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Anti-integrin αvβ6 autoantibodies are increased in PSC patients with concomitant IBD and correlate with liver disease severity. 伴有 IBD 的 PSC 患者体内抗整合素 αvβ6 自身抗体增加,并与肝病严重程度相关。
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-25 DOI: 10.1016/j.cgh.2024.10.005
Hannah Bloemen, Alexandra E Livanos, Adrielly Martins, Richard Dean, Ana Catarina Bravo, Arno R Bourgonje, Michael Tankelevich, Jake Herb, Judy Cho, André Anastácio Santos, Cecília M P Rodrigues, Francesca Petralia, Jean-Frederic Colombel, Christopher L Bowlus, Thomas Schiano, Joana Torres, Cynthia Levy, Saurabh Mehandru

Background and aims: Anti-integrin αvβ6 autoantibodies (anti-αvβ6) are found in more than 50% of individuals with ulcerative colitis (UC). We aimed to determine the prevalence of anti-αvβ6 in patients with primary sclerosing cholangitis (PSC) and their association with liver disease severity.

Methods: Four cohorts of pre-liver transplant PSC patients were recruited. Patients with inflammatory bowel disease (IBD) and healthy controls (HC) served as comparators. Total IgG and anti-αvβ6 levels were measured using enzyme-linked immunosorbent assay (ELISA). Olink® inflammation panel was run on a subset of samples. Multivariable linear regression analysis was performed to assess the association between anti-αvβ6 and indices of liver disease severity.

Results: A total of 137 PSC patients (including 76 with PSC-UC, 33 with PSC-Crohn's disease (CD) and 28 with PSC alone) and 160 controls (including 91 with IBD and 69 HC) were enrolled. Anti-αvβ6 levels were significantly higher in PSC-UC and PSC-CD compared to PSC alone (p<0.0001 and 0.003) and HC (p<0.0001 and p<0.0001). However, anti-αvβ6 levels in PSC alone were not increased compared to HC. In patients with PSC-IBD, anti-αvβ6 levels correlated with markers of liver disease severity including alkaline phosphatase level (r=0.32, p=0.004), the revised Mayo PSC risk score (r=0.25, p=0.02) and liver stiffness measurement (r=0.43, p=0.008) after adjusting for age, gender, race/ethnicity and IBD subtype. Additionally, anti-αvβ6 levels were associated with markers of systemic inflammation and tissue remodeling.

Conclusion: Anti-αvβ6 autoantibodies identify a subset of PSC patients with concomitant IBD.

背景和目的:50%以上的溃疡性结肠炎(UC)患者体内存在抗整合素αvβ6自身抗体(抗αvβ6)。我们的目的是确定原发性硬化性胆管炎(PSC)患者中抗αvβ6的流行率及其与肝病严重程度的关系:方法:招募了四组肝移植前的原发性硬化性胆管炎患者。方法:招募了四组肝移植前的 PSC 患者,以炎症性肠病(IBD)患者和健康对照组(HC)作为比较组。使用酶联免疫吸附试验(ELISA)测量总 IgG 和抗αvβ6 水平。对部分样本进行了 Olink® 炎症检测。进行了多变量线性回归分析,以评估抗αvβ6与肝病严重程度指数之间的关联:结果:共纳入了137名PSC患者(包括76名PSC-UC患者、33名PSC-克罗恩病(CD)患者和28名单纯PSC患者)和160名对照组(包括91名IBD患者和69名HC患者)。PSC-UC和PSC-CD患者的抗αvβ6水平明显高于单纯PSC患者(p结论:PSC-UC和PSC-CD患者的抗αvβ6水平明显高于单纯PSC患者:抗αvβ6自身抗体可识别合并有IBD的PSC患者。
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引用次数: 0
Secondhand Smoke Exposure and Metabolic Dysfunction-Associated Steatotic Liver Disease in US Adolescents. 美国青少年二手烟暴露与代谢功能障碍相关的脂肪肝。
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-25 DOI: 10.1016/j.cgh.2024.08.049
Donghee Kim, Brandon J Perumpail, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Aijaz Ahmed
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引用次数: 0
Prevalence of Gastroparesis in Chronic Pancreatitis and Predictive Factors: A Machine Learning Prediction Model. 慢性胰腺炎胃痉挛的患病率和预测因素:机器学习预测模型
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-25 DOI: 10.1016/j.cgh.2024.09.023
Daryl Ramai, Chun-Wei Pan, David M Troendle, Marcello Maida, Antonio Facciorusso, Jorge D Machicado
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引用次数: 0
Long-term Effectiveness and Safety of Risankizumab in Patients with Crohn's Disease from a Large Tertiary Center. 一家大型三级医疗中心的利桑珠单抗对克罗恩病患者的长期有效性和安全性
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.027
Adar Zinger, David Choi, Natalie Choi, Evan Fear, Zachary Fine, Russell D Cohen, David T Rubin

