Therapeutic Advances in Gastroenterology最新文献

{"title":"Observable score for bleeding after colorectal endoscopic mucosal resection.","authors":"Hayato Nakazawa, Kenichiro Okimoto, Tomoaki Matsumura, Masayuki Yokoyama, Tsubasa Ishikawa, Yoshihiro Fukuda, Yoshio Kitsukawa, Akane Kurosugi, Michiko Sonoda, Tatsuya Kaneko, Yuki Ohta, Takashi Taida, Keisuke Matsusaka, Jun-Ichiro Ikeda, Jun Kato","doi":"10.1177/17562848251356112","DOIUrl":"https://doi.org/10.1177/17562848251356112","url":null,"abstract":"<p><strong>Background: </strong>There is insufficient evidence regarding the management of hematochezia after colorectal endoscopic mucosal resection (EMR) without endoscopic hemostasis.</p><p><strong>Objectives: </strong>The aim of this study was to develop an observable score for hematochezia after colorectal EMR.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>This retrospective study included three hospitals in Japan. During the study period, colorectal EMR was performed in 3989 patients (11,414 lesions). Post-EMR hematochezia (delayed bleeding (DB)) was observed in 169 patients (512 lesions). Of these, 47 patients (150 lesions) were classified into the Hemostasis Group, comprising those who underwent endoscopic hemostasis. The remaining 122 (362 lesions) were classified into the non-hemostasis group, comprising those who underwent endoscopy without hemostasis, received preventive hemostasis, and did not undergo emergency endoscopy. Weighted points were assigned to predict observable cases following colorectal EMR through multivariate logistic regression analysis, enabling the development of a predictive model.</p><p><strong>Results: </strong>The prediction model comprised three variables (male gender, American Society of Anesthesiologists Physical Status 3, direct oral anticoagulant). According to the definition, the total score was categorized as lowly observable (2 or 3 points) and highly observable (0 or 1 points) for DB after colorectal EMR. As a result, the rates of observable cases for each risk category were 45.7% and 81.8%, respectively. The model showed good discrimination ability from the c-statistic (95% CI) of 0.71 (0.63-0.79).</p><p><strong>Conclusion: </strong>Although further prospective studies are necessary to validate the utility of the score, it may be useful in clinical practice.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251356112"},"PeriodicalIF":3.9,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12280549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription trends of gastric acid suppressants and association with potential adverse events in Korea: a real-world cross-sectional study.","authors":"Min Jeong Je, Jeong Min Go, Shin Yeong Kim, Min-Gul Kim, Hankil Lee, Ha-Lim Jeon, Jae Hyun Kim","doi":"10.1177/17562848251356406","DOIUrl":"10.1177/17562848251356406","url":null,"abstract":"<p><strong>Background: </strong>Recent changes in the acid-related disease market, particularly the emergence of potassium-competitive acid blockers (P-CABs), require an updated analysis of trends in gastric acid suppressant utilization.</p><p><strong>Objectives: </strong>As the use of P-CAB expands globally, a cross-sectional study is needed to assess its association with potential adverse events from a pharmacovigilance perspective.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>We analyzed gastric acid suppressant use at prescription and patient levels using the Health Insurance Review and Assessment National Patient Sample database (2014-2020). Prescription-level analysis included the annual prescriptions for histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and P-CABs, and proportion of visits by acid-related indications. Patient-level analysis examined annual trends in drug use and clinical characteristics. Logistic regression was used to estimate prevalence odds ratios (ORs) for potential adverse events among drug users and non-users according to the drug class.</p><p><strong>Results: </strong>In 2020, H2RAs were primarily prescribed for gastritis and duodenitis (64.5%), whereas PPIs (55.4%) and P-CABs (58.6%) were primarily used to treat gastroesophageal reflux disease. H2RA prescriptions declined in 2019, whereas the use of P-CAB increased following the approval of tegoprazan in 2018. Patients aged 40-64 years and female users were predominant across all classes of gastric acid suppressants. P-CAB use was significantly associated with osteoporosis (OR = 1.17; 95% confidence interval (CI): 1.13-1.20), pneumonia (OR = 1.65, 95% CI: 1.55-1.75), and acute kidney injury (OR = 1.39, 95% CI: 1.20-1.61).