The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi最新文献

[Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti-interleukins]. [炎症性肠病中的新旧生物制剂和小分子药物：抗白细胞介素］

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-08-25 DOI: 10.4166/kjg.2024.076

Seung Min Hong, Won Moon

{"title":"[Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti-interleukins].","authors":"Seung Min Hong, Won Moon","doi":"10.4166/kjg.2024.076","DOIUrl":"10.4166/kjg.2024.076","url":null,"abstract":"Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a chronic inflammatory disease of the gastrointestinal tract. The introduction of biologics, particularly anti-interleukin (IL) agents, has revolutionized IBD treatment. This review summarizes the role of ILs in IBD pathophysiology and describes the efficacy and positioning of anti-IL therapies. We discuss the functions of key ILs in IBD and their potential as therapeutic targets. The review then discusses anti-IL therapies, focusing primarily on ustekinumab (anti-IL-12/23), risankizumab (anti-IL-23), and mirikizumab (anti-IL-23). Clinical trial data demonstrate their efficacy in inducing and maintaining remission in Crohn's disease and ulcerative colitis. The safety profiles of these agents are generally favorable. However, long-term safety data for newer agents are still limited. The review also briefly discusses emerging therapies such as guselkumab and brazikumab. Network meta-analyses suggest that anti-IL therapies perform well compared to other biological agents. These agents may be considered first- or second-line therapies for many patients, especially those with comorbidities or safety concerns. Anti-IL therapies represent a significant advancement in IBD treatment, offering effective and relatively safe options for patients with moderate to severe disease.","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038111","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}

引用次数: 0

[Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti Integrins]. [炎症性肠病中的新旧生物制剂和小分子：抗整合素]。

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-08-25 DOI: 10.4166/kjg.2024.070

Kyeong Ok Kim, Si Hyung Lee

{"title":"[Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti Integrins].","authors":"Kyeong Ok Kim, Si Hyung Lee","doi":"10.4166/kjg.2024.070","DOIUrl":"10.4166/kjg.2024.070","url":null,"abstract":"Recently, novel biologics or small molecular drugs have been introduced for overcoming the unmet needs associated with anti-tumor necrosis factor α agents for inflammtory bowel disease (IBD) treatment. Among these novel drugs, anti integrin agents block leukocyte trafficking to the intestine by blocking the interaction between integrin and cell adhesion molecules. Vedolizumab (anti-α4β7) is most widely used anti-integrin approved in both ulcerative colitis and Crohn's disease .It has been shown to be effective in both induction and maintenance therapy with a favorable safety profile due to gut selectivity. Several models incorporating clinical, genetic, immune and gut microbial markers to predict response to vedolizumab in IBD have been developed. Etrolizumab (anti-β7) blocks leukocyte trafficking via α4β7 and cell adhesion via αEβ7 integrins. In addition, the introduction of subcutaneous vedolizumab showed similar efficacy and safety with improved patients' convenience. Other investigational anti-integrin therapies include abrilumab (anti-α4β7 IgG2), PN-943 (orally administered and gut-restricted α4β7 antagonist peptide), AJM300 (orally active small molecule inhibitor of α4), and ontamalimab (anti-MAdCAM-1 IgG).","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038110","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}

引用次数: 0

[Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti-Tumor Necrosis Factors]. [炎症性肠病中的新老生物制剂和小分子药物：抗肿瘤坏死因子]。

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-08-25 DOI: 10.4166/kjg.2024.060

