Lancet Gastroenterology & Hepatology最新文献

{"title":"Temporal trends in hepatitis C incidence among people tested more than once in Georgia, 2017–23: a nationwide, retrospective cohort","authors":"Davit Baliashvili, Shaun Shadaker, Nathan Furukawa, Vladimer Getia, Maia Tsereteli, Hasan Symum, Paige A Armstrong, Rania A Tohme, Senad Handanagic","doi":"10.1016/s2468-1253(25)00124-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00124-4","url":null,"abstract":"<h3>Background</h3>Achieving low incidence is one of WHO's key targets for the elimination of hepatitis C virus (HCV) infection. As progress in Georgia's hepatitis C elimination programme moves the country closer to reaching this target, tracking new cases of hepatitis C has become a priority. We aimed to estimate temporal trends in hepatitis C incidence among people who were tested more than once for hepatitis C in Georgia.<h3>Methods</h3>We conducted a retrospective cohort study in adults (aged ≥18 years) tested at least twice for antibodies against HCV (anti-HCV), with the first test being non-reactive, in Georgia from Jan 1, 2017, to Dec 31, 2023. Data were extracted from Georgian national hepatitis C screening and treatment databases on Jan 8, 2024. We calculated the incidence of anti-HCV seroconversion and current chronic HCV infections per 100 000 person-years and 95% CIs overall for 2017–23 and by year for 2017–22. For people who seroconverted but did not undergo testing to confirm current infection, we used multiple imputations to impute the status of current chronic HCV infection. To estimate the magnitude of change, we calculated incidence rate ratios (IRRs) with 95% CIs.<h3>Findings</h3>Among 1 264 181 adults with repeat anti-HCV testing during the study period, 519 936 (41·1%) were men and 744 245 (58·9%) were women. In total, 18 846 (1·5%) seroconverted to anti-HCV-reactive after a median follow-up time of 1025 days (IQR 503–1553). The overall incidence rate of anti-HCV seroconversion was 514 cases per 100 000 person-years (95% CI 506–521). The overall estimated incidence rate of current chronic HCV infection was 293 cases per 100 000 person-years (288–299). The annual incidence rate of anti-HCV seroconversion was 3·7 times lower in 2022 than in 2017, declining from 1399 cases per 100 000 person-years (1346–1454) to 377 cases per 100 000 person-years (361–394; IRR 0·27 [95% CI 0·25–0·29]). The annual incidence rate of chronic HCV infection was 4·6 times lower in 2022 than in 2017, declining from 935 cases per 100 000 person-years (892–981) to 205 cases per 100 000 person-years (193–217; IRR 0·22 [95% CI 0·20–0·24]).<h3>Interpretation</h3>We found a high but decreasing incidence rate of hepatitis C in Georgia among people tested more than once. The country should scale up preventive interventions to reduce incidence further and reach elimination targets.<h3>Funding</h3>None.<h3>Translation</h3>For the Georgian translation of the abstract see Supplementary Materials section.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"109 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptick of food allergies in recent years—real or epiphenomenon?","authors":"Carina Venter, Heidi M Staudacher","doi":"10.1016/s2468-1253(25)00202-x","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00202-x","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"13 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise for colon cancer: from supportive care to therapy","authors":"","doi":"10.1016/s2468-1253(25)00206-7","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00206-7","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"149 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research in Brief","authors":"Holly Baker","doi":"10.1016/s2468-1253(25)00201-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00201-8","url":null,"abstract":"&lt;h2&gt;Section snippets&lt;/h2&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;&lt;span&gt;&lt;span&gt;Semaglutide shows benefit in MASH&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;&lt;/h2&gt;Once-weekly semaglutide improves liver histology outcomes in patients with metabolic dysfunction-associated steatohepatitis (MASH), according to interim results from the &lt;span&gt;&lt;span&gt;ESSENCE trial&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;. Arun J Sanyal and colleagues randomly assigned patients with biopsy-defined MASH and fibrosis stage 2 or 3 to receive either subcutaneous semaglutide 2·4 mg (n=534) or placebo (n= 266) once-weekly for 240 weeks.At the 72-week interim analysis, 62·9% of patients in the semaglutide group versus 34·3% in the placebo&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;&lt;span&gt;&lt;span&gt;Nivolumab plus ipilimumab for hepatocellular carcinoma&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;&lt;/h2&gt;First-line immunotherapy with nivolumab plus ipilimumab improves survival in patients with unresectable hepatocellular carcinoma, according to the &lt;span&gt;&lt;span&gt;phase 3 CheckMate 9DW trial&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;. Thomas Yau and colleagues randomly assigned patients who had not yet received systemic therapy to receive the immunotherapy combination (n=335) or a standard tyrosine-kinase inhibitor (either lenvatinib or sorafenib; n=333).At a median follow-up of 35·2 months, median overall survival was 23·7 months (95% CI 18·8–29·4) in&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;&lt;span&gt;&lt;span&gt;CAR T-cell therapy for advanced gastric cancers&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;&lt;/h2&gt;Satricabtagene autoleucel (satri-cel), a CAR T-cell therapy targeting CLDN18.2, significantly prolongs progression-free survival in patients with heavily pretreated advanced gastric or gastro-oesophageal junction cancers, according to the &lt;span&gt;&lt;span&gt;phase 2 CT041-ST-01 trial&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.Changsong Qi and colleagues randomly assigned patients with CLDN18.2-positive tumours who were refractory to at l","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"11 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Gastroenterol Hepatol 2024; 9: 415–27","authors":"","doi":"10.1016/s2468-1253(25)00203-1","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00203-1","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"1 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Gastroenterol Hepatol 2025; 10: 715–25","authors":"","doi":"10.1016/s2468-1253(25)00204-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00204-3","url":null,"abstract":"<em>Feagan BG, Sands BE, Siegel CA, et al. Safety and efficacy of the anti-TL1A monoclonal antibody tulisokibart for Crohn's disease: a phase 2a induction trial.