Therapeutic Advances in Gastroenterology最新文献

{"title":"Patient and physician preferences for treatment of hepatitis C virus infection in Japan: a discrete choice experiment: plain language summary of publication.","authors":"Daisuke Nakamoto, Yi Piao, Manami Yoshida, Michael LoPresti, Dilip Makhija, Kyung Min Kwon, Jamie Zagorski, Masahisa Jinushi, Yuichiro Eguchi","doi":"10.1177/17562848261452508","DOIUrl":"https://doi.org/10.1177/17562848261452508","url":null,"abstract":"<p><p>What is this summary about? This summary explains what both people living with hepatitis C and doctors think is meaningful when treating hepatitis C in Japan. We asked people living with hepatitis C and doctors about their opinions on hepatitis C treatment using a questionnaire. What was the study question? \"What do people living with hepatitis C in Japan and their doctors consider most meaningful when choosing treatment?\" Why was it asked? Understanding what people living with hepatitis C and doctors value when choosing hepatitis C treatment may help support continuing treatment, which is important for eliminating hepatitis C. What were the results? Among 95 people living with hepatitis C and 118 doctors, both groups thought that the total out-of-pocket costs for hepatitis C treatment was the most meaningful thing. Safety was ranked as the next most meaningful thing. People living with hepatitis C were more concerned about costs for treatment and less concerned about side-effect risks than doctors. People living with hepatitis C cared more about the number of tablets they had to take each day than the duration of treatment. For doctors, both were about the same. What do the results mean? For people living with hepatitis C, treatment costs are the most important concern. Improving awareness of Japan's financial assistance programs may help reduce out-of-pocket costs for hepatitis C treatment, thereby making it easier for people living with hepatitis C to receive treatment. Providing care that is adjusted to the situations, concerns, and treatment goals of people living with hepatitis C may help reduce barriers and gaps in hepatitis C treatment. Simple treatment options, such as one pill a day and/or minimized hospital visits during treatment course can make hepatitis C treatment more accessible. Good communication between people living with hepatitis C and doctors may help them make treatment decisions together, based on clear explanations of options and what matters most to people living with hepatitis C. In 2016, the World Health Organization (WHO) set a goal to eliminate HCV as a public health threat by 2030. These efforts will support achieving the goal in Japan.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261452508"},"PeriodicalIF":3.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279319","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 inverse probability of treatment weighted comparison between vedolizumab, ustekinumab, and tofacitinib in anti-TNF-experienced ulcerative colitis patients.","authors":"Antonio Tursi, Andrea Pasta, Walter Elisei, Brigida Barberio, Luisa Bertin, Giammarco Mocci, Giovanni Maconi, Antonietta Gerarda Gravina, Raffaele Pellegrino, Giorgia Bodini, Alfredo Papa, Edoardo Vincenzo Savarino","doi":"10.1177/17562848261455563","DOIUrl":"10.1177/17562848261455563","url":null,"abstract":"<p><strong>Background: </strong>Biologics and small-molecule therapies are widely used for ulcerative colitis (UC), but their comparative effectiveness in anti-tumor necrosis factor (TNF)-exposed patients is unclear.</p><p><strong>Objectives: </strong>To compare the effectiveness and safety of vedolizumab, ustekinumab, and tofacitinib in anti-TNF-experienced patients with UC.</p><p><strong>Design: </strong>Multicenter retrospective observational cohort study.</p><p><strong>Methods: </strong>A multicenter retrospective cohort of anti-TNF-experienced UC patients treated with vedolizumab (<i>n</i> = 260), tofacitinib (<i>n</i> = 149), or ustekinumab (<i>n</i> = 193) was analyzed. Partial Mayo Score (pMayo), endoscopic remission, and biomarker response were assessed at baseline, 12, 24, and 52 weeks, respectively. Inverse Probability of Treatment Weighting (IPTW) was applied to balance baseline characteristics, and longitudinal changes were analyzed using repeated-measures general linear models with post hoc corrections.