</p><p><strong>Conclusion: </strong>P-CABs have reshaped the prescription landscape of gastric acid suppressants. Further longitudinal cohort studies are required to evaluate long-term safety in routine clinical practice.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251356406"},"PeriodicalIF":3.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of recombinant thrombomodulin administration on disseminated intravascular coagulation due to severe acute pancreatitis (Recover-AP study).","authors":"Takeshi Ogura, Saori Ueno, Akitoshi Hakoda, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Taro Iwatsubo, Ahmad F Aboelezz, Hiroki Nishikawa","doi":"10.1177/17562848251353626","DOIUrl":"10.1177/17562848251353626","url":null,"abstract":"<p><strong>Background: </strong>If severe acute pancreatitis (SAP) is complicated by disseminated intravascular coagulation (DIC) or walled-off necrosis (WON), the mortality rate may increase. Therefore, prevention of the development of WON and treatment of DIC are likely to play important roles in improving survival in SAP. Although recombinant human soluble thrombomodulin (rhTM) might play a useful role in treating DIC, the impact of rhTM on improving survival and resolution of DIC due to SAP is still unclear.</p><p><strong>Objective: </strong>This study aimed to evaluate the clinical impact of rhTM in patients with SAP and DIC.</p><p><strong>Design: </strong>A single-center retrospective study.</p><p><strong>Method: </strong>The patients were divided into two groups: the rhTM group and the non-rhTM group, in which rhTM was not administered. The primary outcome was the DIC resolution rate at 7 days after starting treatment. The mortality rate at 28 days was secondarily evaluated.</p><p><strong>Results: </strong>Among 321 SAP patients, 63 patients were complicated with DIC, and they were divided into rhTM (<i>n</i> = 28) and non-rhTM (<i>n</i> = 35) groups. The rate of development of WON was significantly higher in the non-rhTM group (51.4%, 18/35) compared with the rhTM group (25.0%, 7/28) (<i>p</i> = 0.033). The resolution rate of DIC within 7 days was significantly higher in the rhTM group (89.3%, 25/28) compared with the non-rhTM group (60.0%, <i>n</i> = 9/35) (<i>p</i> = 0.009). The mortality rate within 14 days, which might have been strongly influenced by the presence of DIC, was significantly higher in the non-rhTM group (20.0%, 7/35) compared with the rhTM group (0%, 0/28) (<i>p</i> = 0.01). According to multivariate analysis, rTM non-administration was an independent factor for failed DIC resolution or developing WON.</p><p><strong>Conclusion: </strong>In conclusion, rhTM may play a role not only in improving the resolution rate of DIC and improving the survival rate of SAP, but also in preventing the development of WON.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251353626"},"PeriodicalIF":3.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of endoscopic ultrasound-guided hepaticogastrostomy-based internal drainage for unresectable malignant hilar biliary obstruction: a comprehensive evaluation with malignant distal biliary obstruction.","authors":"Daiki Yamashige, Susumu Hijioka, Yoshikuni Nagashio, Shota Harai, Yasuhiro Komori, Aoi Kita, Masaru Kuwada, Soma Fukuda, Shin Yagi, Kohei Okamoto, Daiki Agarie, Shunsuke Sugawara, Miyuki Sone, Yutaka Saito, Takuji Okusaka","doi":"10.1177/17562848251356099","DOIUrl":"10.1177/17562848251356099","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) may not provide adequate drainage for patients with malignant hilar biliary obstruction (MHBO). Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is a salvage method for malignant distal biliary obstruction (MDBO); however, its effectiveness for MHBO remains unclear.</p><p><strong>Objectives: </strong>We aimed to evaluate the short- and long-term outcomes of EUS-HGS for MHBO.</p><p><strong>Design: </strong>This was a single-center retrospective cohort study.</p><p><strong>Methods: </strong>Unresectable patients who underwent initial EUS-HGS because of ERCP failure were recruited. Distal biliary stenosis or Bismuth types I and II-IV were defined as MDBO and MHBO, respectively. We defined EUS-HGS for MDBO as the control and analyzed the outcomes for MHBO.