Sang Un Kim, Hyun Seok Lee

{"title":"[Old and New Biologics and Small Molecules in Inflammatory Bowel Disease: Anti-Tumor Necrosis Factors].","authors":"Sang Un Kim, Hyun Seok Lee","doi":"10.4166/kjg.2024.060","DOIUrl":"10.4166/kjg.2024.060","url":null,"abstract":"Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, is a chronic condition characterized by relapsing and remitting inflammation of the gastrointestinal tract. The pathogenesis involves a complex interplay of genetic, environmental, and immune factors. Treatment paradigms have evolved significantly over the past few decades, with the introduction of biologics, particularly anti-TNF (tumor necrosis factor) agents, marking a significant advancement. Anti-TNF therapies, including infliximab, adalimumab, golimumab, and certolizumab pegol, have efficacy in inducing and maintaining remission, promoting mucosal healing, and improving the quality of life in moderate to severe IBD patients. The early and appropriate use of these agents can mitigate disease progression and reduce the dependency on corticosteroids, enhancing long-term patient outcomes. Nevertheless, these therapies are expensive and are associated with potential adverse effects, including increased risk of infections and malignancies. This review discusses the mechanisms, clinical efficacy, safety profiles, and therapeutic positioning of anti-TNF agents in IBD management, integrating current Korean treatment guidelines.","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038112","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}

引用次数: 0

[Small Molecule Therapy for Inflammatory Bowel Disease: JAK Inhibitors and S1PR Modulators]. [炎症性肠病的小分子疗法：JAK抑制剂和S1PR调节剂]。

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-08-25 DOI: 10.4166/kjg.2024.064

Yu Kyung Jun, Hyuk Yoon

{"title":"[Small Molecule Therapy for Inflammatory Bowel Disease: JAK Inhibitors and S1PR Modulators].","authors":"Yu Kyung Jun, Hyuk Yoon","doi":"10.4166/kjg.2024.064","DOIUrl":"10.4166/kjg.2024.064","url":null,"abstract":"Small molecules, including Janus kinase (JAK) inhibitors and sphingosine-1-phosphate receptor modulators (S1PRMs), are promising new treatments for inflammatory bowel disease (IBD). Small molecules exhibit more predictable pharmacokinetics than biologics, are less likely to induce immune responses, and can be administered orally. JAK inhibitors function by blocking the activity of JAK enzymes, which prevents the subsequent phosphorylation and activation of signal transducer and activator of transcription (STAT) proteins. Tofacitinib and filgotinib are approved for treating ulcerative colitis (UC), while upadacitinib is approved for UC and Crohn's disease. Nevertheless, JAK inhibitors can increase the risk of herpes zoster, cancer, major adverse cardiovascular events, and venous thromboembolism. S1PRMs bind to S1PRs, particularly S1PR1, on lymphocytes. This interaction inhibits lymphocytes from exiting the lymph nodes and migrating to the gut, thereby reducing inflammation and the immune response in the intestinal mucosa. Ozanimod and etrasimod are S1PRMs approved for the treatment of UC, but they can cause side effects such as bradycardia, conduction disorder, and macular edema. Overall, JAK inhibitors and S1PRMs offer significant benefits in managing IBD, although their potential side effects require careful monitoring.","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038113","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}

引用次数: 0

[Treatment Strategies for Gastric Cancer Patients with Gastric Outlet Obstruction]. [胃癌患者胃出口梗阻的治疗策略]。

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-07-25 DOI: 10.4166/kjg.2024.054

Hyun Lim

引用次数: 0

[A New Korean Nomenclature for Steatotic Liver Disease]. [韩国脂肪肝新命名法]。

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-07-25 DOI: 10.4166/kjg.2024.066

引用次数: 0

Etiology and Outcomes of Patients with Extreme Hyperbilirubinemia in Korea: A Retrospective Cohort Study. 韩国极度高胆红素血症患者的病因和预后：回顾性队列研究

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-07-25 DOI: 10.4166/kjg.2024.038