</p><p><strong>Results: </strong>After IPTW adjustment, at week 52, clinical remission was highest with tofacitinib compared with ustekinumab (<i>p</i> < 0.001) and vedolizumab (<i>p</i> = 0.002). Steroid-free clinical remission showed a similar pattern (tofacitinib vs ustekinumab: <i>p</i> = 0.006; tofacitinib vs vedolizumab: <i>p</i> < 0.001). No significant differences in biochemical remission were found across groups at week 52 (<i>p</i> = 0.931). Endoscopic remission favored vedolizumab over ustekinumab and tofacitinib (<i>p</i> < 0.001). Subgroup analyses revealed superior tofacitinib performance in extensive colitis and in patients with ⩾2 prior biologic classes (vs vedolizumab: <i>p</i> = 0.089; vs ustekinumab: <i>p</i> < 0.001). Adverse events were infrequent and similar across groups.</p><p><strong>Conclusion: </strong>In anti-TNF-experienced UC patients, tofacitinib was associated with higher long-term clinical and steroid-free remission rates, ustekinumab showed intermediate effectiveness with a favorable safety profile, while vedolizumab was associated with higher endoscopic remission. These findings may help inform individualized, outcome-oriented treatment strategies, but they should be interpreted with caution and confirmed in prospective head-to-head studies.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261455563"},"PeriodicalIF":3.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273634","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":"Advanced phenotypes and favorable 1-year outcomes with accelerated step-up strategy in newly diagnosed inflammatory bowel disease in a tuberculosis-endemic, resource-constrained setting.","authors":"Trung Hoang Dinh, Luan Minh Dang, Chuong Dinh Nguyen, Diem Thi-Ngoc Vo, Tien Manh Huynh, Thong Duy Vo, Hoang Huu Bui, Duc Trong Quach","doi":"10.1177/17562848261455281","DOIUrl":"10.1177/17562848261455281","url":null,"abstract":"<p><strong>Background: </strong>The incidence of inflammatory bowel disease (IBD) is rising across Southeast Asia, yet real-world data on clinical phenotypes, treatment strategies, and outcomes in tuberculosis (TB)-endemic, resource-constrained settings remain scarce.</p><p><strong>Objectives: </strong>To characterize disease phenotypes, treatment utilization, and 1-year outcomes in a Vietnamese inception cohort of newly diagnosed IBD patients in a tuberculosis-endemic, resource-constrained setting.</p><p><strong>Design: </strong>Single-center, hybrid retrospective-prospective inception cohort study.</p><p><strong>Methods: </strong>Consecutive adults diagnosed with Crohn's disease (CD) or ulcerative colitis (UC) at a tertiary referral center in Ho Chi Minh City, Vietnam, between June 2019 and June 2024. A Baseline Cohort (<i>N</i> = 126) was analyzed for phenotypic characterization. Patients completing ⩾12 months of follow-up comprised the Outcome Cohort (<i>N</i> = 66) for assessment of treatment patterns and clinical, biochemical, and endoscopic outcomes. Treatment followed an accelerated step-up strategy with originator anti-tumor necrosis factor (TNF) agents (infliximab/adalimumab) after mandatory TB screening.</p><p><strong>Results: </strong>Among 126 patients (80 CD, 46 UC), CD was characterized by substantial diagnostic delay (median 12 months), with 57.6% presenting stricturing or penetrating behavior and 25.0% having undergone intestinal resection before IBD confirmation. Extensive colitis (E3) predominated among UC patients (63.0%), and 78.3% had moderate-to-severe disease. Anti-TNF utilization increased from 13.6% within the first 2 months after diagnosis to 45.5% at 1 year. In the Outcome Cohort (<i>N</i> = 66), steroid-free clinical remission was achieved in 63.6%, and mucosal healing was documented in 62.3% of endoscopically evaluated patients. Serious infections occurred in 9.1%, with TB reactivation in 4.5%.</p><p><strong>Conclusion: </strong>IBD in Vietnam presents with diagnostic delays, complicated phenotypes, and high surgical rates at initial presentation. Despite these challenges, an accelerated step-up strategy with early anti-TNF escalation was associated with favorable 1-year steroid-free remission and mucosal healing rates. These findings suggest that treat-to-target care with early biologic escalation may be feasible in selected patients in TB-endemic, resource-constrained settings, provided that structured TB monitoring is implemented.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261455281"},"PeriodicalIF":3.8,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254105","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 practice patterns in the pre-endoscopic management of individuals presenting with acute upper gastrointestinal bleeding: results of an international survey.","authors":"Mahmoud Obeidat, Diana-Elena Floria, Brigitta Teutsch, Zsolt Abonyi-Tóth, Stig B Laursen, Marine Camus, Franck Verdonk, Áron Vincze, Zsolt Bognár, Vasile Drug, Keith Siau, Ian M Gralnek, Péter Hegyi, Bálint Erőss","doi":"10.1177/17562848261455285","DOIUrl":"10.1177/17562848261455285","url":null,"abstract":"<p><strong>Background: </strong>Despite recent guideline recommendations on managing acute upper gastrointestinal bleeding (AUGIB), mortality rates have not substantially improved over the years.