Background and aims: Risankizumab is a selective IL23 inhibitor approved for the treatment of Crohn's disease (CD). We report a large long-term real-world experience with risankizumab in CD.

Methods: We performed a prospective monitoring of clinical outcomes in patients in our center who started treatment with risankizumab. Patients with active luminal disease who had at least 12 weeks of follow-up were included in the effectiveness analysis. Harvey-Bradshaw Index (HBI) as well as C-reactive protein (CRP) and fecal calprotectin (FCP) were used to monitor disease activity. Primary outcomes were clinical remission and steroid-free clinical remission rates at weeks 12, 26, and 52. Univariate analysis followed by a multivariate analysis using a logistic regression model was performed to identify predictors of steroid-free clinical remission at one year. All patients who started treatment with risankizumab for any indication were included in the safety analysis.

Results: 134 patients were included in the effectiveness analysis. 70 (52%) were ustekinumab-experienced. Clinical remission rates were 69%, 64%, and 54% at weeks 12, 26, and 52, respectively. Steroid-free clinical remission rates at 12, 26, and 52 weeks were 58%, 58%, and 50% respectively. Remission rates in ustekinumab-experienced patients were not statistically lower compared to naïve patients, and in a multivariate analysis, prior ustekinumab treatment was not associated with lower odds of achieving steroid-free clinical remission at one year. Adverse effects were assessed in 243 patients and were consistent with previous literature.

Conclusions: This large real-world experience with risankizumab with long-term follow-up demonstrates effectiveness and safety in patients with CD; there was comparable effectiveness in ustekinumab-naïve and ustekinumab-experienced patients.

背景和目的:利桑珠单抗是一种选择性IL23抑制剂,已被批准用于治疗克罗恩病(CD)。我们报告了利坦珠单抗治疗克罗恩病的大量长期实际经验:我们对本中心开始使用利坦单抗治疗的患者的临床疗效进行了前瞻性监测。疗效分析包括至少随访 12 周的活动性管腔疾病患者。哈维-布拉德肖指数(HBI)以及C反应蛋白(CRP)和粪便钙蛋白(FCP)用于监测疾病活动性。主要结果是第12、26和52周的临床缓解率和无类固醇临床缓解率。先进行单变量分析,然后使用逻辑回归模型进行多变量分析,以确定一年后无类固醇临床缓解的预测因素。所有因任何适应症开始接受利桑珠单抗治疗的患者均纳入安全性分析:134名患者被纳入有效性分析。70人(52%)有使用乌司替尼的经验。第12、26和52周的临床缓解率分别为69%、64%和54%。12周、26周和52周的无类固醇临床缓解率分别为58%、58%和50%。有乌司替库单抗治疗经验的患者的缓解率与无经验患者相比并没有统计学意义上的降低,而且在一项多变量分析中,之前接受过乌司替库单抗治疗的患者在一年后获得无类固醇临床缓解的几率也没有降低。对243名患者的不良反应进行了评估,结果与之前的文献一致:利坦珠单抗在CD患者中的长期随访显示了其有效性和安全性;对乌司他珠单抗无效患者和有乌司他珠单抗治疗经验患者的疗效相当。
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引用次数: 0
Multi-dimensional patient-reported outcomes and quality of life at diagnosis of IBD: A population-based inception cohort study. 确诊 IBD 时患者报告的多维结果和生活质量:基于人群的初始队列研究。
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.08.047
Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Jakob Benedict Seidelin, Johan Burisch

Background and aims: Patient-reported outcomes (PROs) are pivotal in assessing treatment efficacy and estimating the burden of inflammatory bowel diseases (IBD). We investigated PROs at the time of IBD diagnosis.