</p><p><strong>Results: </strong>The MDBO group (<i>n</i> = 208) was treated using EUS-HGS alone. In the MHBO group (<i>n</i> = 63), EUS-HGS alone (unilateral drainage, <i>n</i> = 26), EUS-HGS with bridging (EUS-HGSB, bilateral drainage, <i>n</i> = 21), and ERCP + EUS-HGS (bilateral drainage, <i>n</i> = 16) were performed. In EUS-HGS (MDBO), EUS-HGS (MHBO), EUS-HGSB, and ERCP + EUS-HGS, the technical success rates were 98.6%, 96.3%, 95.5%, and 94.1%; clinical success rates were 88.5%, 76.9%, 85.7%, and 75.0%; adverse event rates were 19.7%, 15.4%, 9.5%, and 25.0%; and non-recurrent biliary obstruction (RBO) rates at 180 days were 45.5%, 19.8%, 61.9%, and 68.4%, respectively. In multivariate analysis of the MHBO group, EUS-HGSB tended to have a lower risk of RBO (adjusted hazard ratio (aHR), 0.39; <i>p</i> = 0.09), and ERCP + EUS-HGS showed a significantly lower risk (aHR, 0.25; <i>p</i> = 0.03) compared to EUS-HGS alone (unilateral drainage).</p><p><strong>Conclusion: </strong>ERCP + EUS-HGS followed by EUS-HGSB, providing bilateral drainage, can offer preferred palliation for MHBO. These drainages may serve as potential salvage options in the management of MHBO.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251356099"},"PeriodicalIF":3.9,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fourteen-day vonoprazan-amoxicillin dual therapy versus 14-day bismuth-based quadruple therapy for <i>Helicobacter pylori</i> treatment: a randomized clinical trial.","authors":"Jin-Yan Zhang, Jin-Hai Chen, Yu-Lin Huang, Ji Li, Dong Xu, Zhong Xu, Xiao-Yi Lei","doi":"10.1177/17562848251354868","DOIUrl":"10.1177/17562848251354868","url":null,"abstract":"<p><strong>Background: </strong>Potassium-competitive acid blockers (P-CABs) have shown potential in <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication, but the efficacy of dual therapy with P-CABs and amoxicillin remains underexplored.</p><p><strong>Objectives: </strong>This study evaluated the efficacy, safety, and compliance of a 14-day vonoprazan-amoxicillin (VA) dual therapy compared to a bismuth-based quadruple therapy (BQT) in treatment-naive patients.</p><p><strong>Design: </strong>A randomized clinical trial.</p><p><strong>Methods: </strong>This single-center, prospective, randomized controlled trial enrolled 250 <i>H. pylori</i>-positive patients from November 2022 to April 2024. Participants were randomly assigned (1:1) to receive 14-day VA dual therapy or BQT (lansoprazole, bismuth, amoxicillin, and clarithromycin). The primary outcomes were eradication rates in intention-to-treat (ITT) and per-protocol (PP) analyses. Secondary outcomes included adverse events and treatment compliance.</p><p><strong>Results: </strong>Eradication rates in the ITT analysis were 92.0% for the VA dual group and 88.0% for the BQT group (<i>p</i> = 0.292). In the PP analysis, eradication rates were 95.8% and 91.7%, respectively (<i>p</i> = 0.188). The VA dual group demonstrated statistically significant non-inferiority to the BQT group in both the ITT and PP analyses (both <i>p</i> < 0.001). The incidence of adverse events was significantly lower in the VA dual group compared to the BQT group (11.2% vs 20.8%, <i>p</i> = 0.038), with no severe adverse events reported. The compliance rates of both groups were 97.6%.</p><p><strong>Conclusion: </strong>The 14-day VA dual therapy is highly effective and well-tolerated, demonstrating non-inferiority to BQT. Given its reduced antibiotic usage and lower adverse events, it may be a viable first-line alternative for <i>H. pylori</i> in southern China.</p><p><strong>Trial registration: </strong>This trial was registered on the Chinese Clinical Trial Registry with the registration number ChiCTR2200055752.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251354868"},"PeriodicalIF":3.9,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom burden in end-stage liver disease: a prospective cohort study of the symptoms experienced by patients and the role of palliative care.","authors":"Hugo M Oliveira, Filipa Ribeiro, Graça Lopes, Eliana Frias, Filipe Andrade, Verónica Guiomar, Eduardo Eiras, Francisca Rego, Rui Nunes","doi":"10.1177/17562848251353624","DOIUrl":"10.1177/17562848251353624","url":null,"abstract":"<p><strong>Background: </strong>Liver disease is a leading cause of morbidity and mortality. Patients with end-stage liver disease (ESLD) experience multiple physical symptoms. Despite the poor prognosis and significant symptom burden, palliative care integration remains limited.