had a prevalence of 0.51 billion people (ASPR: 5885.40, 95% UI: 5467.62 to 6334.18; ASDALYs: 871.78, 95% UI: 735.05 to 1044.78) worldwide. ASPRs of MASLD and T2DM increased over the 2 decades. ASDALYs decreased over time for dyslipidemia (APC: -1.43%, 95% CI: -1.58 to -1.27%) and hypertension (APC: -1.32%, 95% CI: -1.43 to -1.21%) but increased for T2DM (APC: 1.09%, 95% CI: 1.04 to 1.14%) and obesity (APC: 0.70%, 95% CI: 0.63 to 0.78%), while it remained stable for MASLD. The global burden of metabolic diseases was generally higher in males compared to females. The highest ASDALYs for all these metabolic diseases were observed in low-middle SDI countries.</p><p><strong>Conclusion: </strong>The global burden of MASLD and other metabolic diseases is substantial. National and global policies must better address metabolic diseases including the MASLD public health threat.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1141-1154"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555081","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":"Impact of Acute and Sub-Acute Gluten Exposure on Gastrointestinal Symptoms and Psychological Responses in Non-Coeliac Gluten Sensitivity: A Randomised Crossover Study.","authors":"Julie Iven, Annelies Geeraerts, Tim Vanuytsel, Jan Tack, Lukas Van Oudenhove, Jessica R Biesiekierski","doi":"10.1002/ueg2.70014","DOIUrl":"10.1002/ueg2.70014","url":null,"abstract":"<p><strong>Background/aims: </strong>Non-coeliac gluten sensitivity (NCGS) is a controversial entity, characterised by symptom improvement with gluten exclusion in the absence of coeliac disease. We primarily investigated the effects of acute and sub-acute gluten on psychological and mood profiles, with secondary outcomes examining gastrointestinal symptoms and biological markers in healthy controls (HC) and individuals with NCGS.</p><p><strong>Methods: </strong>A randomised, single-blind, crossover study used acute (16 g gluten or whey in yoghurt) and sub-acute (gluten-containing (16 g) or gluten-free muffins per day for 5 days) challenges. (Extra)intestinal symptoms, intestinal permeability, high-sensitive C-reactive protein and cortisol awakening response were assessed. Responses over time were analysed using generalised linear mixed models.</p><p><strong>Results: </strong>Twenty HCs (15% men, mean age 30 years) and 16 individuals with NCGS (31% men, mean age 33 years) participated. No significant group-by-nutrient interactions were observed. Negative affect scores were higher and positive affect scores were lower in NCGS compared to HC (p = 0.01 and p = 0.04, respectively). Participants experienced higher tension scores after gluten compared with placebo (p = 0.01 acute; p = 0.05 sub-acute) regardless of the group. After acute administration, fatigue scores increased in NCGS (p = 0.03) compared with HC regardless of nutrient intake. After sub-acute administration, abdominal pain scores (p < 0.001) and bloating (p = 0.001) increased in NCGS compared with HC regardless of nutrient intake. No differences were found for biological markers.</p><p><strong>Conclusions: </strong>These findings reveal that NCGS is characterised by baseline differences in affect, and higher acute fatigue and subacute gastrointestinal symptoms that are not gluten-specific. This may be explained by nocebo effects, warranting research into novel mechanisms and re-evaluating the NCGS definition.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov no: NCT03798262; NCT03798249.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1295-1306"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731997","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":"The Brescia International Multidisciplinary Consensus Guidelines on the Optimal Pathology Assessment and Multidisciplinary Pathways of Non-Pancreatic Neoplasms in and Around the Ampulla of Vater (PERIPAN).","authors":"Mohammad Abu Hilal, Bas A Uijterwijk, Daniël H L Lemmers, Boris V Janssen, Marc G Besselink, Denise Bianchi, Arantza Fariña, Noriyoshi Fukushima, Anthony J Gill, Seung-Mo Hong, Alyssa Krasinskas, Claudio Luchini, Laura Melocchi, Giulio Rossi, Aldo Scarpa, Olca Basturk, Deyali Chatterjee, Angela Chou, Irene Esposito, Roger Feakins, Bas Groot Koerkamp, Ralph H Hruban, Stefano La Rosa, Chanjuan Shi, Aatur Singhi, Joanne Verheij, Huamin Wang, Sergio Alfieri, Fabio Ausania, Adnan Alseidi, Marco J Bruno, Ugo Boggi, Claudio Bnà, Christos Dervenis, Massimo Falconi, Michele Ghidini, Jakob W Kist, Giovanni Marchegiani, Michele Milella, Roberto Salvia, Ajith Siriwardena, Hanneke Wilmink, Alberto Zaniboni, Shaimaa Al-Janabi, Maia Blomhoff Holm, Eva Roos, Naoki Sano, In Hye Song, Zeynep Tarcan, Gianpaolo Balzano, Isabella Frigerio, Alfredo Guglielmi, Giuseppe Malleo, Horacio Asbun, Volkan Adsay, Caroline Verbeke","doi":"10.1002/ueg2.70074","DOIUrl":"10.1002/ueg2.70074","url":null,"abstract":"<p><strong>Importance: </strong>The lack of multidisciplinary workflow guidelines and clear definitions and classifications for neoplasms in and around the ampulla of Vater results in inconsistencies affecting patient care and research.