Methods: The Short Inflammatory Bowel Disease Questionnaire (SIBDQ), IBD-Disability Index (IBD-DI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and disease activity-related PROs were assessed in the Copenhagen IBD Inception Cohort, a prospective, population-based cohort of patients newly diagnosed with IBD between May 2021 and May 2023.

Results: A total of 203 UC and 116 CD patients were recruited. At diagnosis, 160 (78.8%) and 99 (85.3%) patients with UC and CD, respectively, reported moderate-to-severe impairment in at least one PRO (p=0.18), with 89 (43.8%) and 74 (63.8%), respectively, reporting moderate-to-severe impairment in at least two PROs (p<0.01). Being female, the disease extent of UC, and extraintestinal manifestations were associated with impaired PROs. There were no differences found according to CD phenotype. FACIT-F, IBD-DI, and SIBDQ scores showed weak, but significant, correlations with the Mayo Endoscopic Score in UC, and the FACIT-F score with C-reactive protein (CRP). In CD, SIBDQ, IBD-DI, and FACIT-F correlated moderately with CRP and fecal calprotectin, but not with the endoscopic severity of CD. None of the PROs correlated with iron, ferritin, or vitamin D levels. Among the most prevalent symptoms reported were fatigue, abdominal pain, urgency, and passing of blood in both CD and UC.

Conclusion: We found a substantial patient-reported disease burden in newly diagnosed IBD, underscoring the importance of vigilant PRO monitoring in clinical practice.

Funding: This study was funded by an unrestricted grant from the Novo Nordisk Fonden.

背景和目的:患者报告结果(PROs)对于评估治疗效果和估计炎症性肠病(IBD)的负担至关重要。我们对确诊 IBD 时的患者报告结果进行了调查:方法:我们在哥本哈根 IBD 初诊队列中评估了短式炎症性肠病问卷(SIBDQ)、IBD-残疾指数(IBD-DI)、慢性疾病治疗疲劳功能评估(FACIT-F)以及疾病活动相关的 PROs:结果:共招募了 203 名 UC 和 116 名 CD 患者。在确诊时,分别有 160 名(78.8%)和 99 名(85.3%)UC 和 CD 患者报告至少一项 PRO 存在中度至重度损伤(P=0.18),分别有 89 名(43.8%)和 74 名(63.8%)患者报告至少两项 PRO 存在中度至重度损伤(P结论:我们发现,在新诊断的 IBD 患者中,患者报告的疾病负担很重,这强调了在临床实践中警惕性监测 PRO 的重要性:本研究由诺和诺德基金会(Novo Nordisk Fonden)无限制资助。
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引用次数: 0
Dysphagia Megalatriensis. Megalatriensis 吞咽困难症。
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.08.050
Zehra Naseem, Arjun Chatterjee, Yi Qin
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引用次数: 0
Calibration, Clinical Utility and Specificity of Clinical Decision Support Tools in Inflammatory Bowel Disease. 炎症性肠病临床决策支持工具的校准、临床实用性和特异性。
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.020
Dahham Alsoud, João Sabino, Marc Ferrante, Bram Verstockt, Séverine Vermeire

Background and aims: Clinical decision support tools (CDSTs) have been developed to predict response to vedolizumab (VDZ) and ustekinumab (UST) in Crohn's disease (CD) and ulcerative colitis (UC). In addition to assessing their discrimination performance, our study aimed to evaluate their calibration, clinical utility and specificity.

Methods: We included 280 CD and 218 UC patients initiating VDZ, and 194 CD patients initiating UST. We assessed discrimination by comparing rates of effectiveness outcomes between response probability groups forecasted by CDSTs. Calibration curves and decision curve analysis evaluated the calibration and clinical utility of VDZ-CDSTs. Additionally, we examined the agreement between UST-CDST and VDZ-CDST in assigning response probability groups among CD patients starting UST.

