Therapeutic Advances in Gastroenterology最新文献

{"title":"Maintenance therapy with once or twice daily budesonide orodispersible tablets after budesonide viscous solution in eosinophilic esophagitis.","authors":"Jana Defrancq, Karlien Raymenants, Jan Tack, Tim Vanuytsel, Lucas Wauters","doi":"10.1177/17562848261465758","DOIUrl":"10.1177/17562848261465758","url":null,"abstract":"<p><strong>Background: </strong>Budesonide orodispersible tablets (BOT) are the first drug specifically developed for eosinophilic esophagitis (EoE), whereas budesonide viscous solution (BVS) is used off-label.</p><p><strong>Objectives: </strong>We aimed to assess the histological, endoscopic, clinical, and safety outcomes before and after switching maintenance therapy from BVS to BOT.</p><p><strong>Design: </strong>Observational cohort study of EoE patients who switched therapy from BVS to BOT at the same dose (1 mg) and dosing schedule (once daily (OD) or twice daily (BID)).</p><p><strong>Methods: </strong>We performed a retrospective analysis of a prospectively collected dataset. Routine procedures included endoscopy with biopsies to assess histological and endoscopic disease and whether candidiasis was present. Histological remission was defined as <15 eosinophils per high-power field (eos/HPF) and deep histological remission as <6 eos/HPF. Online questionnaires, including dysphagia symptom questionnaire (DSQ), eosinophilic esophagitis symptom activity index (EEsAI), numerical rating scale (NRS) for symptoms and adult eosinophilic esophagitis quality of life questionnaire (EoE-QoL-A), were filled out by patients to assess symptom severity and health-related quality of life (HRQoL). Data are presented as proportions or medians with interquartile ranges, using non-parametric paired tests for proportions or other variables.</p><p><strong>Results: </strong>In total, 45 patients were included. The majority of patients switched to BOT 1 mg OD (<i>n</i> = 32, 25 males, age 35 (27.8-40.3) years and body mass index 24.3 (21.4-27.5) kg/m²). Endoscopy and questionnaires were repeated 170 (145.3-182) days after switch. The proportion of patients achieving histological (<i>p</i> = 0.04) and deep histological (<i>p</i> = 0.01) remission increased significantly. The total endoscopic reference score decreased significantly (<i>p</i> = 0.003). Symptoms remained low (DSQ: <i>p</i> = 1; EEsAI: <i>p</i> = 0.9; NRS: <i>p</i> = 0.1), while a significant improvement in HRQoL (EoE-QoL-A: <i>p</i> = 0.008) was observed. A numeric increase in candidiasis was noted (<i>p</i> = 0.3). Similar results were obtained for EoE patients switching maintenance therapy from BVS to BOT 1 mg BID.</p><p><strong>Conclusion: </strong>Maintenance therapy with BOT after BVS may be feasible and effective in the real-world management of EoE patients, with only a numeric increase in the endoscopic suspicion of candidiasis.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261465758"},"PeriodicalIF":3.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498385","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":"Noninvasive electrical neuromodulation involving vagus nerve mechanism for functional constipation and irritable bowel syndrome with constipation.","authors":"Jie Liu, Chanlan Lv, Xiuli Zhu, Na Hong, Yizhou Huang, Chenyu Sun, Yichen Wang, Yan Yan, Yuting Huang, Yue Yu","doi":"10.1177/17562848261469142","DOIUrl":"10.1177/17562848261469142","url":null,"abstract":"<p><p>Functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C) are prevalent disorders of gut-brain interaction with limited effective treatments. The vagus nerve exerts considerable influence on the gastrointestinal (GI) tract, indicating that noninvasive electrical neuromodulation targeting this nerve could provide a promising therapeutic avenue for both FC and IBS-C. This review explores several emerging noninvasive neuromodulation techniques involving the vagus nerve, such as transcutaneous auricular vagal nerve stimulation, percutaneous electrical nerve field stimulation, and transcutaneous electrical acustimulation. The clinical applications of these methods in managing FC and IBS-C are evaluated. Existing evidence supports the efficacy and safety of noninvasive neuromodulation in relieving symptoms of these conditions. Future investigations should aim to refine these techniques, advance device technology, and further clarify the mechanisms of action.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261469142"},"PeriodicalIF":3.