Gastro hep advances最新文献

{"title":"Efficacy and Descriptive Safety Assessment of Programmed Cell Death Protein-(Ligand) 1 Inhibitors Plus Chemotherapy as First-Line Treatment for Gastric and Gastroesophageal Junction Cancer in Asian and Non-Asian Patients: A Meta-Analysis","authors":"Florian Lordick ,&nbsp;Efrat Dotan ,&nbsp;Lin Zhan ,&nbsp;Xiaowei Zhang ,&nbsp;Afsaneh Barzi ,&nbsp;Nadeem Ghali ,&nbsp;Keun-Wook Lee ,&nbsp;Samuel J. Klempner ,&nbsp;Matthew R. Strickland ,&nbsp;Sara Lonardi ,&nbsp;Taroh Satoh","doi":"10.1016/j.gastha.2026.100938","DOIUrl":"10.1016/j.gastha.2026.100938","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Programmed cell death protein-(ligand) 1 (PD-[L]1) inhibitors have improved survival outcomes for patients with advanced gastric cancer (GC) or gastroesophageal junction cancer (GEJC). Given the higher incidence of GC mortality in Asian vs non-Asian populations coupled with some differences in etiology and treatment, this meta-analysis compared survival outcomes associated with first-line (1L) PD-(L)1 inhibitors plus chemotherapy in Asian and non-Asian patients with advanced GC/GEJC.</div></div><div><h3>Methods</h3><div>A systematic literature review was undertaken to identify randomized, phase III studies examining efficacy and safety of 1L PD-(L)1 inhibitor plus chemotherapy treatment in patients with advanced GC/GEJC. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled using fixed and random effects models. Safety data were summarized descriptively.</div></div><div><h3>Results</h3><div>Seven studies (3669 Asian and 3104 non-Asian patients) were included; 76% of patients had GC, ∼40% were aged ≥65 years, and 71% were male. PD-(L)1 inhibitors plus chemotherapy improved OS (HR, 0.80; 95% confidence interval [CI], 0.75–0.84) and PFS (HR, 0.75; 95% CI, 0.71–0.80) in the overall population. For the Asian and non-Asian regional breakdown, similar benefits were observed for OS (HR, 0.79; 95% CI, 0.73–0.85 and HR, 0.81; 95% CI, 0.74–0.89, respectively), with a comparable effect size for PFS (HR, 0.70; 95% CI, 0.64–0.76 and HR, 0.79; 95% CI, 0.70–0.89, respectively). Treatment-related adverse event rates were consistent across PD-(L)1 inhibitor plus chemotherapy (94%–98%) and placebo plus chemotherapy (92%–97%) groups.</div></div><div><h3>Conclusion</h3><div>1L PD-(L)1 inhibitors plus chemotherapy improved survival outcomes in patients with advanced GC/GEJC, regardless of Asian/non-Asian regional breakdown. These findings suggest that survival benefit is generalizable and independent of recruitment region.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 6","pages":"Article 100938"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147859487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should I Admire the Cecum for a While Once I Get There? A Trilogy","authors":"Manoop S. Bhutani ,&nbsp;Dongfeng Tan ,&nbsp;Paul F. Mansfield","doi":"10.1016/j.gastha.2026.100909","DOIUrl":"10.1016/j.gastha.2026.100909","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 5","pages":"Article 100909"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147603644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Video Fluoroscopic Swallow Study as a Screening Tool for Esophageal Dysmotility: A Call for More Widespread Implementation of a Standardized Esophageal Sweep Protocol","authors":"Eleanor Aubrey Belilos ,&nbsp;Gabrielle Klugman ,&nbsp;Yanyu Zhang ,&nbsp;Rana Abraham","doi":"10.1016/j.gastha.2026.100915","DOIUrl":"10.1016/j.gastha.2026.100915","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 5","pages":"Article 100915"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147658292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recompensation in Patients With Alcohol-Related Liver Disease—A Multicenter Study","authors":"Anand V. Kulkarni ,&nbsp;Madhumita Premkumar ,&nbsp;Karan Kumar ,&nbsp;Akash Roy ,&nbsp;Suprabhat Giri ,&nbsp;Ashirvad Pasumarthy ,&nbsp;Mithun Sharma ,&nbsp;Shantan Venishetty ,&nbsp;Sowmya Iyengar ,&nbsp;Manasa Alla ,&nbsp;Rakesh Kalapala ,&nbsp;Padaki Nagaraj Rao ,&nbsp;Duvvur Nageshwar Reddy ,&nbsp;Ashwani K. Singal ,&nbsp;K. Rajender Reddy","doi":"10.1016/j.gastha.2026.100897","DOIUrl":"10.1016/j.gastha.2026.100897","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Removal of etiology of cirrhosis may lead to recompensation in decompensated cirrhosis. Few studies have reported on rates of recompensation, as per Baveno VII criteria, in viral etiology-related decompensated cirrhosis. Our aim was to assess the rate and predictors of recompensation in the spectrum of alcohol-related liver disease (ALD).