Results: In the overall cohort, CDSTs allocated 7.2%, 50.0% and 42.8% of the patients to the low, intermediate and high response probability groups, respectively. VDZ-CDSTs groups demonstrated significant differences in the rates of clinical and endoscopic response and remission, while UST-CDST groups showed significant discrimination only for clinical remission. Although VDZ-CDSTs overestimated clinical remission rates, they more accurately predicted rates of VDZ persistence without need for surgery or dose escalation. Compared to empirically treating all patients with VDZ, VDZ-CDSTs yielded higher net benefits in selecting patients who would continue VDZ without need for surgery or dose escalation. Finally, the agreement between UST-CDST and VDZ-CDST in predicting response was 73.7%.

Conclusion: VDZ-CDSTs significantly discriminated response to VDZ and were more beneficial in identifying patients who would continue therapy without requiring surgery or dose escalation, compared to treating all patients empirically.

背景和目的:目前已开发出临床决策支持工具(CDST),用于预测克罗恩病(CD)和溃疡性结肠炎(UC)患者对韦多珠单抗(VDZ)和乌斯特库单抗(UST)的反应。除了评估它们的鉴别性能外,我们的研究还旨在评估它们的校准、临床实用性和特异性:我们纳入了280名开始使用VDZ的CD和218名UC患者,以及194名开始使用UST的CD患者。我们通过比较 CDST 预测的反应概率组间的有效率来评估其鉴别性。校准曲线和决策曲线分析评估了 VDZ-CDST 的校准和临床实用性。此外,我们还考察了 UST-CDST 和 VDZ-CDST 在分配开始 UST 的 CD 患者的应答概率组别时的一致性:在整个队列中,CDST 将 7.2%、50.0% 和 42.8% 的患者分别分配到低、中和高反应概率组。VDZ-CDSTs 组在临床和内镜反应率及缓解率方面表现出显著差异,而 UST-CDST 组仅在临床缓解率方面表现出显著差异。虽然VDZ-CDSTs高估了临床缓解率,但它们更准确地预测了无需手术或剂量升级的VDZ持续率。与根据经验对所有患者进行VDZ治疗相比,VDZ-CDSTs在选择无需手术或剂量升级即可继续VDZ治疗的患者方面产生了更高的净收益。最后,UST-CDST 和 VDZ-CDST 在预测反应方面的一致性为 73.7%:结论:VDZ-CDST能明显区分患者对VDZ的反应,与对所有患者进行经验性治疗相比,VDZ-CDST更有利于识别无需手术或剂量升级即可继续治疗的患者。
{"title":"Calibration, Clinical Utility and Specificity of Clinical Decision Support Tools in Inflammatory Bowel Disease.","authors":"Dahham Alsoud, João Sabino, Marc Ferrante, Bram Verstockt, Séverine Vermeire","doi":"10.1016/j.cgh.2024.09.020","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.020","url":null,"abstract":"<p><strong>Background and aims: </strong>Clinical decision support tools (CDSTs) have been developed to predict response to vedolizumab (VDZ) and ustekinumab (UST) in Crohn's disease (CD) and ulcerative colitis (UC). In addition to assessing their discrimination performance, our study aimed to evaluate their calibration, clinical utility and specificity.</p><p><strong>Methods: </strong>We included 280 CD and 218 UC patients initiating VDZ, and 194 CD patients initiating UST. We assessed discrimination by comparing rates of effectiveness outcomes between response probability groups forecasted by CDSTs. Calibration curves and decision curve analysis evaluated the calibration and clinical utility of VDZ-CDSTs. Additionally, we examined the agreement between UST-CDST and VDZ-CDST in assigning response probability groups among CD patients starting UST.</p><p><strong>Results: </strong>In the overall cohort, CDSTs allocated 7.2%, 50.0% and 42.8% of the patients to the low, intermediate and high response probability groups, respectively. VDZ-CDSTs groups demonstrated significant differences in the rates of clinical and endoscopic response and remission, while UST-CDST groups showed significant discrimination only for clinical remission. Although VDZ-CDSTs overestimated clinical remission rates, they more accurately predicted rates of VDZ persistence without need for surgery or dose escalation. Compared to empirically treating all patients with VDZ, VDZ-CDSTs yielded higher net benefits in selecting patients who would continue VDZ without need for surgery or dose escalation. Finally, the agreement between UST-CDST and VDZ-CDST in predicting response was 73.7%.</p><p><strong>Conclusion: </strong>VDZ-CDSTs significantly discriminated response to VDZ and were more beneficial in identifying patients who would continue therapy without requiring surgery or dose escalation, compared to treating all patients empirically.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":null,"pages":null},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496258","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}
引用次数: 0
Hepatitis Delta Virus Testing and Prevalence Among Chronic Hepatitis B Patients Across Three U.S. Safety-Net Health Systems. 美国三个安全网医疗系统中慢性乙型肝炎患者的 Delta 病毒检测和流行率。
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.025
Robert J Wong, Mamta K Jain, Bolin Niu, Yi Zhang, George Therapondos, Mae Thamer