Ji Yoon Kwak, Hankyu Jeon, Seong Je Kim, Ji Hee Han, Ra Ri Cha, Sang Soo Lee

{"title":"Etiology and Outcomes of Patients with Extreme Hyperbilirubinemia in Korea: A Retrospective Cohort Study.","authors":"Ji Yoon Kwak, Hankyu Jeon, Seong Je Kim, Ji Hee Han, Ra Ri Cha, Sang Soo Lee","doi":"10.4166/kjg.2024.038","DOIUrl":"https://doi.org/10.4166/kjg.2024.038","url":null,"abstract":"Background/aim: Extreme hyperbilirubinemia is occasionally observed in intensive care unit (ICU) and non-ICU settings. This study examined the etiologies of extreme hyperbilirubinemia (bilirubin level ≥12 mg/dL) and the factors associated with the 30-day mortality.Methods: This retrospective observational cohort study identified 439 patients with extreme hyperbilirubinemia at the Gyeongsang National University Changwon Hospital between 2016 and 2020. The patients were classified into three groups and 11 diseases according to their etiology. The risk factors associated with 30-day mortality at the baseline were investigated using the Cox proportional hazards model.Results: Of 439 patients with extreme hyperbilirubinemia, 287, 78, and 74 were in the liver cirrhosis/malignancy group, the ischemic injury group, and the benign hepatobiliary-pancreatic etiological group, respectively, with corresponding 30-day mortality rates of 42.9%, 76.9%, and 17.6%. The most common disease leading to hyperbilirubinemia was a pancreatobiliary malignancy (28.7%), followed by liver cirrhosis (17.3%), hepatocellular carcinoma (10.9%), and liver metastases (8.4%). The etiologies of hyperbilirubinemia, obstructive jaundice, infection, albumin level, creatinine level, and prothrombin time-international normalized ratio were independently associated with the 30-day mortality.Conclusions: This study suggests three etiologies of extreme hyperbilirubinemia in the ICU and non-ICU settings. The prognosis of patients with extreme hyperbilirubinemia depends largely on the etiology and the presence of obstructive jaundice.","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763684","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}

引用次数: 0

Impact of Dementia in Colorectal Cancer Patients: United States Population-Based Cohort Study. 痴呆症对结直肠癌患者的影响：美国人群队列研究》。

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-07-25 DOI: 10.4166/kjg.2024.057

Thanathip Suenghataiphorn, Narathorn Kulthamrongsri, Pojsakorn Danpanichkul, Sakditad Saowapa, Natchaya Polpichai, Jerapas Thongpiya

{"title":"Impact of Dementia in Colorectal Cancer Patients: United States Population-Based Cohort Study.","authors":"Thanathip Suenghataiphorn, Narathorn Kulthamrongsri, Pojsakorn Danpanichkul, Sakditad Saowapa, Natchaya Polpichai, Jerapas Thongpiya","doi":"10.4166/kjg.2024.057","DOIUrl":"https://doi.org/10.4166/kjg.2024.057","url":null,"abstract":"Background/aims: Various socioeconomic and racial disparities are well-documented for colon cancer. However, the association of dementia, which is a growing cause of mortality in the elderly, remains unexplored. We aim to understand the association between these two conditions, in the elderly population group.Methods: We utilized the 2020 National Inpatient Sample to investigate records admitted for colorectal cancer identified through ICD-10 CM codes. We divided records by the presence of dementia. Adjusted odds ratios (aORs) for predefined outcomes were determined using multivariable logistic and linear regression models, adjusting for comorbidities. The primary outcome assessed was inpatient mortality, while secondary outcomes include other inpatient complications.Results: We identified 33,335 hospitalizations with ages more than 60. The mean age was 75.2 and males constituted 50.4%. In a survey multivariable logistic and linear regression model adjusting for patient and hospital factors, utilizing propensity score matching, the presence of dementia is associated with lower inpatient mortality (aOR 0.49, 95% confidence interval [CI] [0.26, 0.92], p=0.03), lower hospitalization costs (beta coefficient -2,823, 95% CI [-5,266, -440], p=0.02), lower odds of acute respiratory failure (aOR 0.54, p=0.01), lower mechanical ventilation usage (aOR 0.26, p<0.01) but higher odds of mental status change (aOR 1.97, 95% CI [1.37, 2.84], p<0.01).Conclusions: The presence of dementia is associated with a lower risk of inpatient mortality, and other clinical outcomes, in colorectal cancer cases admitted for hospitalization. Etiologies behind this relationship should be explored to understand this inverse relationship.","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763685","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}