</div></div><div><h3>Methods</h3><div>Retrospective multicenter cohort study across 5 Indian centers included patients with a spectrum of ALD from January 2018 to November 2024. Clinical and biochemical data were collected and patients followed, and end points of recompensation, mortality, and transplant-free survival were evaluated.</div></div><div><h3>Results</h3><div>Among 344 patients (age: 41.2 ± 8.4 years; Model for End-Stage Liver Disease: 23.9 ± 6.2; men: 98.3%), 242 had decompensated cirrhosis with alcohol-associated hepatitis (DC + AAH), and 102 had decompensated cirrhosis without alcohol-associated hepatitis (DC-AAH). Twenty percent (69/344) achieved recompensation as per Baveno VII criteria over 21 (range, 12–67) months. The recompensation rate was higher among those with DC-AAH (30.4%; 31/102) compared to DC + AAH (15.7%; 38/242; <em>P</em> = .002). Transplant-free survival was higher among those who recompensated (DC + AAH: 92.1% vs 77.9%; DC-AAH: 93.5% vs 76.1%). On competing risk regression analysis, duration of abstinence (subdistribution hazard ratio, 1.03 [95% confidence interval, 1.01–1.05]; <em>P</em> = .04) and Child score (subdistribution hazard ratio 0.83 [95% confidence interval, 0.71–0.98]; <em>P</em> = .03) predicted recompensation. Model for End-Stage Liver Disease (hazard ratio, 1.09 [1.09–1.16]; <em>P</em> = .001) and recompensation (hazard ratio, 0.14 [0.04–0.49]; <em>P</em> = .002) predicted mortality.</div></div><div><h3>Conclusion</h3><div>Twenty percent of patients in the spectrum of ALD demonstrated recompensation, which was associated with improved survival.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 5","pages":"Article 100897"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147658448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Seronegative Autoimmune Hepatitis: Diagnostic Challenges and Clinical Implications","authors":"Aya Fadel,&nbsp;Yanie Oliva,&nbsp;Jose A. Gascon,&nbsp;Zahraa F. Saadoon,&nbsp;Lamia Nasser,&nbsp;Dima Nathir Dawood Sarah,&nbsp;Robert J. Hernandez,&nbsp;Arumugam R. Jayakumar,&nbsp;Hussain Hussain","doi":"10.1016/j.gastha.2026.101055","DOIUrl":"10.1016/j.gastha.2026.101055","url":null,"abstract":"<div><div>Postpartum autoimmune hepatitis (AIH) is a rare but serious condition triggered by immune rebound after delivery. Diagnosis is typically supported by elevated immunoglobulins and positive autoimmune markers; however, seronegative presentations remain diagnostically challenging. We present the fourth reported worldwide case of seronegative postpartum AIH in a 36-year-old woman who developed jaundice, pruritus, pale stools, and dark urine 4 months after delivery. Laboratory evaluation revealed severe hepatocellular injury with aspartate aminotransferase 1373 U/L, alanine aminotransferase 2137 U/L, and marked hyperbilirubinemia. Viral, toxic, metabolic, and rheumatologic investigations were negative, while autoimmune serologies and immunoglobulin levels remained normal. Imaging demonstrated hepatomegaly without biliary obstruction or vascular abnormalities. Liver biopsy revealed acute-on-chronic autoimmune-mediated hepatitis with necrosis, confirming seronegative postpartum AIH. This case emphasizes seronegative AIH as a critical consideration in postpartum acute hepatitis, with liver biopsy essential for diagnosis and early treatment.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 10","pages":"Article 101055"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148742346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Dysfunction–Associated Steatotic Liver Disease Is Associated With Adverse Social Factors: An Analysis Using All of Us","authors":"Manuela Araque,&nbsp;Stephanie M. Garces,&nbsp;Hui Yu,&nbsp;Mengsheng Zha,&nbsp;Sakina Qazi,&nbsp;Yan Guo,&nbsp;David Goldberg,&nbsp;Vatche Agopian,&nbsp;Jacob L. McCauley,&nbsp;Yvonne N. Flores,&nbsp;Patricia D. Jones","doi":"10.1016/j.gastha.2026.101077","DOIUrl":"10.1016/j.gastha.2026.101077","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and Aims&lt;/h3&gt;&lt;div&gt;Metabolic dysfunction–associated steatotic liver disease (MASLD) is progressive, with estimated global prevalence exceeding 30%. Social determinants of health (SDOH) may impact MASLD risk and progression. However, this has not been fully characterized. We harnessed the power of the &lt;em&gt;All of Us&lt;/em&gt; Research Program (&lt;em&gt;AoU&lt;/em&gt;) dataset to conduct a comprehensive analysis examining the association between various SDOH and MASLD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Metabolic dysfunction–associated steatotic liver disease (MASLD) is progressive, with estimated global prevalence exceeding 30%. Social determinants of health (SDOH) may impact MASLD risk and progression. However, this has not been fully characterized. We harnessed the power of the &lt;em&gt;All of Us&lt;/em&gt; Research Program (&lt;em&gt;AoU&lt;/em&gt;) dataset to conduct a comprehensive analysis examining the association between various SDOH and MASLD.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective cross-sectional analysis of the &lt;em&gt;AoU&lt;/em&gt; database. We identified participants with MASLD using ICD-9 and -10 codes and excluded individuals with other chronic liver diseases or self-reported heavy alcohol use. Healthy control participants were devoid of chronic liver diseases, heavy alcohol use, and comorbidities associated with MASLD if obese. We examined SDOH by combining relevant questions from various &lt;em&gt;AoU&lt;/em&gt; surveys and conducted univariate and multivariate logistic regression to examine the association between various SDOH and MASLD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We conducted a retrospective cross-sectional analysis of the &lt;em&gt;AoU&lt;/em&gt; database. We identified participants with MASLD using ICD-9 and -10 codes and excluded individuals with other chronic liver diseases or self-reported heavy alcohol use. Healthy control participants were devoid of chronic liver diseases, heavy alcohol use, and comorbidities associated with MASLD if obese. We examined SDOH by combining relevant questions from various &lt;em&gt;AoU&lt;/em&gt; surveys and conducted univariate and multivariate logistic regression to examine the association between various SDOH and MASLD.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;After matching cases to controls by age and race/ethnicity, the sample of 57,895 participants had a 1:3 case to control ratio; 16,666 had complete SDOH survey data (MASLD to controls, 1:3.4). Compared to controls, individuals with MASLD were more likely to have less than a high school education (10.7% vs 9.7%; &lt;em&gt;P&lt;/em&gt; &lt; .001) and annual income ≤$35,000 (42.4% vs 34.3%; &lt;em&gt;P&lt;/em&gt; &lt; .001). Compared to controls, participants with MASLD had significantly higher levels of social isolation, neighborhood disorder, perceived stress, food insecurity, and transportation insecurity (&lt;em&gt;P&lt;/em&gt; &lt; .001 for all).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;After matching cases to controls by age and race/ethnicity, the sample of 57,895 participants had a 1:3 case to control ratio; 16,666 had complete SDOH survey data (MASLD to controls, 1:3.4). ","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 11","pages":"Article 101077"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148941011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ultrasound-Guided Radiofrequency Ablation in the Management of Pancreatic Tumors: A Comprehensive Systematic Review and Meta-Analysis","authors":"Sanket Basida,&nbsp;Muhammad Nadeem Yousaf,&nbsp;Chukwunonso Ezeani,&nbsp;Drew Nannini,&nbsp;Parit Zalavadia,&nbsp;Madhav Changela,&nbsp;Dushyant Singh Dahiya,&nbsp;Shyam Thakkar","doi":"10.1016/j.gastha.2026.101066","DOIUrl":"10.1016/j.gastha.2026.101066","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Radiofrequency ablation (RFA) is a proven therapy for solid organ tumors. Endoscopic ultrasound-guided RFA (EUS-RFA) is a less invasive, emerging technique that may serve as an alternative to surgical resection for unresectable pancreatic tumors (UPT). However, its efficacy, safety, and clinical outcomes in tumor subgroups remain unclear. This systematic review and meta-analysis evaluate the efficacy, clinical, and technical success (TS) of EUS-RFA for UPT.</div></div><div><h3>Methods</h3><div>A comprehensive search of PubMed, Web of Science, Embase, Cochrane, and <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> (as of April 2025) identified studies on EUS-RFA and pancreatic tumors. Primary outcomes were TS, defined as probe placement and ablation regardless of outcome, and clinical success (CS), defined as symptomatic improvement or tumor size reduction with necrosis. Secondary outcomes included adverse events and efficacy for tumor subtypes. A pooled analysis using random-effect modeling was performed using the <em>metafor</em> R package.</div></div><div><h3>Results</h3><div>Seventeen studies involving 168 patients (52.38% female) and 182 tumors were included. Tumors included pancreatic neuroendocrine tumors (106, 58.24%), pancreatic ductal adenocarcinomas (49, 26.92%), and others. Tumors were located primarily in the body, neck, or tail (54.02%). Average ablation sessions per patient were 1.1. Pooled TS and CS rates were 89% and 84%, respectively. Nonfunctional neuroendocrine tumors and mixed type showed the highest CS rate (91%). The most common adverse event included abdominal pain (6.5%) and hyperamylasemia (3.6%).</div></div><div><h3>Conclusion</h3><div>EUS-RFA is a promising, safe modality for managing UPT, with high TS (89%) and CS (84%) rates. Larger clinical trials are needed to confirm safety, outcomes, and survival benefits for pancreatic cancer subtypes.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 10","pages":"Article 101066"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148777757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bile Acid Profiles Define Disease-Specific Cholestatic States in Primary Sclerosing and Primary Biliary Cholangitis","authors":"Brian D. Juran,&nbsp;Bryan M. McCauley,&nbsp;Chang Hu,&nbsp;Ahmad H. Ali,&nbsp;Erik M. Schlicht,&nbsp;Jackie K. Bianchi,&nbsp;Marjana J. Schell,&nbsp;Elizabeth J. Atkinson,&nbsp;Johannes R. Hov,&nbsp;Mette Vesterhus,&nbsp;William Rosenberg,&nbsp;Nicholas F. LaRusso,&nbsp;Gregory J. Gores,&nbsp;Tom H. Karlsen,&nbsp;Konstantinos N. Lazaridis","doi":"10.1016/j.gastha.2026.101073","DOIUrl":"10.1016/j.gastha.2026.101073","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC) are chronic cholestatic liver diseases with overlapping features but distinct biology. While bile acids (BAs) are central to cholestatic pathophysiology, the extent to which circulating BAs define disease-specific states remains unclear.</div></div><div><h3>Methods</h3><div>Plasma BA profiling and clinical laboratory tests were performed in patients with PSC (n = 269), PBC (n = 262), and matched controls (n = 269/262), respectively. BA composition, conjugation patterns, and pool characteristics were compared within and across diseases. Associations with hepatic decompensation were evaluated using univariable and exploratory multivariable analyses, including comparison with established prognostic scores.</div></div><div><h3>Results</h3><div>Both PSC and PBC exhibited elevated total BA levels compared with controls; however, BA composition and conjugation patterns differed between diseases. PSC was characterized by increased BA conjugation fraction and reduced glycine-to-taurine ratios, whereas PBC showed preserved overall conjugation with increased glycine predominance. In PSC, BA composition was further modulated by inflammatory bowel disease and colectomy, with depletion of secondary BA species. Across both diseases, advancing liver disease stage was associated with shifts toward primary and conjugated BA dominance. BA variables and clinical laboratory tests were associated with hepatic decompensation, particularly in PSC. Exploratory multivariable models showed comparable performance of BA-based and clinical laboratory–based models, and their combination did not materially improve prediction.</div></div><div><h3>Conclusion</h3><div>Plasma BA profiles define distinct cholestatic states in PSC and PBC that reflect disease type, intestinal modifiers, and liver disease stage. While BA variables are associated with clinical outcomes, their principal value lies in complementing established clinical laboratory–based assessments rather than improving predictive accuracy.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 10","pages":"Article 101073"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148777758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Herbal Products on Metabolic Parameters in Metabolic-Dysfunction Associated Liver Disease: A Systematic Review and Network Meta-Analysis","authors":"Revathi Thirumushi Sairaj,&nbsp;Alejandro Chen Liang,&nbsp;Yeison Cruz Castillo,&nbsp;Mariela Denise Fermin Madera,&nbsp;Jose Medina,&nbsp;Tatiana Alexandra Moreno Díaz,&nbsp;Gabriela Flores Monar,&nbsp;Supritha Chintamaneni,&nbsp;Camila Sanchez Cruz,&nbsp;Rashmi Advani,&nbsp;Sushovan Guha,&nbsp;Ernesto Calderón-Martinez","doi":"10.1016/j.gastha.2026.101040","DOIUrl":"10.1016/j.gastha.2026.101040","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Metabolic dysfunction–associated steatotic liver disease (MASLD) is closely linked to dyslipidemia, insulin resistance, and impaired glucose metabolism. Herbal products are widely used in MASLD, but their comparative metabolic effects and certainty of evidence remain unclear. We conducted a systematic review and network meta-analysis to evaluate herbal products on metabolic outcomes in MASLD.</div></div><div><h3>Methods</h3><div>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and International Prospective Register of Systematic Reviews registration (CRD420251236813), we searched PubMed, Web of Science, EMBASE, and Cochrane through September 2025 for randomized trials of herbal products in adults with MASLD. Primary outcomes were triglycerides (TG), fasting blood glucose (FBG), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR); secondary outcomes included cholesterol fractions, hemoglobin A1c, and body mass index. Random-effects network meta-analysis estimated mean differences (MDs) (95% confidence interval); certainty was assessed using CINeMA (Confidence in Network Meta-Analysis).</div></div><div><h3>Results</h3><div>A total of 123 trials were included (n = 8595). For TG, significant reductions vs placebo occurred with Korean red ginseng (MD: –99.00), naringenin (MD: –92.50), and artichoke leaf (MD: –52.60; all <em>P</em> &lt; .01); surface under the cumulative ranking curve (SUCRA) favored naringenin and Korean red ginseng (both 0.96). For FBG, green tea (MD: –16.98; <em>P</em> = .03), hesperidin + flaxseed (MD: –14.44), and garlic (MD: –13.51) were top-ranked (SUCRA: 0.90, 0.89, 0.87). For HOMA-IR, sumac (MD: –2.32; <em>P</em> &lt; .01), green tea (MD: –1.81), and berberine + tocotrienols + green coffee (MD: –1.80) showed greatest improvements (SUCRA: 0.94 for sumac). Artichoke leaf, curcumin, and green tea improved total cholesterol, low density lipoprotein-cholesterol, and body mass index; no intervention reduced hemoglobin A1c. CINeMA showed high confidence only for artichoke leaf on total cholesterol; moderate for select TG, high density lipoprotein-cholesterol, and HOMA-IR outcomes; remaining were low or very low.</div></div><div><h3>Conclusion</h3><div>Selected herbal products, particularly artichoke leaf, curcumin, green tea, flaxseed, and garlic may offer modest, domain-specific metabolic improvements in MASLD, though confidence was low for most outcomes. These therapies may serve as adjuncts, not substitutes for approved treatments. Larger randomized controlled trials with standardized formulations, long-term safety data, and liver-specific outcomes are needed.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 10","pages":"Article 101040"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148777823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Outcomes Are a Practical Tool for Monitoring Crohn’s Disease Activity in Real-World Care","authors":"Wai Kin Su,&nbsp;Susan J. Connor,&nbsp;Jane M. Andrews,&nbsp;William Wilson","doi":"10.1016/j.gastha.2026.101104","DOIUrl":"10.1016/j.gastha.2026.101104","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and Aims&lt;/h3&gt;&lt;div&gt;Crohn’s disease activity scores are used to “quantify” disease activity, for clinical care, and research. They can be impractical to use repeatedly in busy clinical settings. In a large real-world dataset, we therefore investigated how often each of indices, patient-reported outcomes 3 (PRO3), patient-reported outcomes 2 (PRO2), Crohn’s Disease Activity Index (CDAI), and Harvey–Bradshaw Index (HBI), could be calculated and explored the correlation amongst them.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Crohn’s disease activity scores are used to “quantify” disease activity, for clinical care, and research. They can be impractical to use repeatedly in busy clinical settings. In a large real-world dataset, we therefore investigated how often each of indices, patient-reported outcomes 3 (PRO3), patient-reported outcomes 2 (PRO2), Crohn’s Disease Activity Index (CDAI), and Harvey–Bradshaw Index (HBI), could be calculated and explored the correlation amongst them.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Crohn’s Colitis Care is a cloud-based inflammatory bowel disease–specific electronic medical record used in Australasia. Data to generate disease activity indices are sought at each clinical assessment. Completion rates of, and agreement between PRO2 and PRO3 with CDAI and HBI were calculated. Statistical analysis was performed using the Pearson correlation coefficient and simple linear regression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Crohn’s Colitis Care is a cloud-based inflammatory bowel disease–specific electronic medical record used in Australasia. Data to generate disease activity indices are sought at each clinical assessment. Completion rates of, and agreement between PRO2 and PRO3 with CDAI and HBI were calculated. Statistical analysis was performed using the Pearson correlation coefficient and simple linear regression.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 26,230 clinical assessments for people with Crohn’s disease, CDAI was available in 6509 (24.8%) of assessments, HBI in 7286 (27.8%), PRO3 in 21,234 (81.0%), and PRO2 in 21,416 (81.6%). There was 87.6% agreement in disease severity categorization between PRO2 and CDAI, Pearson coefficient 0.85, and Coefficient of Determination (R&lt;sup&gt;2&lt;/sup&gt;) value = 0.73. There was 93.3% agreement in disease severity categorization between PRO2 and HBI, Pearson coefficient 0.94, and R&lt;sup&gt;2&lt;/sup&gt; value = 0.89. Similarly, there was 86.8% agreement in disease severity categorization between PRO3 and CDAI, Pearson coefficient 0.95, and R&lt;sup&gt;2&lt;/sup&gt; value = 0.90. There was 88.2% agreement in disease severity categorization between PRO3 and HBI, Pearson coefficient 0.93, and R&lt;sup&gt;2&lt;/sup&gt; value = 0.86.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Of 26,230 clinical assessments for people with Crohn’s disease, CDAI was available in 6509 (24.8%) of assessments, HBI in 7286 (27.8%), PRO3 in 21,234 (81.0%), and PRO2 in 21,416 (81.6%). There was 87.6% agreement in disease severity categorization between PRO2 and CDAI, Pearson coefficient 0.85, and Coefficient of Det","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"5 12","pages":"Article 101104"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149161534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}