</p><p><strong>Objectives: </strong>We aimed to understand real-life pre-endoscopic assessment and management practices in AUGIB.</p><p><strong>Design: </strong>We conducted an international online survey from April to November 2023.</p><p><strong>Methods: </strong>Key domains captured respondents' demographics and clinical practice location, definitions of hemodynamic instability, and pre-endoscopic assessment. We provided descriptive proportions of responses. Secondary analyses explored differences in responses based on years of clinical experience.</p><p><strong>Results: </strong>Among the 533 clinicians who completed the survey, 47.1% reported using a triage system for AUGIB, and only 60.4% applied risk stratification scores at the time of presentation. Normal saline and balanced crystalloid fluids were almost equally preferred for initial fluid resuscitation. Hemodynamically unstable patients were typically managed in emergency departments and/or intensive care units. Over 85% of respondents followed a restrictive blood transfusion strategy in stable patients, but this dropped to 50.3% in hemodynamically unstable cases. Among respondents, 34.3% did not routinely use prokinetics, and 27.6% avoided their use, even in cases of severe bleeding or suspected gastric emptying disorders. The majority (87.1%) prescribed proton pump inhibitors before endoscopy. For suspected variceal bleeding, 83.7% reported using vasoactive agents, and 74.3% reported administering prophylactic antibiotics. Younger clinicians were more likely to follow recent guidelines than those with over 15 years of clinical experience.</p><p><strong>Conclusion: </strong>We found considerable variation in the pre-endoscopic management of individuals with AUGIB. Overall adherence to international guidelines was inconsistent, which may have implications for patient outcomes.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261455285"},"PeriodicalIF":3.8,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254037","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":"How does survodutide work? Plain language review of a potential new medication for obesity and liver disease.","authors":"Jaime P Almandoz, Alexander Dimitri Miras, Jochen Seufert, Elizabeth Paul","doi":"10.1177/17562848261457269","DOIUrl":"https://doi.org/10.1177/17562848261457269","url":null,"abstract":"<p><p>What is this review about? This review provides an overview of a medication called survodutide. <b>Survodutide</b> is not yet approved for use but is currently being tested to treat people living with <b>obesity</b>, as well as those living with <b>MASH</b> (metabolic dysfunction-associated steatohepatitis). Obesity is a long-term disease in which extra energy stored as fat by the body begins to have harmful effects on health. MASH is an advanced form of a condition commonly called \"fatty liver disease\", or <b>MASLD</b> (metabolic dysfunction-associated steatotic liver disease). MASLD causes abnormal amounts of fat to build up in the liver. Obesity and MASH are linked diseases. Both involve problems related to <b>metabolism</b>, that is, the way that the body uses and stores energy. People living with obesity and those living with MASH often have other related health conditions at the same time. Improvements in dietary nutrition and increased physical activity are recommended treatments for people living with obesity and MASH. However, interventions such as medication and bariatric surgery are also effective treatments for metabolic dysfunction for those living with these diseases. Such therapies can help people reach their health goals. This review provides an overview of how survodutide works to help treat obesity and MASH. It also describes the key improvements in health status and the side effects experienced by people who took survodutide in clinical trials.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261457269"},"PeriodicalIF":3.4,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200839","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 effectiveness of endoscopic and stool-based colorectal cancer screening strategies: a systematic review and network meta-analysis.","authors":"Motoki Kaneko, Atsushi Sakuraba","doi":"10.1177/17562848261454186","DOIUrl":"10.1177/17562848261454186","url":null,"abstract":"<p><strong>Background: </strong>The population impact of colorectal cancer (CRC) screening depends on test performance and uptake, yet the comparative effectiveness of colonoscopy (CS), flexible sigmoidoscopy (FS), fecal immunochemical test (FIT), and guaiac-based fecal occult blood test (gFOBT) remains uncertain.