Therapeutic Advances in Gastroenterology最新文献

{"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}

{"title":"Follow your \"gut\"-calling for colonoscopy in patients with upper gastrointestinal adenomas: a systematic review and meta-analysis.","authors":"Hanyuan Xu, Kai Song, Yuelun Zhang, Chengzhen Lyu, Kun He, Wangyang Chen, Wei Chen, Dong Wu","doi":"10.1177/17562848251351522","DOIUrl":"10.1177/17562848251351522","url":null,"abstract":"<p><strong>Background: </strong>Early detection and removal of adenomas through colonoscopy significantly reduces colorectal cancer (CRC) incidence and mortality. However, there is a lack of summarized evidence evaluating the necessity of colonoscopy in patients with upper gastrointestinal (UGI) adenomas.</p><p><strong>Objectives: </strong>We aimed to assess the risk of colorectal neoplasms in individuals with UGI adenomas to provide evidence on whether patients with UGI adenomas should undergo colonoscopy examination.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>A search of PubMed and Embase was performed up to November 30, 2024. The studies comparing the risk of colorectal neoplasms in patients with and without UGI adenomas were included. Pooled odds ratios (ORs) of colorectal adenomas were estimated using random-effects models. Trial sequential analysis (TSA) was performed to control for random errors.</p><p><strong>Results: </strong>A total of 15 studies with 210,508 participants were included. Our analysis revealed a significant association between UGI adenomas and an increased risk of colorectal adenomas (pooled OR 2.36, 95% confidence interval (CI), 1.82-3.06). TSA confirmed the reliability of these findings. In addition, the presence of duodenal adenomas was linked to an increased risk of advanced colorectal adenomas (pooled OR 2.95, 95% CI, 1.80-4.84) and CRC (pooled OR 2.15, 95% CI, 1.51-3.06). Sensitivity analyses supported the robustness of these associations. Subgroup analysis suggested that patients with either gastric or duodenal adenomas had a higher risk of colorectal adenomas.</p><p><strong>Conclusion: </strong>This is the first meta-analysis suggesting that patients with UGI adenomas are at increased risk of colorectal adenomas and CRC. These findings highlight the need for colonoscopy in this patient population and supplement colonoscopy screening guidelines. <b><i>Trial registration</i>:</b> This meta-analysis protocol was registered on PROSPERO (CRD42024623610).</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251351522"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592700","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":"Different perceptions on the diagnosis and treatment of Crohn's disease between patients and gastroenterologists: a multicenter retrospective study.","authors":"Zhenzhen Fan, Ruixia Li, Xiaoqi Zhang, Minhu Chen, Qian Cao, Yihong Fan, Fang Xiao, Yufang Wang, Liangru Zhu, Hong Guo, Kaichun Wu, Jie Liang","doi":"10.1177/17562848251351515","DOIUrl":"10.1177/17562848251351515","url":null,"abstract":"<p><strong>Background: </strong>Physician assessments of patient symptoms may not align with the patients' subjective experiences, potentially affecting disease management. The key drivers of patients with Crohn's disease (CD) regarding their physicians' engagement in treatment decision-making are unknown.</p><p><strong>Objective: </strong>This study aimed to compare cognitive differences between patients and gastroenterologists in the diagnostic and treatment processes of CD.</p><p><strong>Design: </strong>Retrospective multicenter study.</p><p><strong>Methods: </strong>This study was conducted at 39 inflammatory bowel disease (IBD) centers across China, ultimately recruiting 601 patients with CD and 181 gastroenterologists.</p><p><strong>Results: </strong>Regarding symptom focus, physicians were more concerned about abdominal pain, while patients, particularly inpatients, were more concerned about frequent medical visits. There were also significant differences in the treatment goals. Patients prioritized improving their quality of life, whereas physicians showed a hierarchical difference in their focus: resident and attending physicians emphasized mucosal healing, while deputy chief physicians and above placed greater importance on long-term remission (clinical, endoscopic, and histological). Regarding knowledge gaps about CD, physicians significantly overestimated patients' understanding of biologics (93.37% vs 71.55%, κ = 0.117), with inpatients showing slightly higher awareness than outpatients (73.96% vs 70.42%). Regarding follow-up compliance, the discrepancy was especially prominent: 46.96% of physicians recommended follow-up every ⩽2 months, while 61.73% of patients preferred follow-up every 6 months. The economic burden of CD revealed that 21.30% of patients were willing to spend over 50% of their household income on treatment, which far exceeded physicians' expectations (9.94%). Lastly, there was a significant divergence in decision-making models: 49.17% of physicians advocated for shared decision-making, but only 14.31% of patients agreed with this model (κ = 0.353).</p><p><strong>Conclusion: </strong>There are notable cognitive disparities between patients with CD and physicians in their approaches to disease management, particularly concerning follow-up frequency and treatment options. These differences underscore the need for targeted interventions to bridge the gap between patient and physician perspectives. Therefore, future research should focus on enhancing communication between doctors and patients and enabling them to play a more active role in health management and treatment decisions.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251351515"},"PeriodicalIF":3.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555466","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":"Comment on \"Burden of coeliac disease in Germany: real-world insights from a large retrospective health insurance claims database analysis\".","authors":"Bonetti Marta, Baldoni Monia, Valitutti Francesco","doi":"10.1177/17562848251348572","DOIUrl":"10.1177/17562848251348572","url":null,"abstract":"","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251348572"},"PeriodicalIF":3.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555465","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}