United European Gastroenterology Journal最新文献

{"title":"Concomitant Use of Etrasimod With Opioids or Antidepressants in Patients With Ulcerative Colitis-A Safety Analysis.","authors":"Anita Afzali, Miguel Regueiro, Andres J Yarur, Yamile Zabana, Siew C Ng, Sujatha Menon, Aoibhinn McDonnell, Krisztina Lazin, Michael Keating, Abhishek Bhattacharjee, Diogo Branquinho, Eustratios Bananis, Laurent Peyrin-Biroulet","doi":"10.1002/ueg2.12745","DOIUrl":"10.1002/ueg2.12745","url":null,"abstract":"<p><strong>Background: </strong>Etrasimod is an oral, once-daily (q.d.), selective sphingosine 1-phosphate (S1P)_1,4,5 receptor modulator for the treatment of moderately to severely active ulcerative colitis (UC). Unlike the S1P receptor modulator ozanimod, etrasimod does not have a molecular structure to inhibit monoamine oxidase (MAO). Coadministration of drugs that inhibit MAO with opioids and antidepressants may increase the risk of adverse events (AEs).</p><p><strong>Aims: </strong>This post hoc analysis evaluated the incidence of AEs potentially related to serotonin syndrome in patients taking etrasimod and concomitant opioids or antidepressants in the Phase 3 ELEVATE UC 52 and ELEVATE UC 12 trials.</p><p><strong>Methods: </strong>Safety data pooled from both trials were analysed in subgroups of patients receiving etrasimod 2 mg q.d. (up to 52 weeks of exposure) with/without concomitant opioids or antidepressants. We report the proportions of patients who had ≥ 1 concurrent AE potentially associated with serotonin syndrome, including hypertension-related events.</p><p><strong>Results: </strong>Among 527 patients receiving etrasimod, 77 (14.6%) and 35 (6.6%) were taking concomitant opioids or antidepressants, respectively. The incidence of AEs potentially related to serotonin syndrome, including hypertension-related AEs, was low (≤ 8.6%) and generally comparable in all subgroups. No reported AEs were serious or led to treatment discontinuation among patients taking these concomitant medications.</p><p><strong>Conclusions: </strong>The incidence of AEs was low and comparable in patients receiving etrasimod with or without concomitant opioids or antidepressants. This analysis further supports the low likelihood of clinically relevant drug-drug interactions between etrasimod and medications commonly prescribed to patients with UC, such as opioids or antidepressants. (ClinicalTrials.gov: NCT03945188; NCT03996369).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"719-727"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075788","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":"CiThroModel Improves Prediction of Symptomatic Venous Thromboembolism in Hospitalized Patients With Cirrhosis Without Hepatocellular Carcinoma.","authors":"Alberto Zanetto, Alessandro Vitale, Filippo Pelizzaro, Vittorio Simeon, Elena Campello, Laura Turco, Lorenz Balcar, Francesco Paolo Russo, Patrizia Burra, Paolo Simioni, Marco Senzolo","doi":"10.1002/ueg2.12758","DOIUrl":"10.1002/ueg2.12758","url":null,"abstract":"<p><strong>Background & aims: </strong>Venous thromboembolism (VTE) is a recognized complication of acutely ill patients, but its incidence and risk factors in those with cirrhosis are uncertain.</p><p><strong>Methods: </strong>We retrospectively studied a consecutive cohort of cirrhosis patients non-electively admitted to our medical unit to determine the rates of symptomatic VTE during hospitalization. Firstly, we explored associations with baseline, clinical and laboratory characteristics using logistic regression. Secondly, we developed a clinical prediction model that could predict the risk of in-hospital VTE.</p><p><strong>Results: </strong>We included 687 patients (median age 61 years old; 68% male; Child-Pugh A/B/C, 13%/40%/47%). During hospitalization, 34 patients (4.9%) experienced VTE. Multivariate analysis showed that male sex (OR: 2.56, p = 0.05), AKI (OR: 3.1, p = 0.001), bacterial infections (OR: 2.6, p = 0.008), Pugh score (OR: 1.6. p < 0.001), family history of thrombosis (OR: 3.1, p = 0.04), reduced mobility (OR: 4.6, p < 0.001), and C-reactive protein (OR: 1.1, p = 0.005) were independent predictors of VTE. We combined these variables in a prediction model (CirrhosisThrombosisModel) that accurately discriminated between high- and low-risk patients. The AUROC of CiThroModel was significantly higher than that of Padua prediction score (0.882 vs. 0.742). After validating the CiThroModel using bootstrapping, the adjusted model maintained optimal discrimination ability (0.862) and calibration. The adjusted formula to calculate the in-hospital risk of VTE was -9.00 + 0.82 [Male sex] + 1.14 [AKI] + 0.98 [Infection] + 0.48 * Child Pugh score + 1.14 [VTE family history] + 1.54 [Reduced mobility] + 0.15 * PCR/10.