</p><p><strong>Objectives: </strong>To compare the 10-year effects of CS, FS, FIT, and gFOBT on CRC incidence, CRC mortality, and all-cause mortality.</p><p><strong>Design: </strong>A systematic review and network meta-analysis.</p><p><strong>Data sources and methods: </strong>We searched PubMed, EMBASE, and Cochrane CENTRAL from inception to June 13, 2025, for randomized controlled trials enrolling average-risk adults comparing CS, FS, FIT, or gFOBT with no screening (NS) or each other. Risk ratios (RRs) with 95% confidence intervals (CI) were synthesized using a frequentist random-effects model. Intention-to-treat (ITT) analyses estimated invitation-based population effectiveness, with exploratory per-protocol (PP) analyses serving as a complementary assessment for screening completers (high risk of bias and very low certainty). The sparse network lacked closed loops, precluding formal inconsistency assessment.</p><p><strong>Results: </strong>In ITT analyses, CS (RR 0.83, 95% CI 0.72-0.96) and FS (0.78, 0.74-0.83), but not FIT (limited evidence) or gFOBT, reduced CRC incidence versus NS. For CRC mortality, FS (0.74, 0.67-0.83) and gFOBT (0.87, 0.79-0.95), but not CS or FIT, reduced risk. No strategy reduced all-cause mortality. In exploratory PP analyses, CS (0.78, 0.62-0.99) and FS (0.72, 0.66-0.79) reduced CRC incidence. For CRC mortality, CS (0.52, 0.31-0.85), FS (0.58, 0.49-0.70), and gFOBT (0.71, 0.61-0.82) reduced risk.</p><p><strong>Conclusion: </strong>CS reduced CRC incidence in ITT analyses but showed limited population-level effectiveness when uptake was low. FS reduced CRC incidence and mortality in ITT analyses, and gFOBT reduced CRC mortality. Screening strategies should be selected based on test characteristics, real-world participation, and healthcare capacity. PP findings were exploratory and should not be used in isolation to guide recommendations.</p><p><strong>Trial registration: </strong>PROSPERO registration number CRD420251127511.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261454186"},"PeriodicalIF":3.8,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200868","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":"Efficacy and safety of risankizumab in moderate-to-severe Crohn's disease: a systematic review and meta-analysis.","authors":"Hafsa Nasim, Abdul Hannan Siddiqui, Syed Jawad Khan, Kisa Fatima, Aimen Naz, Zaland Ahmed Yousafzai, Javeria Malik, Nida Naeem, Usama Khan, Raghabendra Kumar Mahato","doi":"10.1177/17562848261454195","DOIUrl":"10.1177/17562848261454195","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) is a chronic inflammatory disorder with limited therapeutic options for treatment-refractory patients. This meta-analysis evaluates the efficacy and safety of risankizumab (IL-23 p19 inhibitor) in moderate-to-severe CD.</p><p><strong>Objectives: </strong>To evaluate the clinical, endoscopic, and safety outcomes of risankizumab in patients with moderate-to-severe CD.</p><p><strong>Design: </strong>Systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Data sources and methods: </strong>A systematic search identified seven RCTs evaluating risankizumab at different doses, including a total of 4411 patients. We searched multiple databases, including PubMed, Cochrane CENTRAL, ClinicalTrials.gov, and Web of Science. Outcomes included clinical and endoscopic remission, endoscopic response, mucosal healing, stool frequency and abdominal pain scores. Data were pooled using a random-effects model, with risk ratios (RRs) and 95% confidence intervals (CIs) reported. Separate meta-analyses were conducted for the induction and maintenance phases.</p><p><strong>Results: </strong>Risankizumab was significantly more effective than placebo or active comparator in achieving clinical remission (CDAI) during induction (RR, 1.85; 95% CI, 1.69-2.01; <i>p</i> < 0.00001; <i>I</i> ² = 0%) and maintenance (RR, 1.40; 95% CI, 1.21-1.62; <i>p</i> < 0.00001; <i>I</i> ² = 58%). Endoscopic outcomes were robust, with significant rates of endoscopic remission (RR, 2.81; 95% CI, 2.04-3.87; <i>p</i> < 0.00001; <i>I</i> ² = 50%) and endoscopic response (RR, 4.17; 95% CI, 3.31-5.77; <i>p</i> < 0.00001; <i>I</i> ² = 0%) post-induction. Risankizumab significantly increased mucosal healing (RR, 3.40; <i>p</i> < 0.00001; <i>I</i> ² = 61%) and reduced the risk of CD-related hospitalizations by 78% (RR, 0.22; 95% CI, 0.14-0.34; <i>p</i> < 0.00001; <i>I</i> ² = 0%). While fecal calprotectin levels significantly improved (RR, 1.79; <i>p</i> < 0.00001; <i>I</i> ² = 0%), no significant benefit was observed for high-sensitivity C-reactive protein maintenance (<i>p</i> = 0.39; <i>I</i> ² = 59%). Subgroup analyses indicated consistent treatment effects across doses, with the Peyrin-Biroulet (2024) and FORTIFY trials identified as primary sources of observed heterogeneity in maintenance outcomes.