</p><p><strong>Objectives: </strong>To assess the symptom burden in ESLD patients, the viability of applying a symptom scale in routine evaluations, and to assess the impact of palliative care on symptom management.</p><p><strong>Design: </strong>Observational, prospective cohort study.</p><p><strong>Methods: </strong>We prospectively included patients with chronic liver disease following their first episode of decompensation or diagnosis of hepatocarcinoma (HCC). Data collected included patient demographics, ESLD etiology, history of decompensation, and patient-reported symptom burden. Two-sided tests were used to identify factors of disease severity and evaluate the benefits of palliative care intervention.</p><p><strong>Results: </strong>Forty-four patients were assessed, divided into two cohorts: palliative care cohort (52.3%; <i>n</i> = 23) and hepatology care cohort (47.7%; <i>n</i> = 21). Patients in the palliative care cohort were older (69.35 ± 11.71 vs 59.86 ± 7.11 years; <i>p</i> = 0.002), had lower functional status (59.13 ± 2.51 vs 72.38 ± 2.92; <i>p</i> = 0.002), and higher prevalence of unstable decompensated cirrhosis (60.9% vs 28.6%; <i>p</i> = 0.043) and HCC (<i>p</i> < 0.001). This cohort reported a higher overall symptom burden, with rates of 82.6% for asthenia, 65.2% for pain, and 56.5% for anorexia. Palliative care interventions tended to reduce the prevalence of pain, anorexia, and dyspnea, with a significant decrease in pain intensity from 86.7% to 23.1% (<i>p</i> = 0.008) and asthenia intensity from 100% to 84.2% (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Significant differences in symptom prevalence were observed between the two cohorts, likely due to specific clinical characteristics of each group. The use of a symptom assessment scale proved to be simple and effective, revealing a high prevalence of symptoms. Palliative care was associated with a positive impact on symptom management.</p><p><strong>Trial registration: </strong>NCT06181474.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251353624"},"PeriodicalIF":3.9,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in inflammatory bowel disease endoscopy - a review of current evidence and a critical perspective on future challenges.","authors":"Ilaria Lodola, Ferdinando D'Amico, Silvio Danese, Tommaso Lorenzo Parigi","doi":"10.1177/17562848251350896","DOIUrl":"10.1177/17562848251350896","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic and relapsing immune-mediated condition with a rising global prevalence. Endoscopic diagnosis, monitoring and surveillance currently depend on individual endoscopists, introducing subjectivity, variability, delays and potential diagnostic discrepancies. Artificial intelligence (AI) is poised to transform these processes. To date, most AI applications have focused on ulcerative colitis (UC) severity assessment, demonstrating promising results in replicating human evaluation, standardizing severity evaluation and facilitating the application of more complex scoring systems. Research into AI for Crohn's disease (CD) has lagged behind UC, due to challenges such as disease heterogeneity and transmural extension; nevertheless, significant progress has been made to automate capsule endoscopy readings for CD. Beyond the grading of disease severity, AI is also being explored for tasks such as identifying dysplastic lesions, differentiating IBD from other conditions, assessing intestinal barrier permeability, guiding treatment decisions and integrating data from multiple omics, though studies in these areas remain exploratory. This review examines the current landscape of AI applications in IBD endoscopy, summarizes key studies in the field and explores the future potential of AI in IBD care.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251350896"},"PeriodicalIF":3.9,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting resistance to biological therapy using human leukocyte antigen genes in patients with inflammatory bowel disease.","authors":"Ângela Domingues, Ana Carvalho, António Martinho, Caroline Soares, Diana Martins, Paula Sousa, Ricardo Araújo, Eugénia Cancela, Américo Silva, Paula Ministro","doi":"10.1177/17562848251353293","DOIUrl":"10.1177/17562848251353293","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of anti-tumor necrosis factor (TNF) therapy in inflammatory bowel disease (IBD) is often compromised by the development of antidrug antibodies. In this setting, the human leukocyte antigen (HLA)-DQA1*05 allele has been significantly associated with the formation of antidrug antibodies to anti-TNF agents, loss of response, and treatment discontinuation.