Background & aims: Despite a high prevalence of risk factors associated with hepatitis delta virus (HDV) infection among safety-net populations, data evaluating HDV testing and prevalence are limited. We aim to evaluate HDV testing practices and HDV prevalence among an ethnically diverse, multi-center cohort of safety-net patients with chronic hepatitis B (CHB).

Methods: We retrospectively evaluated 13,218 patients with CHB (54.2% male, 57.9% non-white minorities, 12.5% HIV, 23.0% HCV) across three U.S. safety-net health systems from 2010-2022 to evaluate proportion tested for HDV and proportion positive among those tested. Adjusted multivariate logistic regression models evaluated for predictors of HDV testing and predictors of anti-HDV positive.

Results: Anti-HDV testing was performed in 6.1% overall and in 4.9% that met AASLD criteria for HDV testing. Greater odds of testing was observed in men vs. women (OR 1.49, 95%CI 1.27-1.75), Asian individuals vs. white individuals (OR 2.18, 95%CI 1.74-2.72), black/African American individuals vs. white individuals (OR 1.29, 95%CI 1.07-1.56), and patients with Medicare or Medicaid. Among CHB patients tested for HDV, 15.7% were positive (22.9% among those meeting AASLD HDV testing criteria). Only 2 (1.6%) patients had follow-up HDV RNA testing. Greater proportion of anti-HDV positive was observed in patients with baseline cirrhosis (47.4% vs. 13.3%, p<0.001), and patients with Medicare or Medicaid vs. those with commercial insurance.

Conclusions: Among an ethnically diverse, multi-center safety-net cohort of CHB patients, low rates of HDV testing were observed, even among those with high-risk HDV risk factors. Among those tested, 15.7% were positive, only 2 had follow up RNA testing. This highlights the need for greater awareness, education, and advocacy to improve HDV testing rates.