</p><p><strong>Conclusion: </strong>The CiThroModel seems a valuable tool for identifying hospitalized patients with cirrhosis at risk of VTE (https://majinzin.shinyapps.io/vterisk/).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"728-737"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024435","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":"Duodenal Ablation Under the Spotlight of Science: A Promising Approach With Open Questions.","authors":"Mladen Maksic","doi":"10.1002/ueg2.70010","DOIUrl":"10.1002/ueg2.70010","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"840"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188361/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inadequate Therapy Response on Advanced Therapy in Ulcerative Colitis Adult Patients: A Retrospective Analysis of German Health Claims Data.","authors":"Axel Dignass, Irina Blumenstein, Carolina Schwedhelm, Katrin Strassen, Leonie Kunk, Sophie Marquardt, Anna Seiffert, Nataliia Kulchytska, Ivonne Hänsel, Alexa Benson, Agnes Kisser","doi":"10.1002/ueg2.12755","DOIUrl":"10.1002/ueg2.12755","url":null,"abstract":"<p><strong>Background: </strong>The treatment landscape for active ulcerative colitis is rapidly evolving and current real-world evidence on response to advanced therapy is limited. This study aimed to determine indicators of inadequate therapeutic response among patients with ulcerative colitis in Germany initiating advanced therapy.</p><p><strong>Methods: </strong>This retrospective analysis used German claims data (2015-2022) from adult patients (≥ 18 years). The prevalence and incidence of ulcerative colitis (ICD-10-GM: K51.X) were estimated. Inadequate response to therapy was evaluated in patients initiating advanced therapy based on eight predefined indicators observed for 12 months following dispensation of index treatment.</p><p><strong>Results: </strong>Mean ulcerative colitis patient age in 2016-2022 ranged from 49.6 to 51.5 years, 47.6%-48.3% were female. Administrative prevalence ranged from 0.45% in 2016 to 0.53% in 2022. The number of patients initiating advanced treatment ranged from 157 to 347 across the study years (3.2%-4.9% of overall treated study population). On average from 2016-2021, 78.8% had inadequate response in the 12 months following index treatment. Common indicators included prolonged use of corticosteroids (46.2%) and augmentation with conventional therapies (43.9%).</p><p><strong>Conclusions: </strong>Adult ulcerative colitis patients showed a high prevalence of inadequate response to advanced therapies. Our findings reveal a need for improved UC advanced therapy options, providing insight into inadequate response patterns. This may help identify patients who could benefit from a change in therapy to improve long-term outcomes.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"710-718"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060795","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":"Defining Optimal Surveillance Intervals Following Post-Colorectal Endoscopic Submucosal Dissection.","authors":"Daryl Ramai, Hiroyuki Aihara, Lumir Kunovsky","doi":"10.1002/ueg2.12763","DOIUrl":"10.1002/ueg2.12763","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"669-671"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441995","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":"Inter-Rater Disagreements in Applying the Montreal Classification for Crohn's Disease: The Five-Nations Survey Study.","authors":"Offir Ukashi, Aurelien Amiot, David Laharie, Luis Menchén, Ana Gutiérrez, Samuel Fernandes, Tommaso Pessarelli, Fábio Correia, Carlos Gonzalez-Muñoza, Julia López-Cardona, Giulio Calabrese, Rocio Ferreiro-Iglesias, Natalie Tamir-Degabli, Nikolas Konstantine Dussias, Amjad Mousa, Raquel Oliveira, Nicolas Richard, Ido Veisman, Kassem Sharif, Shomron Ben-Horin, Carlos