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580906","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":"Predictability of peripheral blood inflammatory markers in prediction of lymph node metastasis in gastric cancer.","authors":"Xiang Li, Wei Dai, Xi Li, Xuan Chen, Yajun Chen, Zhongxue Fu, Jun Zhang","doi":"10.1177/17562848261451338","DOIUrl":"10.1177/17562848261451338","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) has high incidence and mortality rates worldwide, and lymph node metastasis (LNM) is a key determinant of prognosis and treatment strategy.</p><p><strong>Objectives: </strong>In this study, we aimed to investigate the association between eight inflammatory markers and LNM in GC and develop a prognostic model for LNM using inflammatory indicators.</p><p><strong>Design: </strong>This was a retrospective multicenter study.</p><p><strong>Methods: </strong>Clinical, pathological, and laboratory data from 868 GC patients were analyzed. Independent risk factors for LNM were identified through univariate logistic regression (LR), least absolute shrinkage and selection operator regression, and multivariable LR. Fourteen machine learning models were constructed using 10-fold cross-validation, and model performance was evaluated by calculation of the area under the receiver operating curve (AUC).</p><p><strong>Results: </strong>Five clinical and pathological characteristics were identified as independent risk factors for LNM in GC: Glasgow prognostic score (GPS), T stage, histological differentiation, vascular invasion, and total lymph node count. The categorical boosting (CatBoost) model demonstrated the best performance (AUC: 0.808) of all machine learning models tested, followed by the random forest model (0.806). Conversely, the AdaBoost model had the lowest AUC score (0.727). Further analysis of the CatBoost model showed that at the optimal threshold (0.56), it correctly identified approximately 82.7% of patients with LNM and approximately 69.4% of LNM-negative patients.</p><p><strong>Conclusion: </strong>These findings demonstrate the value of inflammatory markers, including the GPS, in prediction of LNM in patients with GC, as well as the ability of machine learning models to enhance prognostic accuracy, support informed treatment decisions, and improve patient outcomes.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261451338"},"PeriodicalIF":3.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473713","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":"Immunomodulatory biomaterials as a novel therapeutic platform for inflammatory bowel disease.","authors":"Lydia Blacklock, Gordon Moran, Alvaro Mata, Amir Ghaemmaghami","doi":"10.1177/17562848261463601","DOIUrl":"10.1177/17562848261463601","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic autoimmune condition of the gut caused by an inappropriate reaction towards commensal bacteria by immune cells that reside within the gut-associated lymphoid tissue. IBD is of rising concern due to increased global incidence with no outright cure. Patients have changeable response to standard therapeutic pathways that result in lifelong contact with healthcare systems. This narrative review aims to evaluate the therapeutic potential of immunomodulatory biomaterials for IBD as an alternative approach to current treatment options. A literature search was conducted using PubMed, Google Scholar and Web of Science databases. The primary aim was to identify pre-clinical, laboratory studies that investigated biomaterials in the presence of IBD models. Herein, we review the advent of biomaterials that demonstrate immunomodulatory capacity to directly alleviate chronic IBD pathology. We demonstrate the difference between natural and synthetic polymers as building blocks for biomaterials, such as hydrogels, microspheres and nanospheres, which can be functionalised based upon specific IBD inflammatory markers. Here, we assess examples of immunomodulatory biomaterials tested in IBD cellular, tissue and animal models as inflammation-targeted alternatives to current therapeutics. We also discuss the gaps for further research, from administration to scalability considerations to demonstrate the realistic use of immunomodulatory biomaterials for IBD in the clinic.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261463601"},"PeriodicalIF":3.