背景与目的:尽管在安全网人群中与乙型肝炎病毒(HDV)感染相关的风险因素流行率很高,但评估 HDV 检测和流行率的数据却很有限。我们旨在评估不同种族、多中心慢性乙型肝炎(CHB)安全网患者队列中的 HDV 检测方法和 HDV 感染率:我们回顾性评估了 2010-2022 年间美国三个安全网医疗系统中的 13,218 名慢性乙型肝炎患者(54.2% 为男性,57.9% 为非白人少数民族,12.5% 为 HIV 感染者,23.0% 为 HCV 感染者),以评估 HDV 检测比例以及检测结果呈阳性的患者比例。调整后的多变量逻辑回归模型评估了 HDV 检测的预测因素和抗 HDV 阳性的预测因素:6.1%的患者进行了抗HDV检测,4.9%的患者符合AASLD的HDV检测标准。男性与女性(OR 1.49,95%CI 1.27-1.75)、亚洲人与白人(OR 2.18,95%CI 1.74-2.72)、黑人/非洲裔美国人与白人(OR 1.29,95%CI 1.07-1.56)以及享受医疗保险或医疗补助的患者进行检测的几率更大。在接受 HDV 检测的慢性阻塞性肺病患者中,15.7% 呈阳性(在符合 AASLD HDV 检测标准的患者中为 22.9%)。只有 2 例(1.6%)患者进行了 HDV RNA 后续检测。基线肝硬化患者的抗 HDV 阳性比例更高(47.4% 对 13.3%,p 结论:在一个种族多元化、多中心安全网队列的慢性阻塞性肺病患者中,HDV检测率很低,即使是那些具有高危HDV风险因素的患者也是如此。在接受检测的患者中,15.7%呈阳性,只有2人进行了后续RNA检测。这凸显了加强意识、教育和宣传以提高 HDV 检测率的必要性。
{"title":"Hepatitis Delta Virus Testing and Prevalence Among Chronic Hepatitis B Patients Across Three U.S. Safety-Net Health Systems.","authors":"Robert J Wong, Mamta K Jain, Bolin Niu, Yi Zhang, George Therapondos, Mae Thamer","doi":"10.1016/j.cgh.2024.09.025","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.025","url":null,"abstract":"<p><strong>Background & aims: </strong>Despite a high prevalence of risk factors associated with hepatitis delta virus (HDV) infection among safety-net populations, data evaluating HDV testing and prevalence are limited. We aim to evaluate HDV testing practices and HDV prevalence among an ethnically diverse, multi-center cohort of safety-net patients with chronic hepatitis B (CHB).</p><p><strong>Methods: </strong>We retrospectively evaluated 13,218 patients with CHB (54.2% male, 57.9% non-white minorities, 12.5% HIV, 23.0% HCV) across three U.S. safety-net health systems from 2010-2022 to evaluate proportion tested for HDV and proportion positive among those tested. Adjusted multivariate logistic regression models evaluated for predictors of HDV testing and predictors of anti-HDV positive.</p><p><strong>Results: </strong>Anti-HDV testing was performed in 6.1% overall and in 4.9% that met AASLD criteria for HDV testing. Greater odds of testing was observed in men vs. women (OR 1.49, 95%CI 1.27-1.75), Asian individuals vs. white individuals (OR 2.18, 95%CI 1.74-2.72), black/African American individuals vs. white individuals (OR 1.29, 95%CI 1.07-1.56), and patients with Medicare or Medicaid. Among CHB patients tested for HDV, 15.7% were positive (22.9% among those meeting AASLD HDV testing criteria). Only 2 (1.6%) patients had follow-up HDV RNA testing. Greater proportion of anti-HDV positive was observed in patients with baseline cirrhosis (47.4% vs. 13.3%, p<0.001), and patients with Medicare or Medicaid vs. those with commercial insurance.</p><p><strong>Conclusions: </strong>Among an ethnically diverse, multi-center safety-net cohort of CHB patients, low rates of HDV testing were observed, even among those with high-risk HDV risk factors. Among those tested, 15.7% were positive, only 2 had follow up RNA testing. This highlights the need for greater awareness, education, and advocacy to improve HDV testing rates.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":null,"pages":null},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496264","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}
引用次数: 0
Patients with Inflammatory Bowel Disease are at Increased Risk for Complications of Herpes Zoster. 炎症性肠病患者并发带状疱疹的风险更高。
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.022
Freddy Caldera, Siddharth Singh, Emily E Zona, Oscar Ramirez Ramirez, Jonathan Inselman, Herbert Heien, Andrew P Keaveny, Mary S Hayney, Francis A Farraye

Background and aims: Patients with inflammatory bowel disease (IBD) are at an increased risk for vaccine-preventable diseases, such as herpes zoster (HZ). The aim of this study was to determine whether complications of HZ are more frequent in patients with IBD than in non-IBD controls.

Methods: This was a retrospective, cohort study using the Optum Research Database. Patients with IBD were matched 1:1 to non-IBD controls based on age, sex, and index year, which was defined as the diagnosis of HZ. We then identified the complications of HZ that occurred up to 90 days after the index date. We compared patients with IBD with non-IBD controls and evaluated the 90-day risk of HZ complications. We used a composite primary outcome for any HZ complication. Secondary outcomes were risk factors for complications.

Results: Four thousand seven fifty-six patients with IBD met the inclusion criteria and were matched to the controls. Patients with IBD were more likely to have complications of HZ than controls [738 (15.52%) vs. 595 (12.51%), p < 0.0001]. Patients with IBD with higher comorbidity scores were more likely to develop complications (1.86 vs. 1.18 p < 0.0001). In the logistic regression analysis of patients with IBD having a higher comorbidity score, above 50 years of age, on anti-TNF or corticosteroids were all at increased risk of a complication of HZ.

Conclusion: Patients with IBD are more likely to have complications of HZ than controls. Efforts are needed to increase HZ vaccine uptake to reduce the morbidity of HZ.