</p><p><strong>Objective: </strong>The PERIPAN international multidisciplinary consensus group aimed to standardize the multidisciplinary diagnostic workflow and achieve consensus on definitions and classifications in order to ensure proper classification and optimal diagnostic assessment and consequently to improve patient care and future research.</p><p><strong>Design: </strong>An international team of 43 experts (pathologists, surgeons, radiologists, gastroenterologists, oncologists) from 12 countries identified knowledge gaps, reviewed 37061 articles, and proposed recommendations using the Scottish Intercollegiate Guidelines Network methodology (SIGN), including the Delphi methodology and the AGREEII tool for quality assessment and external validation.</p><p><strong>Results: </strong>The 38 consensus questions and 51 recommendations provide guidance on the following key aspects: I. More specific anatomic criteria for the definition of what qualifies as \"ampullary\" neoplasms, their distinction from duodenal and common bile duct tumors, and clinicopathologic characteristics of anatomic subsets; II. Avoidance of the confusing term \"periampullary\" for final classification; III. Refined definitions of intestinal, pancreatobiliary and mixed subtypes, and introduction of rare histologic subtypes; IV. The use and limitations of immunohistochemical and molecular profiling; V. Biopsy acquisition; VI. Clinical information required for accurate pathology assessment of biopsies and ampullectomy specimens; VII. Key items to be included in pathology reports of endoscopic specimens.</p><p><strong>Conclusions and relevance: </strong>Recognition of the Brescia PERIPAN guidelines will allow a more accurate classification of true ampullary cancers and their differentiation from other \"periampullary\" tumors. This will have significant implications for endoscopic interpretation and management, staging, pathologic diagnosis and therapeutic evaluation as well as oncologic treatment of various anatomic and histologic subsets of ampullary tumors. This will enhance the quality of both clinical care and future research in this complex medical field.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1048-1068"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745143","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":"Non-Adherence to Standard Therapy in Autoimmune Hepatitis: Impact of Steroid Use and Over-the-Counter Medications.","authors":"Ewa Wunsch, Linda Krause, Ansgar Wilhelm Lohse, Christoph Schramm, Bernd Löwe, Natalie Uhlenbusch, Romée Snijders, José Willemse, Maciej Janik, Tom J G Gevers, Piotr Milkiewicz","doi":"10.1002/ueg2.70083","DOIUrl":"10.1002/ueg2.70083","url":null,"abstract":"<p><strong>Background and aims: </strong>Non-adherence to treatment may be one of the most important causes for the failure of therapy goals in autoimmune liver diseases (AILD). We aimed to assess factors related to non-adherence in adult non-transplanted patients with autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC).</p><p><strong>Approach and results: </strong>A cross-sectional online survey was conducted in patients with AILD who were prescribed pharmacotherapy for liver disease. Adherence was defined as skipping their medication less than once a week and never reducing or stopping their medication themselves. Sociodemographic data were analyzed relating to medication and disease-related factors in the context of adherence. Multivariable logistic regression analyses were used to identify factors associated with adherence while adjusting for known confounders. A total of 1097 patients with AILD were included: 444 patients with AIH, 377 with PBC and 276 with PSC. Patients with AIH were the most non-adherent group (47%), in comparison to those suffering from PBC (29%), and PSC (38%). In multivariable logistic regression models, over-the-counter medication use was identified as one important common factor that was negatively associated with treatment adherence in all patients and most relevant in the case of the AIH group. Among standard treatments, steroids, though not azathioprine, were negatively associated with adherence in the AIH group.</p><p><strong>Conclusions: </strong>This anonymous survey revealed high non-adherence in patients with AILD, particularly those with AIH treated with steroids. Over-the-counter medication intake may reflect low treatment confidence in standard treatments and should be carefully assessed in patients with AILD in a clinical setting.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1184-1193"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765567","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}