引用次数: 0

Effective Endoscopic Submucosal Dissection of a Huge Esophageal Liposarcoma: A Case Report. 食管巨大脂肪肉瘤的有效内镜黏膜下剥离术：病例报告

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-06-25 DOI: 10.4166/kjg.2024.047

Myeong Jin Lee, Moon Won Lee, Dong Chan Joo, Seung Min Hong, Dong Hoon Baek, Bong Eun Lee, Gwang Ha Kim, Geun Am Song

{"title":"Effective Endoscopic Submucosal Dissection of a Huge Esophageal Liposarcoma: A Case Report.","authors":"Myeong Jin Lee, Moon Won Lee, Dong Chan Joo, Seung Min Hong, Dong Hoon Baek, Bong Eun Lee, Gwang Ha Kim, Geun Am Song","doi":"10.4166/kjg.2024.047","DOIUrl":"https://doi.org/10.4166/kjg.2024.047","url":null,"abstract":"This case report presents the successful endoscopic submucosal dissection (ESD) of a well-differentiated esophageal liposarcoma in a 51-year-old male with persistent dysphagia. The cause was initially diagnosed as a 10 cm pedunculated lesion extending from the upper esophageal sphincter to the mid-esophagus. An ESD was chosen over traditional surgery because it is less invasive. The procedure involved a precise submucosal injection and excision with special techniques to manage bleeding from a central vessel. Despite the extraction challenges owing to the size of the lesion, it was successfully removed orally. A histopathological examination of the 8.3×4.2×2.3 cm specimen revealed the characteristic features of a well-differentiated liposarcoma, including MDM2 and CDK4 positivity. The follow-up revealed no recurrence, and active surveillance has been performed since. This report highlights the versatility of ESD in treating significant esophageal tumors and provides evidence for its efficacy as a minimally invasive alternative.","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452622","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}

引用次数: 0

[Risks of Cancer Associated with Therapeutic Drugs for Inflammatory Bowel Disease]. [与炎症性肠病治疗药物相关的恶性肿瘤风险]。

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi Pub Date : 2024-06-25 DOI: 10.4166/kjg.2024.053

Won Moon, Jae Jun Park

{"title":"[Risks of Cancer Associated with Therapeutic Drugs for Inflammatory Bowel Disease].","authors":"Won Moon, Jae Jun Park","doi":"10.4166/kjg.2024.053","DOIUrl":"10.4166/kjg.2024.053","url":null,"abstract":"Crohn's disease and ulcerative colitis are lifelong chronic inflammatory conditions, with many patients requiring ongoing immunomodulatory drug therapy for maintenance treatment. Recent therapeutic goals in inflammatory bowel disease (IBD) are not only aimed at symptomatic remission but also at achieving mucosal healing to improve the natural course of the disease. In this context, therapeutic approaches are being applied in clinical settings that involve early and appropriate use of drugs, such as immunomodulators or biologics, that have the potential to induce healing of the inflamed intestine before irreversible intestinal damage occurs. All drugs that continuously control intestinal inflammation in IBD can heal the mucosa and potentially reduce the incidence of colitis-associated bowel cancer; however, the continuous use of immunosuppressants can potentially increase the risk of malignancies. The safety issues of the drugs used in clinical practice are partly confirmed during their development processes or shortly after initial marketing, but in other cases, they are estimated through post-marketing case reports or epidemiological studies, sometimes decades after drug approval. This review explores the risks associated with malignancies related to the treatment of IBD, focusing on drugs currently approved in Republic of Korea.","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452620","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}

引用次数: 0