</p><p><strong>Conclusion: </strong>These findings suggest that risankizumab is an effective and safe option for inducing and maintaining remission in moderate-to-severe CD. Further long-term studies should refine dosing, assess long-term outcomes, and support its integration into clinical guidelines.</p><p><strong>Trial registration: </strong>PROSPERO ID: CRD42024611707.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261454195"},"PeriodicalIF":3.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158849","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 effect of fecal microbiota transplantation on quality of life in patients with chronic pouchitis: a post hoc analysis of the MicroPouch trial.","authors":"Sarah Søgaard Jakobsen, Sabrina Just Kousgaard, Frederik Cold, Sofie Ingdam Halkjær, Andreas Munk Petersen, Jens Kjeldsen, Jane Møller Hansen, Ole Thorlacius-Ussing","doi":"10.1177/17562848261452497","DOIUrl":"10.1177/17562848261452497","url":null,"abstract":"<p><strong>Background: </strong>During surgical treatment for ulcerative colitis, an ileal pouch-anal anastomosis is often constructed. Pouchitis, the most common complication after this surgery, substantially reduces patients' quality of life (QoL). In chronic pouchitis, antibiotic treatment often proves ineffective. Fecal microbiota transplantation (FMT) has emerged as a potential treatment for chronic pouchitis.</p><p><strong>Objectives: </strong>To determine the effect of FMT on QoL in patients with chronic pouchitis.</p><p><strong>Design: </strong>An exploratory post hoc analysis of data from the MicroPouch trial. A double-blinded, placebo-controlled study comprising a 4-week intervention period and 12-month follow-up.</p><p><strong>Method: </strong>Thirty patients with chronic pouchitis were randomized 1:1 to receive either FMT or placebo. Treatment was administered by enema once daily for 2 weeks, then every other day for the following 2 weeks. QoL was assessed using three questionnaires-the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), the Pouch Dysfunction Score (PDS), and the 36-item Short Form Questionnaire (SF-36)-at baseline and at subsequent follow-ups.</p><p><strong>Results: </strong>At the 30-day follow-up, FMT-treated patients showed a significant decrease in QoL from baseline, measured by the SIBDQ (<i>p</i> = 0.03). Within the FMT group, the PDS did not change significantly from baseline to day 30 (<i>p</i> = 0.36). The placebo group reported higher SF-36 QoL scores at both baseline and day 30 (<i>p</i> = 0.02), although neither group showed significant within-group changes over time.</p><p><strong>Conclusion: </strong>In patients with chronic pouchitis, FMT may temporarily worsen symptoms and reduce QoL, as indicated by three QoL questionnaires showing no improvement or poorer outcomes versus placebo. <b><i>Trial registration</i>:</b> The study is registered at ClinicalTrials.gov (Trial number NCT04100291), date: 12 September 2019.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261452497"},"PeriodicalIF":3.8,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151922","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 UK vedolizumab real-life experience study in inflammatory bowel disease (VEST): patient characteristics, drug persistence and patient-centred outcomes.","authors":"Keith Bodger, Cheryl Booker, Frederick Taylor, Tariq Ahmad, Stuart Bloom, Jeffrey Butterworth, Klaartje Kok, Alan Lobo, Peter Irving, J R Fraser Cummings","doi":"10.1177/17562848261446551","DOIUrl":"10.1177/17562848261446551","url":null,"abstract":"<p><strong>Background: </strong>VEST was a multi-centre study of real-world use of vedolizumab in inflammatory bowel disease (IBD) in routine practice in the United Kingdom.</p><p><strong>Objectives: </strong>To describe real-world indications, effectiveness, patient-reported outcomes and safety.</p><p><strong>Design: </strong>Prospective observational cohort study at 22 centres.</p><p><strong>Methods: </strong>Patients receiving vedolizumab as part of standard care were included. Data were collected at infusion visits for activity indices (Harvey-Bradshaw Index (HBI) or partial Mayo Score (PMS)), physician global assessment (PGA), patient-reported quality-of-life and treatment perception (IBD-Control Questionnaire) and adverse events. Clinical response (Wk14) was defined as a reduction in HBI ⩾3 or PMS ⩾2, clinical remission as HBI ⩽4 or PMS ⩽1 and analysed using non-responder imputation. One-year persistence was defined as continuing on vedolizumab after an infusion at ⩾48 weeks. Biomarker and endoscopic data were not available.