</em> Lancet Gastroenterol Hepatol <em>2025; <strong>10:</strong> 715–25—</em>In figure 5B of this Article, the righthand subheading should have been “CD TL1A regulon”. This correction has been made as of July 9, 2025.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"109 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical success after peroral endoscopic myotomy in the context of reflux-related symptoms","authors":"Yasutoshi Shiratori, Anthony Kalloo","doi":"10.1016/s2468-1253(25)00141-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00141-4","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"22 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the safety and quality of paediatric endoscopy in the Netherlands","authors":"Isabelle van Dijk, Margreet Wessels, Michael Groeneweg, Herbert M van Wering, René Scheenstra, Bas L A M Weusten, Marcel J M Groenen, Tim G J de Meij","doi":"10.1016/s2468-1253(25)00194-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00194-3","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"68 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in validation of treatment-response biomarkers in Crohn's disease?","authors":"Saiumaeswar Yogakanthi, Tim Raine","doi":"10.1016/s2468-1253(25)00138-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00138-4","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"6 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of peripheral blood DNA methylation signatures to predict response to biological therapy in adults with Crohn's disease (EPIC-CD): an epigenome-wide association study","authors":"Vincent W Joustra, Andrew Y F Li Yim, Peter Henneman, Ishtu Hageman, Tristan de Waard, Evgeni Levin, Alexandra J Noble, Thomas P Chapman, Femke Mol, Sarah van Zon, Donghyeok Lee, Colleen G C McGregor, Melanie S Hulshoff, Jack J Satsangi, Wouter J de Jonge, Geert R D'Haens","doi":"10.1016/s2468-1253(25)00102-5","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00102-5","url":null,"abstract":"<h3>Background</h3>Biological therapeutics are widely used in Crohn's disease, with evidence of efficacy from randomised trials and real-world experience. Primary non-response is a common, poorly understood problem. We aimed to assess blood methylation as a predictor of response to adalimumab, vedolizumab, or ustekinumab in patients with Crohn's disease.<h3>Methods</h3>This epigenome-wide association study used data from two ongoing biobanks (one from the Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands [discovery cohort] and the other from the John Radcliffe Hospital, Oxford, UK [validation cohort]) that recruited patients between Oct 1, 2009, and June 17, 2022. Adult participants (age ≥18 years) with active symptomatic and endoscopic Crohn's disease who were scheduled to start adalimumab, vedolizumab, or ustekinumab treatment were included. Patients with ongoing malignancy or serious concomitant inflammatory diseases were excluded. Treatment response was assessed after a median of 28 weeks of treatment (IQR 18–36). Response was defined as a combination of endoscopic criteria (50% or more reduction in the Simple Endoscopic Score for Crohn's Disease) with either clinical or biochemical criteria (corticosteroid-free clinical response: ≥3 point decrease in Harvey–Bradshaw Index [HBI] score or remission [HBI ≤4] and no systemic steroids at follow up; biochemical response: C-reactive protein reduction ≥50% or ≤5 mg/L and faecal calprotectin reduction ≥50% or ≤250 μg/g) compared with baseline. Epigenome-wide DNA methylation and transcriptome-wide gene expression analyses were done on whole peripheral blood leukocyte samples that were collected before the start of treatment. To identify baseline DNA methylation markers associated with response or non-response to treatment, we performed supervised machine learning through stability selected gradient boosting. In a post-hoc analysis, we compared our DNA methylation-based prediction model with clinical decision support tools (CDSTs).<h3>Findings</h3>We profiled the peripheral blood DNA methylome of 273 adults with Crohn's disease scheduled to start adalimumab, vedolizumab, or ustekinumab in the discovery (Amsterdam, n=183; 108 [59·0%] female and 75 [41·0%] male) and the validation cohort (Oxford, n=90; 46 [51·1%] female and 44 [48·9%] male). In the discovery cohort, we defined a panel of DNA methylation biomarkers that were associated with combined endoscopic and clinical or biochemical response to adalimumab (18 markers), vedolizumab (25 markers), or ustekinumab (68 markers), with an area under the curve (AUC) of 0·86 (95% CI 0·58–0·97) for adalimumab, 0·87 (0·67–0·98) for vedolizumab, and 0·89 (0·76–1·00) for ustekinumab. Validation in the Oxford cohort yielded an AUC of 0·25 (0·10–0·35) for adalimumab, 0·75 (0·65–0·85) for vedolizumab, and 0·75 (0·65–0·87) for ustekinumab. In comparison, implementing the CDSTs in the validation cohort yielded an AUC of 0·56 (0·44–0·6","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"7 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}