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473649","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 Israeli IBD Research Nucleus: collaborative advancements in Israeli IBD research.","authors":"Iris Dotan, Shomron Ben-Horin, Doron Schwartz, Haggai Bar-Yoseph, Maya Fischman, Shai S Shen-Orr, Yehuda Chowers, Shmuel Odes, Rami Eliakim, Dan Turner","doi":"10.1177/17562848261463603","DOIUrl":"10.1177/17562848261463603","url":null,"abstract":"<p><p>Inflammatory bowel diseases (IBD) are increasing worldwide, requiring multidisciplinary care and coordinated research infrastructures. Leveraging Israel's integrated healthcare system with IBD centers of specific and complementary research expertise, a national collaborative consortium was established: the Israeli IBD Research Nucleus (IIRN). In this narrative article, we review a decade of IIRN structure, scientific outputs, and lessons learned. The IIRN included five tertiary academic IBD referral centers across Israel, with expertise in epidemiology, mucosal immunology, diet and microbiome, imaging, and psychosocial care. We summarized the IIRN key activities, findings, and contributions across these domains. Publications (2015-2025) were identified using a structured bibliometric approach and included studies aligned with core research programs of the IIRN. This collaborative consortium has been supported since its inauguration by the Leona M. and Harry B. Helmsley Charitable Trust, providing funding, advice, and partnership. The IIRN provided significant contributions in several domains. It established a population-based nationwide registry (epi-IIRN) that integrates data from the four national health maintenance organizations, enabling studies of disease prevalence, course, comorbidities, and treatment patterns. Prospective cohorts of patients with Crohn's disease provided longitudinal insights linking multidisciplinary programs, Mediterranean diet and lifestyle, and psychosocial interventions with patient-reported outcomes, inflammatory markers, and microbiome features. Integrating imaging, video-capsule endoscopy, and biomarker assessment informed monitoring strategies and treat-to-target concepts. Exploratory translational work in microbiome, transcriptomics, and therapeutic drug monitoring refined insights regarding treatment response and sequencing. Artificial intelligence applications explored image and report interpretation to predict Crohn's disease. The IIRN experience illustrates how coordinated national collaborations can leverage epidemiology, prospective cohorts, translational research, and multidisciplinary care programs. This experience highlights both the opportunities and challenges of shared research infrastructure and may inform similar collaborative efforts in other healthcare settings.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261463603"},"PeriodicalIF":3.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450026","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":"Current and novel biomarkers for predicting and assessing therapeutic response in inflammatory bowel disease: a systematic review.","authors":"Shellie Radford, Anoop John, Antonina Latino-Kelly, Catherine Alexander, Owen Wilding, Jaimin Chauhan, Farhad Shokraneh, Siddhee Pradhan, Gordon W Moran","doi":"10.1177/17562848261463913","DOIUrl":"10.1177/17562848261463913","url":null,"abstract":"<p><strong>Background: </strong>Despite the availability of various advanced treatments for inflammatory bowel disease (IBD), it has been impossible to predict which therapy would offer the best response to the patient.</p><p><strong>Objective: </strong>The aim of this systematic review is to explore current and novel biomarkers for predicting and assessing therapeutic response to advanced therapies presently in clinical use in IBD.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO ID: CRD42024559652). A systematic literature search for all primary research looking at biomarkers in predicting response to advanced therapy in Crohn's disease (CD) or ulcerative colitis (UC) was conducted across MEDLINE, EMBASE and PubMed databases. Abstracts, case studies, commentary papers and review articles were excluded.</p><p><strong>Results: </strong>Fifty-five studies were included in this review investigating baseline predictors of response to anti-tumour necrosis factor, ustekinumab, vedolizumab and ozanimod therapies in both CD and UC. The various biomarkers studied included blood, serum, faecal, histological, nutrient, genetic and pharmacokinetic markers. C-reactive protein and faecal calprotectin were among the most commonly studied biomarkers; however, there were inconsistencies with regard to optimum cutoff values used and hence their roles as baseline predictors of response to advanced therapies are yet unclear. None of the biomarker studies to date has yet transitioned to clinical use.</p><p><strong>Conclusion: </strong>Biomarker identification to predict therapeutic response persists to be an ongoing challenge. Further work through large well-designed prospective cohort studies is needed to further refine the clinical utility of these tools.</p><p><strong>Trial registration: </strong><i>The protocol was prospectively registered with the PROSPERO database (CRD42024559652)</i>.