Therapeutic Advances in Gastroenterology最新文献

{"title":"Safety and efficacy of side-by-side versus stent-in-stent stenting for malignant hilar biliary obstruction: a systematic review and meta-analysis.","authors":"Haibin Zhou, Hayat Khizar, Ashraf Ali, Jianfeng Yang","doi":"10.1177/17562848241271962","DOIUrl":"10.1177/17562848241271962","url":null,"abstract":"<p><strong>Objectives: </strong>Stenting of the malignant hilar biliary obstruction (MHBO) area for bile drainage is challenging. Bilateral stenting techniques of stent-in-stent (SIS) and stent-by-stent (SBS) have shown promising results. This study evaluates the efficacy of different stenting methods for MHBO.</p><p><strong>Design: </strong>A meta-analysis was performed to determine the efficacy of SIS and SBS stenting strategies for MHBO.</p><p><strong>Data sources and methods: </strong>Medical databases such as PubMed, Web of Science, Embase, and Scopus, were searched up to August 2023. We selected eligible studies reporting the data on technical and clinical success, adverse events, and incidence of re-obstruction (RO) of SBS and SIS groups in MHBO patients. We compared the outcomes of SBS and SIS groups.</p><p><strong>Results: </strong>A total of 9 studies comparing the data of 545 patients (268 in the SBS group and 277 in the SIS stenting group) were analyzed. There was no significant difference (<i>p</i> > 0.05) in the odds ratio (OR) of Re-obstruction (RO) 0.87 (95% confidence interval (95% CI) 0.6-1.25), technical success 0.58 (95% CI 0.16-2.11), clinical success 1.13 (95% CI 0.62-2.07), and adverse events 1.53 (95% CI 0.88-2.64). The mean difference in procedure time was -12.25 min (95% CI -18.39, -6.12), and the hazard ratio of stent patency was 1.22 (95% CI 1.01-1.47), favoring SBS, with high heterogeneity (<i>I</i> ² = 94%). There was no significant difference in HR for survival 1.05 (95% CI 0.95-1.16) with high heterogeneity (<i>I</i> ² = 84%).</p><p><strong>Conclusion: </strong>Compared with SIS, SBS showed better stent patency with comparable technical and clinical success and adverse events.</p><p><strong>Prospero registration: </strong>The registration number for this study on PROSPERO is CRD42024523230.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113772","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":"Patient preferences for adalimumab in inflammatory bowel disease: a nationwide study from the GETAID.","authors":"Bénédicte Caron, Philippe Seksik, Anthony Buisson, Pauline Wils, Guillaume Savoye, Carmen Stefanescu, David Laharie, Lucas Guillo, Vered Abitbol, Joelle Bonnet, Romain Altwegg, Lucine Vuitton, Driffa Moussata, Arnaud Bourreille, Amélie Biron, Cyrielle Gilletta, Mathurin Fumery, Stephane Nahon, Stephane Nancey, Houda Camara, Laurent Peyrin-Biroulet","doi":"10.1177/17562848241265776","DOIUrl":"10.1177/17562848241265776","url":null,"abstract":"<p><strong>Background: </strong>Several adalimumab preparations are now available for patients with inflammatory bowel disease (IBD). Comparative satisfaction and tolerability are unknown.</p><p><strong>Objectives: </strong>This study investigated IBD patient satisfaction with approved adalimumab biosimilars and their originator.</p><p><strong>Design: </strong>In this cross-sectional study, we included 941 consecutive adalimumab-treated patients with IBD across 45 centres affiliated with the Groupe d'Etude Therapeutique des Affections Inflammatoires du tube Digestif who completed a satisfaction questionnaire comprising four items each rated by a 10-point scale.</p><p><strong>Methods: </strong>The differences in responses were performed using a one-way analysis of variance followed by Tukey's honest significant difference test.</p><p><strong>Results: </strong>The most commonly used drugs at inclusion were Humira^® (436/941, 46.3%), Amgevita^® (177/941, 18.8%) and Hulio^® (105/941, 11.2%). The mean overall satisfaction rate with adalimumab was 8.5 (standard deviation 1.8). Overall satisfaction was significantly higher in patients treated with Humira (8.6 (1.5)), Hulio (8.6 (1.8)) or Amgevita (8.5 (1.4)) (<i>p</i> < 0.05). Satisfaction with the subcutaneous injection form was higher for patients treated with Yuflyma^® (9.0 (1.4)), Humira (8.9 (1.3)) and Hulio (8.9 (1.7)) (<i>p</i> < 0.05). A total of 299 patients (31.8%) described injection site reactions. In all, 223 patients (23.7%) reported being previously treated with another adalimumab of which (32/223, 14.3%) discontinued treatment due to side effects.