背景和目的:炎症性肠病(IBD)患者患带状疱疹(HZ)等疫苗可预防疾病的风险增加。本研究旨在确定 IBD 患者是否比非 IBD 对照组更容易出现 HZ 并发症:这是一项使用 Optum 研究数据库进行的回顾性队列研究。IBD 患者与非 IBD 对照组患者根据年龄、性别和指标年(指标年被定义为 HZ 诊断年)进行 1:1 匹配。然后,我们确定了指数日期后 90 天内发生的 HZ 并发症。我们将 IBD 患者与非 IBD 对照组进行了比较,并评估了 90 天内 HZ 并发症的风险。我们使用了一个综合的主要结果,即任何 HZ 并发症。次要结果为并发症的风险因素:4,756 名 IBD 患者符合纳入标准,并与对照组匹配。与对照组相比,IBD 患者更有可能出现 HZ 并发症[738 例(15.52%)对 595 例(12.51%),P < 0.0001]。合并症评分较高的 IBD 患者更有可能出现并发症(1.86 对 1.18,P < 0.0001)。在逻辑回归分析中,合并症评分较高、年龄超过50岁、服用抗肿瘤坏死因子或皮质类固醇的IBD患者发生HZ并发症的风险均有所增加:结论:与对照组相比,IBD患者更容易出现HZ并发症。需要努力提高HZ疫苗的接种率,以降低HZ的发病率。
{"title":"Patients with Inflammatory Bowel Disease are at Increased Risk for Complications of Herpes Zoster.","authors":"Freddy Caldera, Siddharth Singh, Emily E Zona, Oscar Ramirez Ramirez, Jonathan Inselman, Herbert Heien, Andrew P Keaveny, Mary S Hayney, Francis A Farraye","doi":"10.1016/j.cgh.2024.09.022","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.022","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with inflammatory bowel disease (IBD) are at an increased risk for vaccine-preventable diseases, such as herpes zoster (HZ). The aim of this study was to determine whether complications of HZ are more frequent in patients with IBD than in non-IBD controls.</p><p><strong>Methods: </strong>This was a retrospective, cohort study using the Optum Research Database. Patients with IBD were matched 1:1 to non-IBD controls based on age, sex, and index year, which was defined as the diagnosis of HZ. We then identified the complications of HZ that occurred up to 90 days after the index date. We compared patients with IBD with non-IBD controls and evaluated the 90-day risk of HZ complications. We used a composite primary outcome for any HZ complication. Secondary outcomes were risk factors for complications.</p><p><strong>Results: </strong>Four thousand seven fifty-six patients with IBD met the inclusion criteria and were matched to the controls. Patients with IBD were more likely to have complications of HZ than controls [738 (15.52%) vs. 595 (12.51%), p < 0.0001]. Patients with IBD with higher comorbidity scores were more likely to develop complications (1.86 vs. 1.18 p < 0.0001). In the logistic regression analysis of patients with IBD having a higher comorbidity score, above 50 years of age, on anti-TNF or corticosteroids were all at increased risk of a complication of HZ.</p><p><strong>Conclusion: </strong>Patients with IBD are more likely to have complications of HZ than controls. Efforts are needed to increase HZ vaccine uptake to reduce the morbidity of HZ.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":null,"pages":null},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496272","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}
引用次数: 0
TRAUMA-INFORMED CARE IN GASTROENTEROLOGY: A SURVEY OF PROVIDER ATTITUDES, KNOWLEDGE, AND SKILLS. 胃肠病学中的创伤知情护理:医疗服务提供者的态度、知识和技能调查。
IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-24 DOI: 10.1016/j.cgh.2024.09.015
Christina Tsai, Sara Abdelhalim, Serre-Yu Wong, Xianhong Xie, Manasi Agrawal, Laurie A Keefer
{"title":"TRAUMA-INFORMED CARE IN GASTROENTEROLOGY: A SURVEY OF PROVIDER ATTITUDES, KNOWLEDGE, AND SKILLS.","authors":"Christina Tsai, Sara Abdelhalim, Serre-Yu Wong, Xianhong Xie, Manasi Agrawal, Laurie A Keefer","doi":"10.1016/j.cgh.2024.09.015","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.09.015","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":null,"pages":null},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496277","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}
引用次数: 0
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Clinical Gastroenterology and Hepatology
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