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261463913"},"PeriodicalIF":3.8,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449989","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":"Using artificial intelligence to identify characteristics associated with clinical and economic outcomes in MASH (FOCUS-MASH).","authors":"Kamal Kant Mangla, Semiu O Gbadamosi, Daniel Semeniuta, Jigar Bandaria, Joseph Zabinski, Gary Curhan, Costas Boussios","doi":"10.1177/17562848261462398","DOIUrl":"10.1177/17562848261462398","url":null,"abstract":"<p><strong>Background: </strong>Heterogeneity in the disease characteristics of metabolic dysfunction-associated steatohepatitis (MASH) complicates efforts to identify individuals with high unmet need.</p><p><strong>Objective: </strong>We used artificial intelligence (AI) phenotyping to identify factors associated with rapid fibrosis progression, long-term clinical outcomes, and high healthcare costs.</p><p><strong>Design: </strong>In this retrospective cohort study (January 1, 2013-September 1, 2022), patients with a MASH diagnosis, a Fibrosis-4 index score within 90 days of first MASH diagnosis, and no other liver diseases were identified in a United States electronic medical records and claims dataset.</p><p><strong>Methods: </strong>Using machine learning, characteristics, including diagnoses, procedures, and medications, were grouped into phenotypic signals, which were iteratively refined and evaluated for strength of association with each outcome. Differences between subgroups in the proportions of patients with specific phenotypic signals were calculated.</p><p><strong>Results: </strong>In total, 14,707 patients were included in at least one analysis. Rapid fibrosis progression (<i>n</i> = 1795) was associated with a history of anemia, thrombocytopenia, and cardiovascular (CV) diagnoses. Long-term liver- and CV-related outcomes (<i>n</i> = 13,880) were associated with chronic diseases, kidney diagnoses, cardiac diagnoses, medications, lab tests, and injuries. High healthcare costs (<i>n</i> = 10,133) were associated with heart failure procedure codes, cardiac diagnoses and testing, hospitalization procedure codes and kidney diagnoses, and gastrointestinal diagnoses and abdominal imaging.</p><p><strong>Conclusion: </strong>This study demonstrates the application of AI phenotyping to multidimensional real-world data. This approach could support new methods for proactively identifying patients in clinical practice who require closer monitoring and management.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261462398"},"PeriodicalIF":3.8,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425578","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":"Minocycline-containing therapy in <i>Helicobacter pylori</i> infection: a systematic review and meta-analysis.","authors":"Zhihua Tian, Yanjiao Zhang, Nan Luo, Xuefei Zhao, Shaoli Wang, Zhen Liu","doi":"10.1177/17562848261464690","DOIUrl":"10.1177/17562848261464690","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;&lt;i&gt;Helicobacter pylori&lt;/i&gt; (&lt;i&gt;H. pylori&lt;/i&gt;) infection and its related diseases constitute a significant global public health issue, and the growing antibiotic resistance of &lt;i&gt;H. pylori&lt;/i&gt; poses a serious challenge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Consequently, the search for sensitive, safe, economical, and readily available therapeutic drugs has become a core challenge in contemporary research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This systematic review and meta-analysis of randomized controlled trials and observational studies followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2020).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources and methods: &lt;/strong&gt;This study conducted a thorough and systematic literature review of PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wanfang Data up to October 16, 2025, using keywords such as minocycline and &lt;i&gt;H. pylori&lt;/i&gt;. The included studies were assessed for risk of bias, and meta-analyses were conducted using Review Manager 5.3 and Stata/MP 14.0 to estimate the pooled effect sizes. Risk ratios (RR) were used for statistical analysis, and the corresponding 95% confidence intervals (CI) were calculated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Minocycline exhibits pharmacokinetic characteristics including high absorption, strong lipophilicity, tissue permeability, and a prolonged half-life. Beyond its antibacterial effects, it also possesses non-antimicrobial activities such as anti-inflammatory, immunomodulatory, antioxidant, and