</p><p><strong>Conclusion: </strong>In this real-world setting, patients with IBD had a high level of satisfaction with adalimumab treatment, with some differences in terms of overall satisfaction and satisfaction with the injection device.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11307357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908076","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":"Comparative risk of serious infections and tuberculosis in Korean patients with inflammatory bowel disease treated with non-anti-TNF biologics or anti-TNF-α agents: a nationwide population-based cohort study.","authors":"Min Jee Kim, Ye-Jee Kim, Daehyun Jeong, Seonok Kim, Seokchan Hong, Sang Hyoung Park, Kyung-Wook Jo","doi":"10.1177/17562848241265013","DOIUrl":"10.1177/17562848241265013","url":null,"abstract":"<p><strong>Background: </strong>The risk of serious infection and active tuberculosis in patients with inflammatory bowel disease (IBD) has not been concurrently evaluated based on the use of anti-tumor necrosis factor (TNF)-α agents <i>versus</i> non-anti-TNF biologics (vedolizumab/ustekinumab) in the Korean population.</p><p><strong>Objectives: </strong>We compared the risk of serious infection and active tuberculosis in Korean patients with IBD treated with non-anti-TNF biologics (vedolizumab/ustekinumab) or anti-TNF-α agents.</p><p><strong>Design: </strong>This study was a population-based cohort analysis of nationwide administrative claims data.</p><p><strong>Methods: </strong>Health Insurance Review and Assessment Service claims data (representing 97% of the South Korean population) from between January 2007 and February 2021 were reviewed, and adults with IBD who initiated vedolizumab/ustekinumab or anti-TNF-α treatment (<i>n</i> = 6123) between 2017 and 2020 were enrolled. Intergroup differences in the risk of serious infection requiring hospitalization/emergency department visits or active tuberculosis during the follow-up period were analyzed.</p><p><strong>Results: </strong>In the patients treated with anti-TNF-α agents or vedolizumab/ustekinumab during a mean follow-up of 1.55 ± 1.05 and 0.84 ± 0.69 years, the incidence rates of serious infection were 9.43/100 and 6.87/100 person-years, respectively. Multivariable analysis showed no significant intergroup difference in the risk of serious infection with vedolizumab/ustekinumab or anti-TNF-α treatment; the adjusted relative risk of vedolizumab/ustekinumab compared with anti-TNF-α agents was 0.81 (95% confidence interval 0.46-1.44, <i>p</i> = 0.478). Among patients treated with anti-TNF-α agents and vedolizumab/ustekinumab, the incidence rates of active tuberculosis were 0.87 and 0.37 per 100 person-years, respectively. The relative risk of vedolizumab/ustekinumab compared with anti-TNF-α agents was 0.31 (95% confidence interval 0.07-1.26, <i>p</i> = 0.101). In a subset analysis comparing vedolizumab and ustekinumab with anti-TNF-α agents, similar results were observed.</p><p><strong>Conclusion: </strong>In Korean patients with IBD, non-anti-TNF biologics (vedolizumab/ustekinumab) tended to be associated with a lower risk of serious infection or active tuberculosis than anti-TNF-α agents.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876433","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":"Switching within <i>versus</i> out of class following first-line TNFi failure in ulcerative colitis: real-world outcomes from a German claims data analysis.","authors":"Evi Zhuleku, Daniel Wirth, Riikka Nissinen, Ivana Bravatà, Despina Ziavra, Andreas Duva, Jennifer Lee, Andreas Fuchs, Sabrina Mueller, Thomas Wilke, Bernd Bokemeyer","doi":"10.1177/17562848241262288","DOIUrl":"10.1177/17562848241262288","url":null,"abstract":"<p><strong>Background: </strong>Biologic agents have demonstrated efficacy in treating ulcerative colitis (UC); however, treatment failure to tumor necrosis factor inhibitors (TNFi) is common in the real world. Data on preferential sequencing in clinical practice after failure remain limited.</p><p><strong>Objectives: </strong>This study aimed to evaluate real-world outcomes of patients cycling to TNFis or switching to non-TNFi biologics following first-line failure with TNFis.