</p><p><strong>Objectives: </strong>We aimed to determine whether HLA-DQA1*05 genotyping is associated with clinically meaningful outcomes in patients with IBD.</p><p><strong>Design: </strong>A single-center, prospective study was conducted on patients with IBD who were naïve to biological treatment and were initiating therapy with anti-TNF agents, vedolizumab, or ustekinumab.</p><p><strong>Methods: </strong>All patients were genotyped for HLA-DQA1*05. The primary endpoint was the achievement of a composite outcome encompassing clinical, biochemical, and endoscopic remission at week 54, stratified by HLA-DQA1*05 status. The secondary endpoints included the evaluation of therapeutic persistence and the development of antidrug antibodies.</p><p><strong>Results: </strong>One hundred biologic-naïve patients with IBD initiating biological therapy were included in the study (72 on anti-TNF, 18 on vedolizumab, and 10 on ustekinumab); of these, 43% were HLA-DQA1*05 positive. The presence of the HLA-DQA1*05 allele was not associated with worse clinical outcomes, defined as the composite of clinical, biochemical, and endoscopic remission at week 54, in patients treated with anti-TNF agents, vedolizumab, or ustekinumab. In addition, no significant correlation was observed between the HLA-DQA1*05 genotype and reduced therapy persistence or increased immunogenicity.</p><p><strong>Conclusion: </strong>In our cohort of patients with IBD, the HLA-DQA1*05 genotype was not associated with a higher risk of treatment cessation or worse clinical outcomes.</p><p><strong>Trial registration: </strong>Can we rely on HLA to predict resistance to biological therapy in patients with IBD?URL: https://clinicaltrials.gov/study/NCT05040854?cond=Can%20we%20rely%20on%20HLA&rank=1. Registration number: NCT05040854 (clinicaltrials.gov).</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251353293"},"PeriodicalIF":3.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of endoscopic submucosal dissection in the management of internal hemorrhoids: a retrospective cohort study.","authors":"Hidenori Tanaka, Toshio Kuwai, Shinji Nagata, Naoki Asayama, Yuko Hiraga, Tomohiko Kohno, Yuzuru Tamaru, Masaki Kunihiro, Koki Nakamura, Ken Yamashita, Yoshihiro Kishida, Shiro Oka","doi":"10.1177/17562848251355710","DOIUrl":"10.1177/17562848251355710","url":null,"abstract":"<p><strong>Background: </strong>Improvement in internal hemorrhoids is frequently observed after endoscopic submucosal dissection (ESD) for rectal intraepithelial neoplasia. This study investigated the effectiveness of rectal ESD in the management of internal hemorrhoids.</p><p><strong>Objectives: </strong>Twenty-three patients who underwent ESD for tumors adjacent to the dentate line and associated with internal hemorrhoids.</p><p><strong>Design: </strong>A single-arm, retrospective multi-center study.</p><p><strong>Methods: </strong>The focal improvement (at the scarring area after ESD) and complete improvement rates of hemorrhoids at follow-up colonoscopies were evaluated.</p><p><strong>Results: </strong>Most patients (87%) had mild hemorrhoids. The focal and complete improvement rates of hemorrhoids were 83% and 48%, respectively. Complete improvement rates were 75% (3/4), 42% (5/12), and 43% (3/7) for tumors involving ⩾1/2, between 1/4 and 1/2, and <1/4 of the circumference at the dentate line, respectively. No recurrence was observed after initial improvement, with a median observation period of 35 months.</p><p><strong>Conclusion: </strong>ESD may be an effective treatment for internal hemorrhoids.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251355710"},"PeriodicalIF":3.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving role of endoscopic ultrasound-guided lumen-apposing metal stents in the management of peri-pancreatic fluid collections.","authors":"Ashita Rukmini Vuthaluru, Varun Mehta, Omesh Goyal, Prabhav Mehta, Manjeet Kumar Goyal","doi":"10.1177/17562848251353627","DOIUrl":"10.1177/17562848251353627","url":null,"abstract":"","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251353627"},"PeriodicalIF":3.9,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}