anti-apoptotic properties. Eighteen studies from six countries indicate that &lt;i&gt;H. pylori&lt;/i&gt; is sensitive to minocycline. This study included 33 clinical trials that evaluated minocycline-containing eradication regimens for &lt;i&gt;H. pylori&lt;/i&gt; infection. Based on pairwise meta-analysis, both the intention-to-treat (ITT; RR = 1.04, 95% CI: 0.99-1.08, &lt;i&gt;p&lt;/i&gt; = 0.15) and per-protocol (PP; RR = 1.04, 95% CI: 1.00-1.08, &lt;i&gt;p&lt;/i&gt; = 0.06) analyses showed no significant difference in &lt;i&gt;H. pylori&lt;/i&gt; eradication rates between the minocycline-containing eradication regimen and the control group; however, the overall incidence of adverse reactions was significantly lower (RR = 0.85, 95% CI: 0.78-0.92, &lt;i&gt;p&lt;/i&gt; &lt; 0.05), while compliance rate was comparable to that of the control group (RR = 1.01, 95% CI: 1.00-1.03, &lt;i&gt;p&lt;/i&gt; = 0.15). Based on meta-analysis of proportions, the ITT analysis indicated the &lt;i&gt;H. pylori&lt;/i&gt; eradication rate was 83% (95% CI: 79%-87%), while the PP analysis showed an eradication rate of 88% (95% CI: 83%-92%), an adverse reaction incidence of 29% (95% CI: 23%-36%), and compliance rates of 94% (95% CI: 91%-96%). The analysis revealed that minocycline-containing regimens exhibited favorable efficacy, safety, and patient compliance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Minocycline may be considered a viable antibiotic option for the eradication of &lt;i&gt;H","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261464690"},"PeriodicalIF":3.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413245","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":"Comments on \"Prevalence, patient characteristics and outcomes of high-dose upadacitinib in inflammatory bowel disease\".","authors":"Aliza Altaf, Fiza Memon, Lavish Kumar","doi":"10.1177/17562848261465254","DOIUrl":"10.1177/17562848261465254","url":null,"abstract":"","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261465254"},"PeriodicalIF":3.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392315","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":"Does the pHoenix score reduce the inconclusive GERD diagnosis: a net reclassification index analysis.","authors":"Raúl A Cañadas, Freddy A Ávila, Albis C Hani, Juan P García, Carlos A Rivera, Oscar M Muñoz, Juan S Hernández","doi":"10.1177/17562848261463424","DOIUrl":"10.1177/17562848261463424","url":null,"abstract":"<p><strong>Background: </strong>Acid exposure time (AET) yields inconclusive results in 10%-15% of patients undergoing 24-h ambulatory pH-impedance monitoring (multichannel intraluminal impedance-pH, MII-pH) for suspected gastroesophageal reflux disease (GERD), delaying diagnosis and appropriate management. The pHoenix score (pHx-s) was developed to reduce this diagnostic uncertainty. Its performance in Latin American populations remains uncharacterized.</p><p><strong>Design: </strong>Net reclassification index (NRI) analysis based on a retrospective cohort.</p><p><strong>Methods: </strong>A cohort of symptomatic adults who underwent high-resolution manometry, MII-pH, and upper endoscopy at Hospital Universitario San Ignacio, Bogotá (Colombia) was included. pHx-s was calculated as (upright AET × 0.991) + (supine AET × 1.286) and classified as normal (<7.06), borderline (7.06-8.45), or pathological (>8.45). Diagnostic performance and area under the receiver operating curve (AUC) were calculated. DeMeester score (>14.7) served as the reference standard. NRI analysis is presented independently for patients with and without confirmed GERD.</p><p><strong>Results: </strong>292 patients were included in the analysis (Median 61 years, 71.2% female, 79.1% with hiatal hernia (HH)). The AUC of pHx-s was 0.98 (0.963-0.992). At the lower threshold (7.06), sensitivity was 95.7% and specificity 99.1%; at the upper (⩾8.45), sensitivity 89.8%, and specificity 100%. pHx-s reduced inconclusive results from 13.0% (using exclusively AET criteria) to 4.1% (-68.5%, <i>p</i> < 0.001). Among inconclusive AET cases, pHx-s reassigned 55.3% as pathological and 18.4% as normal, with an overall NR improvement of 14.6%.</p><p><strong>Conclusion: </strong>In this Latin American cohort with a high prevalence of HH, pHx-s substantially reduced inconclusive GERD diagnoses and demonstrated excellent performance compared with the DeMeester score. These findings support the use of the pHx-s in diverse clinical settings.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261463424"},"PeriodicalIF":3.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392252","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}