</p><p><strong>Results: </strong>364 patients, mean age: 48 years; 132 (36%) with Crohn's disease (CD), 224 (62%) with UC and 8 (2%) with IBD-U; 174 (48%) male; 142 (39%) receiving steroids at baseline (Wk0); 141 (39%) bio-naïve. At baseline, 279 (77%) had \"active\" disease. One-year persistence: 58% overall (54% for active disease). Among persistent cases (<i>n</i> = 212), median (IQR) IBD-Control-8 scores improved from 6 (3-10) at baseline to 14 (10-16) at post-induction (Wk14) and 1 year (<i>p</i> < 0.001 vs baseline). Corresponding scores for IBD-Control-VAS were: 50 (30-70), 80 (65-90) and 85 (70-95), respectively (<i>p</i> < 0.001 vs baseline). Each domain of IBD-Control-8 showed improvement. Baseline and post-induction health status (activity index, PGA or IBD-Control) were associated with 1-year persistence, but no significant associations were observed for disease type, duration, bio-naïve status or baseline steroids. Of those with active disease at Wk0, clinical remission rates were 29%, 30% and 38% for CD, UC and IBD-U, respectively, and steroid-free remission rates were 26%, 27% and 38%. Similar remission rates were observed at 1 year. Possible adverse events leading to treatment cessation were rare (3%).</p><p><strong>Conclusion: </strong>In routine clinical practice in the UK, vedolizumab demonstrated high levels of persistence. Similar rates of clinical response, remission and 1-year persistence were seen in UC and CD patients, and in bio-experienced versus naïve cases. Persistent cases experienced significant and sustained improvements in quality of life and treatment perception. Persistence does not imply anti-inflammatory efficacy, as biomarker data were not available.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261446551"},"PeriodicalIF":3.8,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158838","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":"Fecal microbiota transplant and its usefulness in hepatic disorders: a systematic review.","authors":"Arun Kumar Mishra, Amrita Mishra, Akash Vikal, Harpreet Singh, Kamal Y Thajudeen, Gyas Khan, Mohammed Muqtader Ahmed","doi":"10.1177/17562848261452504","DOIUrl":"10.1177/17562848261452504","url":null,"abstract":"<p><strong>Background: </strong>Fecal microbiota transplantation (FMT) is an emerging therapeutic approach aimed at restoring gut microbial balance through the transfer of stool from healthy donors. It has gained significant attention for its role in managing gut dysbiosis-associated disorders, particularly hepatic diseases.</p><p><strong>Objective: </strong>This systematic review evaluated the therapeutic efficacy and clinical potential of FMT in the management of liver-related conditions, including recurrent <i>Clostridium difficile</i> infection (CDI), non-alcoholic fatty liver disease, liver cirrhosis, and hepatic encephalopathy.</p><p><strong>Design: </strong>A systematic review of existing literature was conducted to assess the clinical outcomes, mechanisms, and challenges associated with FMT in hepatic disorders.</p><p><strong>Data sources and methods: </strong>Relevant studies were identified from peer-reviewed scientific databases, focusing on clinical trials, observational studies, and experimental research investigating the role of FMT in gut dysbiosis and liver disease. Data were analyzed to evaluate efficacy, underlying mechanisms, and safety considerations.</p><p><strong>Results: </strong>FMT demonstrated high efficacy in recurrent CDI, with cure rates exceeding 80%-90%. In hepatic disorders, FMT was associated with improved microbial diversity, enhanced gut barrier integrity, and reduced systemic inflammation, contributing to better liver function and clinical outcomes. However, variability in donor selection, potential safety risks, and regulatory limitations remain significant challenges.</p><p><strong>Conclusion: </strong>FMT represents a promising therapeutic strategy in hepatology, underscoring the critical role of the gut-liver axis. Advances such as synthetic microbiota and personalized microbiome-based therapies may further optimize its safety and efficacy, paving the way for innovative, microbiome-centered interventions in liver disease management.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"19 ","pages":"17562848261452504"},"PeriodicalIF":3.8,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139600","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}