</p><p><strong>Design: </strong>Retrospective cohort study in Germany.</p><p><strong>Methods: </strong>Adult patients with UC were identified using administrative claims data from 1 May 2014 to 30 June 2022 provided by a statutory sickness fund. Patients newly initiating first-line therapy with TNFis and then switching to another agent were identified. Patients were defined as within-class switched (WCS), if they cycled to another TNFi, or outside-class switchers (OCS), if they switched to a non-TNFi biologic [ustekinumab (UST) or vedolizumab (VDZ)] and followed from index (switch date) to death, insurance end, or study end on 30 June 2022. Inverse probability of treatment weighting (IPTW) was performed to adjust for differences in baseline characteristics between groups, and weighted Cox regression models were used to compare primary (time to discontinuation and second treatment switch) and secondary outcomes (corticosteroid-free drug survival).</p><p><strong>Results: </strong>We identified 166 patients initiating TNFis and switching to a subsequent treatment (mean age: 42.9 years, 49.4% female). Following IPTW, there were 71 and 76 patients in the WCS and OCS groups, respectively. Compared to OCS, WCS were more likely to discontinue the new therapy [hazard ratio (HR), 1.82, 95% confidence interval (CI), 1.14-2.89, <i>p</i> = 0.012], and switch a second time (HR, 3.46, 95% CI, 1.89-6.36, <i>p</i> < 0.001). Moreover, WCS showed an increased likelihood of initiating prolonged corticosteroid therapy (HR, 1.42, 95% CI, 0.77-2.59, <i>p</i> = 0.260); however, the results were not significant.</p><p><strong>Conclusion: </strong>Following first-line TNFi failure, this study suggests that real-world outcomes among patients with UC are less favorable when cycling to another TNFi, compared to switching to a non-TNFi such as UST or VDZ.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861346","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":"Long-term outcomes and predictors of vedolizumab persistence in ulcerative colitis.","authors":"Beatriz Gros, Hannah Ross, Maureen Nwabueze, Nathan Constantine-Cooke, Lauranne A A P Derikx, Mathew Lyons, Claire O'Hare, Colin Noble, Ian D Arnott, Gareth-Rhys Jones, Charlie W Lees, Nikolas Plevris","doi":"10.1177/17562848241258372","DOIUrl":"10.1177/17562848241258372","url":null,"abstract":"<p><strong>Background: </strong>Long-term vedolizumab (VDZ) outcomes in real-world cohorts have been largely limited to 1-year follow-up, with few bio-naïve patients or objective markers of inflammation assessed.</p><p><strong>Objectives: </strong>We aimed to assess factors affecting VDZ persistence including clinical, biochemical and faecal biomarker remission at 1, 3 and 5 years.</p><p><strong>Design: </strong>We performed a retrospective, observational, cohort study.</p><p><strong>Methods: </strong>All adult inflammatory bowel disease (IBD) patients who had received VDZ induction for ulcerative colitis (UC)/IBD-unclassified (IBDU) were included. Baseline phenotype and follow-up data were collected <i>via</i> a review of electronic medical records.</p><p><strong>Results: </strong>We included 290 patients [UC <i>n</i> = 271 (93.4%), IBDU <i>n</i> = 19 (6.6%)] with a median time on VDZ of 27.6 months (interquartile range: 14.4-43.2). At the end of follow-up, a total of 157/290 (54.1%) patients remained on VDZ. The median time to discontinuation was 14.1 months (7.0-23.3). Previous exposure to ⩾1 advanced therapy, steroid use at baseline and disease extension (E3 and E2 <i>versus</i> E1) were independent predictors for worse VDZ persistence. Clinical remission (partial Mayo < 2) was 75.7% (171/226), 72.4% (157/217) and 70.2% (127/181) at years 1, 3 and 5, respectively. Steroid use during maintenance VDZ therapy occurred in 31.7% (92/290), hospitalization in 15.5% (45/290) and surgery in 3.4% (10/291). The rate of serious adverse events was 1.2 per 100 patient-years of follow-up.</p><p><strong>Conclusion: </strong>VDZ effectiveness appears enduring with favourable long-term safety profile. VDZ persistence was influenced by previous exposure to biologics/small molecules, disease distribution and steroid use at baseline in our study.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861345","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":"DOMINO trial <i>post hoc</i> analysis: evaluation of the diet effects on symptoms in IBS subtypes.","authors":"Claudia Di Rosa, Karen Van den Houte, Annamaria Altomare, Michele Pier Luca Guarino, Linde Besard, Joris Arts, Philip Caenepeel, Hubert Piessevaux, Alain Vandenberghe, Cristophe Matthys, Jessica R Biesiekierski, Luc Capiau, Steven Ceulemans, Olivier Gernay, Lydia Jones, Sophie Maes, Christian Peetermans, Willem Raat, Jeroen Stubbe, Rudy Van Boxstael, Olivia Vandeput, Sophie Van Steenbergen, Lukas Van Oudenhove, Tim Vanuytsel, Mike Jones, Jan Tack, Florencia Carbone","doi":"10.1177/17562848241255296","DOIUrl":"10.1177/17562848241255296","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction characterized by recurrent abdominal pain related to defecation and/or associated to a change in bowel habits. According to the stool type, four different IBS subtypes can be recognized, constipation predominant (IBS-C), diarrhea predominant (IBS-D), mixed (IBS-M), and undefined (IBS-U). Patients report that their IBS symptoms are exacerbated by food. Thus, it is important to find a nutritional approach that could be effective in reducing IBS symptoms.</p><p><strong>Objective: </strong>The present work is a <i>post hoc</i> analysis of the previously published DOMINO trial. It aimed to evaluate the effects of a self-instructed FODMAP-lowering diet smartphone application on symptoms and psychosocial aspects in primary care IBS stratifying the results for each IBS subtypes.</p><p><strong>Design: </strong><i>Post hoc</i> analysis.</p><p><strong>Methods: </strong>Two hundred twenty-two primary care IBS patients followed a FODMAP-lowering diet for 8 weeks with the support of a smartphone application. Two follow-up visits were scheduled after 16 and 24 weeks. IBS-Symptoms Severity Score (IBS-SSS), quality of life (QoL), and adherence and dietary satisfaction were evaluated.</p><p><strong>Results: </strong>After 8 weeks, IBS-SSS improved in all IBS subtypes (<i>p</i> < 0.0001). Physician Health Questiionnaire (PHQ-15) improved only in IBS-D (<i>p</i> = 0.0006), whereas QoL improved both in IBS-D (<i>p</i> = 0.01) and IBS-M (<i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>This <i>post hoc</i> analysis showed that the app is useful in all IBS subtypes; thus, it could be used as an effective tool by both general practitioners and patients to manage symptoms in primary care.</p><p><strong>Trial registration: </strong>Ethical Commission University Hospital of Leuven reference number: S59482. Clinicaltrial.gov reference number: NCT04270487.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861344","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 treatment of primary biliary cholangitis: from shadow to light.","authors":"Drazilova Sylvia, Koky Tomas, Macej Marian, Janicko Martin, Simkova Dagmar, Jarcuska Peter","doi":"10.1177/17562848241265782","DOIUrl":"10.1177/17562848241265782","url":null,"abstract":"<p><p>Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic disease characterized by the destruction of the small intrahepatic bile ducts, which can progress to liver cirrhosis. The gold standard in the treatment of PBC is ursodeoxycholic acid (UDCA), which is indicated in all patients with PBC because it improves not only biochemical parameters but also patients' survival. An important milestone in the identification of patients at risk is the assessment of biochemical response to UDCA. Patients who respond to treatment have a lower incidence of hepatic events and better prognosis than patients who do not. Several scoring systems can be used to assess the response and identify non-responders who will benefit from second-line treatment. Obeticholic acid (OCA) is currently the only approved second-line treatment for PBC, which is effective for non-responders to UDCA therapy or patients, who have not tolerated UDCA therapy. However, OCA is contraindicated in advanced liver cirrhosis and portal hypertension. Moreover, pruritus may be a limiting factor for the administration of OCA. Fibrates have shown promising data supporting their use in non-responders to UDCA because they improve the biochemical parameters and elastographic findings and have possible antipruritic effects. Therefore, the idea of a triple treatment seems interesting. Clinical research is focusing on several other groups of drugs: peroxisome proliferator-activated receptor (PPAR) δ- and α/δ agonists, non-steroidal farnesoid X receptor agonists, fibroblast growth factor 19 modulators, and inhibitors of nicotinamide adenine dinucleotide phosphate oxidase 1 and 4.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856848","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: [10 years of biologic use patterns in patients with inflammatory bowel disease: treatment persistence, switching and dose intensification - a nationwide population-based study].","authors":"Shahed Kamal, Jonathan P Segal","doi":"10.1177/17562848241265761","DOIUrl":"10.1177/17562848241265761","url":null,"abstract":"","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761910","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":"An overview of emerging smart capsules using other-than-light technologies for colonic disease detection.","authors":"Gohar Jalayeri Nia, Ola Selnes, Pablo Cortegoso Valdivia, Anastasios Koulaouzidis","doi":"10.1177/17562848241255298","DOIUrl":"https://doi.org/10.1177/17562848241255298","url":null,"abstract":"<p><p>Wireless capsule endoscopy (CE) has revolutionized gastrointestinal diagnostics, offering a non-invasive means to visualize and monitor the GI tract. This review traces the evolution of CE technology. Addressing the limitations of traditional white light (WL) CE, the paper explores non-WL technologies, integrating diverse sensing modalities and novel biomarkers to enhance diagnostic capabilities. Concluding with an assessment of Technology Readiness Levels, the paper emphasizes the transformative impact of non-WL colon CE devices on GI diagnostics, promising more precise, patient-centric, and accessible healthcare for GI disorders.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761909","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":"Multimodal dynamic ultrasound approach as predictor of response in patients with Crohn's disease treated with ustekinumab.","authors":"Maria Elena Ainora, Antonio Liguori, Irene Mignini, Marco Cintoni, Linda Galasso, Lucrezia Laterza, Loris Riccardo Lopetuso, Matteo Garcovich, Laura Riccardi, Antonio Gasbarrini, Franco Scaldaferri, Maria Assunta Zocco","doi":"10.1177/17562848241259289","DOIUrl":"10.1177/17562848241259289","url":null,"abstract":"<p><strong>Background: </strong>The approval of ustekinumab (UST) has opened new options for the treatment of Crohn's disease (CD), but potential markers predicting the efficacy of this interleukin-12/23 inhibitor are lacking. Contrast-enhanced ultrasound (CEUS) is non-invasive alternative to endoscopy, demonstrating early transmural changes after treatment induction.</p><p><strong>Objectives: </strong>We conducted a prospective monocentric study aiming to explore the value of multimodal intestinal ultrasound (IUS) in predicting the response to UST in patients with active CD who have been previously exposed to anti-tumour necrosis factor α (TNFα).</p><p><strong>Design and methods: </strong>Consecutive patients with moderate-to-severe CD involving the terminal ileum who were scheduled to begin UST therapy were enrolled between January 2020 and October 2021 in the inflammatory bowel diseases outpatient centre. A complete IUS evaluation, including B-mode, Doppler, dynamic CEUS and elastography, was performed at the time of induction (T0) and after 8 (T1), 16 (T2), 24 (T3) and 48 (T4) weeks of therapy. Each IUS parameter and their variations from baseline were correlated with endoscopic response and mucosal healing after 1 year.</p><p><strong>Results: </strong>A total of 52 patients were included, 29 (55.8%) of which reached endoscopic response at T4. The univariate analysis revealed that, between T3 and T0, the percentage changes of bowel wall thickness, Limberg score, mean signal intensity, rise time, wash-in rate, C reactive protein and Harvey-Bradshaw Index were associated with long-term therapeutic outcome. Based on the above parameters, we developed an IUS score that showed a good performance in predicting 1 year-endoscopic response (area under the curve: 0.91).</p><p><strong>Conclusion: </strong>Multimodal ultrasound could be helpful to predict long-term therapeutic outcome in patients with CD treated with UST.</p><p><strong>Registration: </strong>NCT05987501.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443593","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}