Soutullo-Castiñeiras, Gabriele Dragoni, Silvia Rotulo, Agnese Favale, Louis Calméjane, Thomas Bazin, Alfonso Elosua, Sara Lopes, Carla Felice, Violeta Mauriz, Inês Coelho Rodrigues, Julia Jougon, Inês Botto, Helena Tavares de Sousa, Lorenzo Bertani, Paula Ripoll Abadía, Alice De Bernardi, Yamile Zabana, Xavier Serra-Ruiz, Anna Viola, Manuel Barreiro-de Acosta, Henit Yanai, Alessandro Armuzzi, Fernando Magro, Uri Kopylov","doi":"10.1002/ueg2.12757","DOIUrl":"10.1002/ueg2.12757","url":null,"abstract":"<p><strong>Background: </strong>The Montreal classification has been widely used in Crohn's disease since 2005 to categorize patients by the age of onset (A), disease location (L), behavior (B), and upper gastrointestinal tract and perianal involvement. With evolving management paradigms in Crohn's disease, we aimed to assess the performance of gastroenterologists in applying the Montreal classification.</p><p><strong>Methods: </strong>An online survey was conducted among participants at an international educational conference on inflammatory bowel diseases. Participants classified 20 theoretical Crohn's disease cases using the Montreal classification. Agreement rates with the inflammatory bowel diseases board (three expert gastroenterologists whose consensus rating was considered the gold standard) were calculated for gastroenterologist specialists and fellows/specialists with ≤ 2 years of clinical experience. A majority vote < 75% among participants was considered a notable disagreement. The same cases were classified using three large language models (LLMs), ChatGPT-4, Claude-3, and Gemini-1.5, and assessed for agreement with the board and gastroenterologists. Fleiss Kappa was used to assess within-group agreement.</p><p><strong>Results: </strong>Thirty-eight participants from five countries completed the survey. In defining the Montreal classification as a whole, specialists (21/38 [55%]) had a higher agreement rate with the board compared to fellows/young specialists (17/38 [45%]) (58% vs. 49%, p = 0.012) and to LLMs (58% vs. 18%, p < 0.001). Disease behavior classification was the most challenging, with 76% agreement among specialists and fellows/young specialists and 48% among LLMs compared to the inflammatory bowel diseases board. Regarding disease behavior, within-group agreement was moderate (specialists: k = 0.522, fellows/young specialists: k = 0.532, LLMs: k = 0.577; p < 0.001 for all). Notable points of disagreement included: defining disease behavior concerning obstructive symptoms, assessing disease extent via video capsule endoscopy, and evaluating treatment-related reversibility of the disease phenotype.</p><p><strong>Conclusions: </strong>There is significant inter-rater disagreement in applying the Montreal classification, particularly for disease behavior in Crohn's disease. Improved education or revisions to phenotype criteria may be needed to enhance consensus on the Montreal classification.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"685-696"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012414","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":"Leishmaniasis in Patients With Inflammatory Bowel Disease: A National Multicenter Study of GETECCU.","authors":"L Madero-Velázquez, A Mínguez, L Mayorga, J J Ramírez, N Moreno, C Amorós, M A Nieto, R Mena, J M Benítez, L Gimeno-Pitarch, N Maroto, C Suria, F Rodríguez-Moranta, I Ordás, L Ruiz, M A García-Brenes, A Martín-Cardona, C Rubín de Célix, K Cárdenas, D Ginard, L Medina, N Pedrero, R Plaza, R Salmoral, T J Martínez-Pérez, V Algara, E Merino, Y Zabana, A Gutiérrez","doi":"10.1002/ueg2.12740","DOIUrl":"10.1002/ueg2.12740","url":null,"abstract":"<p><strong>Background: </strong>Leishmaniasis (LI) is a vector-borne illness caused by a protozoan of the genus Leishmania. Data on the features of LI in patients with inflammatory bowel disease (IBD) are scarce.</p><p><strong>Aim: </strong>To describe the characteristics of patients with IBD who present with leishmaniasis, infection outcomes and the risk factors associated with developing visceral leishmaniasis (VL).</p><p><strong>Methods: </strong>An observational retrospective study performed in 26 hospitals in Spain, including all adult patients with IBD who developed Leishmaniasis from 2012 to 2022.