Clinical Gastroenterology and Hepatology最新文献

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Subcutaneous Infliximab and Assumptions of Response in Ileal Crohn's Disease: Does Route of Administration Matter? 皮下注射英夫利昔单抗治疗回肠克罗恩病的疗效：给药途径重要吗？

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-05 DOI: 10.1016/j.cgh.2026.02.021

John David Chetwood, Robert David Little

引用次数: 0

Re: Oral Contraceptives and Risk of GERD and Related Esophageal Outcomes - A Cautionary Tale of Hormonal Exposures in Large Database Networks. 口服避孕药与胃食管反流的风险及相关食道结局——大型数据库网络中激素暴露的警世故事。

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-05 DOI: 10.1016/j.cgh.2026.02.023

Katherine M Cooper, Madeline Berschback, Kyle Staller

引用次数: 0

Mirikizumab Long-Term Efficacy and Safety in Patients with Crohn's disease: Results from the VIVID-2 Open-Label Extension Trial. Mirikizumab在克罗恩病患者中的长期疗效和安全性：来自VIVID-2开放标签扩展试验的结果

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-05 DOI: 10.1016/j.cgh.2026.01.049

Bruce E Sands, Edward L Barnes, Geert D'Haens, Tadakazu Hisamatsu, Miguel Regueiro, Colleen R Kelly, David Laharie, Rebecca R Hozak, Guanglei Yu, Arul Gandhi R, Michelle U Lopes, Frederick Durand, Marijana Protic, Richard E Moses, Severine Vermeire

Background and aims: Mirikizumab, an anti-IL-23p19 monoclonal antibody, demonstrated efficacy and safety in patients with moderately to severely active Crohn's disease (CD) up to week (W)52 in VIVID-1. We present the first results from the VIVID-2 open-label extension study in patients who received mirikizumab for two years.

Methods: Of the patients randomized to mirikizumab in VIVID-1 who rolled over to VIVID-2, 465 were included in the safety population for this interim analysis, and 430 met the eligibility criteria for the efficacy population. Of those, 251 were endoscopic responders at W52 of VIVID-1 (300mg subcutaneous dosing every 4 weeks) and 179 were endoscopic non-responders at W52 of VIVID-1 (reinduced with 900mg intravenously at W0, W4, W8, followed by subcutaneous dosing). Missing data were handled using modified non-responder imputation (mNRI) and observed case (OC) approaches.

Results: In the efficacy population, 60.5%(mNRI)/67.1%(OC) achieved endoscopic response, 37.9%/41.7% achieved endoscopic remission, and 73.4%/80.9% achieved Crohn's Disease Activity Index (CDAI) remission at W104. Among W52 endoscopic responders who achieved the specified endpoint at W52, 81.8%/87.6% maintained endoscopic response, 72.5%/78.6% maintained endoscopic remission, and 86.9%/92.9% maintained CDAI remission at W104. Among W52 endoscopic responders who did not achieve the specified endpoint at W52,33.3%/35.4% gained endoscopic remission, and 55.8%/60.8% gained CDAI remission at W104. Among W52 endoscopic non-responders, 30.9%/36.1% achieved endoscopic response at W104. During the second year of mirikizumab treatment, 64.7% of patients experienced treatment-emergent AEs, and 7.7% had serious AEs.

Conclusions: Long-term treatment with mirikizumab for up to 104 weeks was associated with durable improvements in patients with CD. Over 30% of endoscopic non-responders at 1 year achieved endoscopic response with mirikizumab reinduction. Safety was consistent with the known mirikizumab safety profile.

Clinicaltrials: gov ID no: NCT04232553.

背景和目的：Mirikizumab是一种抗il -23p19单克隆抗体，在VIVID-1试验中，Mirikizumab在中度至重度活动性克罗恩病（CD）患者中(W)52周显示出疗效和安全性。我们提出了在接受mirikizumab治疗两年的患者中进行的VIVID-2开放标签扩展研究的第一个结果。方法:患者随机在VIVID-1 mirikizumab翻滚VIVID-2, 465人被包含在这个临时的人口安全分析,和430年人口功效符合资格的标准。其中，251人在第52次给药时有内镜反应（每4周给药300mg）， 179人在第52次给药时无内镜反应（分别在第0、第4、第8次静脉注射900mg，然后皮下给药）。缺失数据采用改进的无应答者归算（mNRI）和观察病例（OC）方法处理。结果：在有效人群中，60.5%(mNRI)/67.1%（OC）在W104时达到内镜下缓解，37.9%/41.7%达到内镜下缓解，73.4%/80.9%达到克罗恩病活动指数（CDAI）缓解。在W52达到指定终点的W52内窥镜应答者中，81.8%/87.6%维持内窥镜应答，72.5%/78.6%维持内窥镜缓解，86.9%/92.9%维持W104 CDAI缓解。在W52未达到指定终点的W52内镜应答者中，33.3%/35.4%在W104时获得内镜缓解，55.8%/60.8%在W104时获得CDAI缓解。在W52例无反应者中，30.9%/36.1%在W104时达到了内镜下反应。在米利珠单抗治疗的第二年，64.7%的患者经历了治疗性不良事件，7.7%的患者发生了严重不良事件。结论：长期使用mirikizumab治疗长达104周与CD患者的持久改善相关。超过30%的内窥镜无反应患者在1年时通过mirikizumab再诱导实现了内窥镜缓解。安全性与已知的mirikizumab安全性一致。临床试验：政府ID号：NCT04232553。

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引用次数: 0

Strategies to Reduce Hypoxemia During Gastrointestinal Endoscopy Using Optimized Low-Flow Oxygen Delivery 利用优化的低流量供氧减少胃肠内镜检查时低氧血症的策略

IF 12.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-04 DOI: 10.1016/j.cgh.2026.02.019

Venkatesan Thiruvenkatarajan, Manesha Sembu, Tharun Kathiravan

引用次数: 0

Moving Beyond Binaries: The Need to Include Both Sexual Orientation and Gender Identity in Disorders of Gut-Brain Interaction 超越二元：在肠-脑相互作用障碍中需要包括性取向和性别认同

IF 12.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-04 DOI: 10.1016/j.cgh.2025.12.027

Agata Mulak

引用次数: 0

Reply. 回复。

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-03 DOI: 10.1016/j.cgh.2026.02.017

H M Staudacher, A Loughman

引用次数: 0

Symptom Differences in Intestinal Methanogen Overgrowth vs Small Intestinal Bacterial Overgrowth: Is Exocrine Pancreatic Insufficiency the Missing Link? IMO与SIBO的症状差异——EPI是缺失的一环吗？

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-01 Epub Date: 2025-08-06 DOI: 10.1016/j.cgh.2025.07.041

Gautam Menon, Shyam Menon

引用次数: 0

Epidemiology of Compensated Advanced Chronic Liver Disease (cACLD) in the United States: Insights From the National Health and Nutrition Examination Survey, 2017-2020 代偿性晚期慢性肝病（cACLD）在美国的流行病学：来自NHANES 2017-2020的见解

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-01 Epub Date: 2025-06-26 DOI: 10.1016/j.cgh.2025.06.010

Ritik M. Goyal , Apoorva Doshi , Sameer Rao , Komal Arora , Supriya Maheshwari , Paul Gaglio

Background & Aims

Compensated advanced chronic liver disease (cACLD) encompasses advanced fibrosis and cirrhosis in asymptomatic patients at risk of developing clinically significant portal hypertension. Patients having cACLD are at high risk of decompensation and liver-related mortality and hence require further evaluation. Due to limited epidemiologic data on cACLD, we aimed to assess its prevalence in the United States (U.S.).

Methods

We performed a cross-sectional study analyzing adults who underwent transient elastography using the National Health and Nutrition Examination Survey (NHANES) database from 2017 to March 2020. The Baveno VII’s liver stiffness measurement criteria were applied: <10 kPa to rule out, 10 to 15 kPa as suggestive, and ≥15 kPa to confirm cACLD. NHANES sample weights were used to produce data that is representative of the civilian, noninstitutionalized U.S. population, and statistical analysis included χ² tests for categorical variables and analysis of variance for continuous variables.

Results

Among 8318 adults with transient elastography results, 222 had cACLD, and 312 had possible cACLD. The weighted prevalence of cACLD among U.S. adults was 2.4% (95% confidence interval, 1.76%–3.03%), and that of possible cACLD was 3.46% (95% confidence interval, 2.62%–4.3%). More than 85% of patients with cACLD were unaware that they had liver disease. Among patients with cACLD, 65.9% were males, 40.8% were diabetic, 81.5% were obese, and 67.1% had hypertension. In patients with cACLD, the prevalence of metabolic dysfunction-associated steatotic liver disease, excessive alcohol use, hepatitis C, and hepatitis B was 61%, 12%, 7.1%, and 0.9%, respectively.

Conclusions

Approximately 5 million people in the U.S. may have cACLD, and another 8 million may have possible cACLD. The majority of patients with cACLD tend to be male, diabetic, and obese. The high rate of unawareness underscores the need for enhanced screening and surveillance strategies to improve early detection and management.

代偿性晚期慢性肝病（cACLD）包括无症状患者的晚期纤维化和肝硬化，有发展为临床显著门脉高压（CSPH）的风险。cACLD患者处于失代偿和肝脏相关死亡的高风险，因此需要进一步评估。由于cld的流行病学资料有限，我们的目的是评估其在美国的患病率。

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引用次数: 0

Limitations of Intestinal Ultrasound Reliability in Crohn's Disease 给古德赛尔等人的信。

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-01 Epub Date: 2025-05-10 DOI: 10.1016/j.cgh.2025.01.049

Jean-Yves Mary, David Laharie

引用次数: 0

A Novel Risk Prediction Model for Hepatocellular Carcinoma in MASLD: A Multinational, Multicenter Cohort Study 一种新的MASLD肝细胞癌风险预测模型：一项多国、多中心队列研究。

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-03-01 Epub Date: 2025-07-10 DOI: 10.1016/j.cgh.2025.06.025

Ho Soo Chun , Minjong Lee , Hye Ah Lee , Eun Seo Park , Jeong Yoon Choi , Hyo Song Baek , Tae Hun Kim , Huapeng Lin , Terry Cheuk-Fung Yip , Hye Won Lee , Emmanuel Tsochatzis , