Annals of Gastroenterology最新文献

{"title":"Prevalence of <i>Helicobacter pylori</i> infection and gastric intestinal metaplasia in Greek patients.","authors":"Stergios N Kouvaras, Ioannis G Koumarianos, Konstantinos Ekmektzoglou, George A Kounis, Charikleia Spiliadi, Sotirios D Georgopoulos, Theodoros Rokkas","doi":"10.20524/aog.2025.1014","DOIUrl":"10.20524/aog.2025.1014","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of the local prevalence of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and gastric intestinal metaplasia (GIM) is imperative in screening the population for gastric cancer. The aim of our study was to estimate the histopathological prevalence of <i>H. pylori</i> infection and GIM in Greek patients.</p><p><strong>Methods: </strong>This was a single-center retrospective study. The age, sex, endoscopic diagnosis, the presence of <i>H. pylori</i> gastritis and the presence of either complete or incomplete GIM, were extracted from the medical reports of our study group and stored in Microsoft Excel. The analysis was focused on the epidemiologic behavior of 2 histologic diagnoses: the presence of <i>H. pylori</i> gastritis and GIM.</p><p><strong>Results: </strong><i>H. pylori</i> gastritis was recorded in 910 of the 2343 patients studied (38.8%, 95% confidence interval [CI] 36.8-40.8%). GIM was found in 601 of 2317 patients (25.9%, 95%CI 24.2-27.8%). The prevalence of incomplete GIM was 15.2%. These results are consistent with those observed in other European countries.</p><p><strong>Conclusions: </strong>This study is the first large Greek study to estimate the histopathological prevalence of <i>H. pylori</i> infection and GIM in a population from a primary care gastrointestinal unit. There was a strong association between <i>H. pylori</i> infection and the development of GIM. <i>H. pylori</i> were more prevalent in non-operated stomachs compared with operated. There was no difference in the prevalence of GIM between operated and non-operated stomachs.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 6","pages":"604-609"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046172","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":"Disease burden and unmet medical need in patients with Crohn's disease in Greece: a cross-sectional patient survey.","authors":"Charalampos Tzanetakos, Vasiliki-Rafaela Vakouftsi, George Mavridoglou, Marina Psarra, George Gourzoulidis","doi":"10.20524/aog.2025.1013","DOIUrl":"10.20524/aog.2025.1013","url":null,"abstract":"<p><strong>Background: </strong>Improving Crohn's disease (CD) management requires a comprehensive understanding of the disease's full impact. Τhis real-world, patient-reported survey investigated the disease burden and unmet medical needs among Greek patients with CD.</p><p><strong>Methods: </strong>Between October 2023 and January 2024, members of the Hellenic Society of Crohn's Disease and Ulcerative Colitis Patients (HELLESCC) completed a structured questionnaire. The questionnaire captured demographics, disease and treatment characteristics, as well as patient-reported outcomes: Short Inflammatory Bowel Disease Questionnaire (SIBDQ), Work Productivity and Activity Impairment (WPAI), Patient Health Questionnaire-9 (PHQ-9), treatment satisfaction, and treatment adherence. To determine associated factors, both univariate and multivariate logistic regression analyses were carried out.</p><p><strong>Results: </strong>Among 240 CD patients, 52.9% had active disease and 83.7% were treated with advanced therapies (biological/small molecule agents). Approximately 73.1% reported impaired quality of life (QoL) (SIBDQ <60), 30.9% reduced work productivity, and 36.0% limitations in daily activities. Nearly half (46.1%) reported moderate-to-severe depressive symptoms (PHQ-9 ≥10). Four of 10 patients expressed dissatisfaction with their treatment and 9.9% reported reduced adherence. Higher disease activity was associated with poorer QoL, reduced work productivity, worse mental health, and lower treatment satisfaction. Notably, 76.3% of patients on advanced therapies reported impaired QoL. Of these, 30.9% were in clinical remission.</p><p><strong>Conclusions: </strong>In Greece, CD patients continue to bear a substantial disease burden, evidenced by reduced QoL, impaired work productivity and daily activity, high rates of depression, and persistent disease activity. A significant proportion also reported dissatisfaction with their treatment, underscoring ongoing unmet needs in disease management.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 6","pages":"629-640"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050337","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":"Interleukin 12/23 and interleukin 23 inhibitors for moderate-to-severe ulcerative colitis: a systematic review and network meta-analysis.","authors":"Bisher Sawaf, Mohammad Al Hayek, Ahmad Kassem, Dahham Alsoud, Mulham Alom, Abdelaziz H Salam, Rana H Shembesh, Mohammed S Beshr, Yusuf Hallak, Shahem Abbarh, Elias Batikh, Mosa Shibani, Muhammed Elhadi, Yaseen Alastal, Miguel Regueiro","doi":"10.20524/aog.2025.1009","DOIUrl":"10.20524/aog.2025.1009","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) is a chronic inflammatory disease affecting ~1.5 million individuals, causing significant impairment in quality of life, psychological well-being, and healthcare burden. Using indirect meta-analysis, this study compared the efficacy and safety of anti-interleukin (IL)-12/23 and IL-23 agents vs. placebo and each other, during induction and maintenance in moderate-to-severe UC.</p><p><strong>Methods: </strong>A systematic search of PubMed, Cochrane, Scopus, Web of Science, and ClinicalTrials. gov was conducted on October 1, 2024. The randomized controlled trials (RCTs) included evaluated ustekinumab, mirikizumab, risankizumab, and guselkumab. The primary outcomes were clinical remission and endoscopic improvement at both induction and maintenance endpoints. Odds ratios (ORs) with 95% confidence intervals (CIs) and surface under the cumulative ranking (SUCRA) values were used to rank treatment efficacy.</p><p><strong>Results: </strong>Six RCTs (n=3808) were analyzed for induction and 5 RCTs (n=1697) for maintenance. During induction, risankizumab demonstrated the highest clinical remission rates (OR 3.89, 95%CI 2.24-6.75; SUCRA 80.7%) and endoscopic improvement rates (OR 4.21, 95%CI 2.12-8.35; SUCRA 87.6%) compared to placebo. In maintenance, guselkumab showed the highest clinical remission (OR 4.28, 95%CI 1.58-11.59; SUCRA 81.6%) and endoscopic improvement (OR 4.21, 95%CI 2.12-8.35; SUCRA 93.1%), and was superior to risankizumab (OR 2.05, 95%CI 1.09-3.84) for endoscopic outcomes.</p><p><strong>Conclusions: </strong>Risankizumab was most effective in induction, while guselkumab was more effective in maintenance. Head-to-head trials are warranted.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 6","pages":"648-660"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046057","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":"RE: Increased capture of post-endoscopic retrograde cholangiopancreatography adverse events by delayed (day 7) follow-up calls: a prospective comparison of physician- and nurse-initiated calls.","authors":"Andrew A Thomson","doi":"10.20524/aog.2025.1016","DOIUrl":"10.20524/aog.2025.1016","url":null,"abstract":"","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 6","pages":"725"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050057","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":"Performance of endoscopic submucosal dissection and submucosal tunneling endoscopic resection for esophageal submucosal tumors: A multicenter retrospective cohort study.","authors":"Fotios Fousekis, Konstantinos Mpakogiannis, Stamatia Vogli, Maximilien Barret, Flavius-Stefan Marin, Shaimaa Elkholy, Mohamed El-Sherbiny, Karim Essam, Hany Haggag, Sukrit Sud, Arjun Koch, Shivam Khare, Rui Morais, João Santos-Antunes, Oleksandr Kiosov, Alberto Herreros de Tejada, Vladyslav Yakovenko, Mandarino Vito Francesco, Ernesto Fasulo, George Tribonias, Ahmed Altonbary, Federico Barbaro, Biswa Ranjan Patra, Hany Shehab, Georgios Mavrogenis","doi":"10.20524/aog.2025.1017","DOIUrl":"10.20524/aog.2025.1017","url":null,"abstract":"<p><strong>Background: </strong>Esophageal submucosal tumors (ESTs) were typically managed through surveillance, but there is now a shift towards endoscopic resection. Endoscopic submucosal dissection (ESD) and submucosal tumor endoscopic resection (STER) appear to be safe and effective treatment options; however, evidence from non-East Asian centers is limited.</p><p><strong>Methods: </strong>This retrospective multicenter study included 97 patients from 15 centers across 9 countries who underwent endoscopic resection of ESTs via ESD or STER. Demographics, tumor characteristics, procedural details, adverse events and follow-up outcomes were recorded and analyzed.</p><p><strong>Results: </strong>Of the 97 patients, 48 underwent ESD and 49 STER. Most lesions were located in the lower esophagus and originated from the <i>muscularis propria</i>. <i>En bloc</i> resection was achieved in 95% of cases, with no significant difference between techniques (STER: 92% vs. ESD: 98%, P=0.18). The most common histologic diagnosis was leiomyoma (52%), followed by granular cell tumors (22%) and gastrointestinal stromal tumors (6%). Adverse events were infrequent: 9 cases of perforation were recorded, with only 4 being unintentional and all managed endoscopically. Follow-up data revealed only 1 case of local recurrence in a patient with a 50 mm lesion treated by STER. Hospital stay was longer after STER than ESD (3 vs. 2 days, P<0.001).</p><p><strong>Conclusions: </strong>ESD and STER are effective and safe for ESTs, with high <i>en bloc</i> resection rates, minimal adverse events and very low recurrence during short-term follow up. These findings support the broader adoption of advanced endoscopic resection, which is transforming the management of ESTs from surgical to endoscopic treatment.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 6","pages":"595-603"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046036","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 ultrasonography-guided gastroenterostomy for malignant and benign gastric outlet obstruction: a systematic review and meta-analysis.","authors":"Raffaele Manta, Angelo Zullo, Vincenzo De Francesco, Marco Spadaccini, Cesare Hassan, Luigi Gatta","doi":"10.20524/aog.2025.0989","DOIUrl":"10.20524/aog.2025.0989","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) with a lumen-apposing metal stent has been proposed as a treatment for patients with gastric outlet obstruction (GOO). We performed a systematic review and meta-analysis to compute the technical success, clinical success and complication rates of EUS-GE in treating GOO due to either neoplastic or benign diseases.</p><p><strong>Methods: </strong>The literature search was conducted in PubMed, EMBASE and the Cochrane Central Register of Controlled Trials, from inception until January 23, 2025, according to the PRISMA and MOOSE statement guidelines. The primary objective was to assess both technical and clinical success. A secondary outcome was to rate the adverse events.</p><p><strong>Results: </strong>Data from 39 studies involving 2845 patients were analyzed. The pooled technical success rate was 95.1%, and the procedure was successful in 95.3% and 95.1% of patients with malignant or benign diseases, respectively. Clinical success was achieved in 93.5% of all patients where the procedure had technical success, and in 93.1% and 94.4% of those treated for malignant and benign conditions, respectively. The overall rate of adverse events was 18.5%, including perforation (4.4%), bleeding (2.7%), stent migration (1.4%), stent closure (3.3%), infection (4.4%), and fistula (2.3%). The procedure-related mortality was 1.4%.</p><p><strong>Conclusion: </strong>EUS-GE appears to be a viable approach for the treatment of GOO patients, for both malignant and benign diseases, with favorable outcomes and an acceptable safety profile.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 5","pages":"554-563"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038846","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":"Evaluating spleen volume in inflammatory bowel disease.","authors":"Konstantinos C Mpakogiannis, Fotios S Fousekis, Viktoria-Efthymia C Mpakogianni, Ioanna Nefeli Mastorogianni, Konstantinos H Katsanos","doi":"10.20524/aog.2025.0993","DOIUrl":"10.20524/aog.2025.0993","url":null,"abstract":"<p><p>Crohn's disease (CD) and ulcerative colitis (UC), known as inflammatory bowel disease (IBD), are characterized by immune system dysregulation. The spleen holds a primary role in systemic inflammation and immune responses. Splenic involvement or splenomegaly in IBD patients may result from secondary causes, such as portal hypertension, myeloproliferative diseases, amyloidosis, splenic abscesses or granulomas. Current research on the direct association between IBD and spleen volume (SV) has expanded significantly. In CD, SV is predominantly increased, and is associated with worsen clinical outcomes. Successful treatment with infliximab often leads to a reduction in the elevated SV. Patients with UC often present spleens with invariant SV, or smaller spleens than those observed in CD, as UC typically affects a more limited part of the gastrointestinal tract compared to CD. However, reduction of SV in UC can also indicate relapsing pancolitis. Recent genetic data also suggest that an increased SV serves as a potential risk factor for the development of IBD, emphasizing the possible bidirectional causal relationship between IBD and SV. Shared pathogenic pathways, including intestinal immune activation, tumor necrosis factor-α activation, bowel toxin absorption and lymphatic tissue involvement, might explain the splenic and intestinal immune dysfunction. Thus, the measurement of SV and its adjustment for body mass index or weight, factors that affect the spleen size, may serve as a potential indicator for IBD monitoring, predicting disease-related flares and complications, and evaluating the response to current biologics. Nonetheless, further insights into the underlying pathogenic pathways linking SV and IBD are considered imperative.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 5","pages":"465-471"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038879","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":"Impact of overt and subclinical hepatogenous diabetes and metformin treatment on circulatory function, renal function and hemodynamics, inflammatory activity, and prognosis in patients with cirrhosis and ascites.","authors":"Ilias Tsiakas, Maria Kosmidou, Grigorios Despotis, Dimitrios Biros, Spiridon Tsiouris, Xanthi Xourgia, Lampros Lakkas, Georgios S Markopoulos, Eleni Bairaktari, Georgios Kolios, Haralampos Milionis, Georgios Kalambokis","doi":"10.20524/aog.2025.0990","DOIUrl":"10.20524/aog.2025.0990","url":null,"abstract":"<p><strong>Background: </strong>Hepatogenous diabetes (HD) is common in advanced cirrhosis. The oral glucose tolerant test (OGTT) is frequently diagnostic, as fasting blood glucose (FBG) may be normal. We investigated the impact of FBG- and OGTT-diagnosed HD, and metformin treatment, on circulatory function, renal function and perfusion, and inflammatory activity in patients with cirrhosis and ascites. Also, long-term prognosis of HD under metformin/metformin-based treatment was assessed.</p><p><strong>Methods: </strong>Mean arterial pressure (MAP), cardiac output (CO), systemic vascular resistance (SVR) as MAP/CO ratio, plasma renin activity (PRA), plasma aldosterone, glomerular filtration rate (GFR), renal blood flow (RBF), and plasma levels of lipopolysaccharide-binding protein (LBP), tumor-necrosis factor-α (TNF-α) and interleukin-6 were evaluated at baseline in patients with and without HD, and after 6 months of metformin treatment for newly diagnosed HD.</p><p><strong>Results: </strong>Compared to OGTT-HD (n=34) and no-HD (n=37), FBG-HD patients (n=35; newly-diagnosed, n=13) had significantly lower SVR (P=0.02/P=0.01), GFR (P=0.01/P=0.008) and RBF (P=0.02/P=0.01), and significantly higher CO (P=0.04/P=0.03), PRA (P=0.009/P=0.006), and levels of LBP (P=0.01/P=0.008) and TNF-α (P=0.03/P=0.02). Initiation of metformin in OGTT-HD and FBG-HD patients induced significant increases in SVR (P=0.02/P=0.04), GFR (P=0.02/P=0.04) and RBF (P=0.04/P=0.05), and significant decreases in PRA (P=0.02/P=0.03) and LBP (P=0.02/P=0.04). Three-year survival in OGTT-HD was significantly higher than in FBG-HD (75.3% vs. 55.3%; P=0.03) and similar to no-HD (81.7%).</p><p><strong>Conclusions: </strong>Circulatory function and renal function and perfusion are aggravated by FBG-HD compared to OGTT-HD or no-HD, possibly because of greater inflammatory activity, while they improve significantly after metformin treatment. Early treatment of HD with metformin may improve prognosis.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 5","pages":"545-553"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038885","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":"Reassessing <i>Clostridioides difficile</i> trends and racial disparities.","authors":"Rebecca Parry","doi":"10.20524/aog.2025.0984","DOIUrl":"10.20524/aog.2025.0984","url":null,"abstract":"","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 5","pages":"577"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038913","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":"The effects of empagliflozin on diuresis and natriuresis in patients with type 2 diabetes mellitus and liver cirrhosis.","authors":"Christos Siafarikas, Chris J Kapelios, Margarita Papatheodoridi, Evangelos Cholongitas, Theodoros Androutsakos, John Vlachogiannakos, Nikolaos Tentolouris, George Papatheodoridis","doi":"10.20524/aog.2025.0992","DOIUrl":"10.20524/aog.2025.0992","url":null,"abstract":"<p><strong>Background: </strong>We investigated the short-term diuretic and natriuretic effect of empagliflozin, a sodium-glucose linked transporter 2 inhibitor, in patients with cirrhosis and type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>This was a prospective, single-arm study including 30 patients with T2DM and cirrhosis (Child-Pugh class A/B). Participants received empagliflozin 10 mg for 15 days while continuing their standard treatment. Clinical and biochemical parameters, and urinary samples, using 24-h urine collection, were recorded before and after treatment. Twenty-seven patients continued empagliflozin for 6 months and were assessed for glycemic control and renal function.</p><p><strong>Results: </strong>Empagliflozin increased median daily urine volume by 475 mL (P=0.010) and fractional sodium excretion (FE_Na) by 16% at day 15 (P=0.030), but the 8 mmol/L increase in 24-h sodium excretion was not significant. Empagliflozin also reduced body weight (-0.8 kg, P<0.001) and systolic blood pressure (-4 mmHg, P=0.029). Glycemic control remained unremarkable at day 15, but improved at 6 months (baseline vs. 6 months: fasting glucose 146 vs. 116 mg/dL, P=0.016; glycosylated hemoglobin 6.2% vs. 6%, P=0.011). Compared to baseline (89.1±20.6 mL/min/1.73m², estimated glomerular filtration rate declined numerically but not statistically significantly at day 15 (85.2±21.8, P=0.056 and at 6 months (82.8±23.7, P=0.035. No serious adverse events were noticed.</p><p><strong>Conclusions: </strong>Up to 6 months' empagliflozin administration in patients with cirrhosis and T2DM seems safe and increases urine output and FE_Na, but its impact on renal function requires further investigation. Larger randomized controlled trials are needed to confirm its long-term efficacy and safety in this setting.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 5","pages":"537-544"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038918","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}