</p><p><strong>Results: </strong>A total of 73 patients were included [mean age 48 years; 65% male; 68% Crohn's disease]. Sixty patients (82.2%) presented localized cutaneous Leishmaniasis (CL), 2 (2.7%) diffuse CL, 3 (4.1%) mucocutaneous Leishmaniasis (MCL) and 8 (11%) VL. All patients were under biologicals (69 [94.5%]) or immunosuppressants (IMM) (4 [5.5%]) at Leishmaniasis diagnosis. AntiTNF was used in 97%, while 2 patients (3%) were receiving ustekinumab. Leishmaniasis resolution was achieved by 48% and 96% of the patients after 1 and 12 months, respectively. Biological withdrawal after Leishmaniasis diagnosis was not statistically related to increased rates of infection resolution among patients with localized CL. Age was the only risk factor associated with VL (OR 1.2, 95%CI 1.04-1.39; p = 0.012).</p><p><strong>Conclusions: </strong>Leishmaniasis in patients with IBD doesn't seem to follow a complicated clinical course, even in those with localized CL who do not discontinue biological therapy after infection diagnosis. Age might be a risk factor for developing VL. This infection should be considered for immunosuppressed patients with IBD and suggestive symptoms dwelling or travelling to endemic areas.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"674-684"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955749","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":"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":"10.1002/ueg2.70008","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"672-673"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188372/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IBUS-SAS Is a Highly Accurate Intestinal Ultrasound Score for Predicting Endoscopic Disease Activity in Ulcerative Colitis.","authors":"Sarah Fischer, David Fischmann, Judith Wilde, Marcel Vetter, Laurin Wolf, Carol Geppert, Raja Atreya, Maximilian Waldner, Deike Strobel, Markus F Neurath, Sophie Haberkamp, Sebastian Zundler","doi":"10.1002/ueg2.70053","DOIUrl":"https://doi.org/10.1002/ueg2.70053","url":null,"abstract":"<p><strong>Background: </strong>The international bowel ultrasound group-segmental activity score (IBUS-SAS) is a validated tool with high interobserver agreement for accurately detecting disease activity in Crohn's disease (CD). Here, we addressed whether the IBUS-SAS is also suitable to assess disease activity in ulcerative colitis (UC).</p><p><strong>Methods: </strong>The IBUS-SAS and Limberg scores were determined in the sigmoid colon of patients with UC. The results were correlated to established scores of clinical, endoscopic and histologic disease activity (partial [pMS] and endoscopic [eMS] Mayo-Score, ulcerative colitis endoscopic index of severity [UCEIS], histologic Nancy index) and/or biomarkers of inflammation (C-reactive protein [CRP], fecal calprotectin). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) for IBUS-SAS and the Limberg score to predict endoscopic and histologic disease activity were computed by receiver operating characteristics (ROC)-analysis.</p><p><strong>Results: </strong>Fifty-eight patients with UC were enrolled. The median IBUS-SAS was 34.8. It was significantly correlated with pMS, eMS, UCEIS, Nancy index, CRP and fecal calprotectin. On ROC-analysis, a cut-off of 15.9 was reached with 100% sensitivity and 80.0% specificity for the prediction of endoscopic activity, resulting in a PPV of 94.7% and an NPV of 100%. The Limberg score performed only slightly worse (100.0%, 60.0%, 89.9%, 100%, respectively). Comparable results were found regarding the Nancy index for sensitivity (93.9% vs. 93.9%), specificity (57.1% vs. 42.9%), PPV (91.4% vs. 88.9%) and NPV (65.7% vs. 59.0%).</p><p><strong>Conclusions: </strong>This study highlights the potential of IUS for the non-invasive quantification of disease activity in UC and suggests that the IBUS-SAS should be considered as a diagnostic tool in trials and real-world management of UC.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182613","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":"Between Hope and Reality: The Art of Delivering Difficult News.","authors":"Zainab L Rai, Carmen Mota Reyes","doi":"10.1002/ueg2.70034","DOIUrl":"https://doi.org/10.1002/ueg2.70034","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151947","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}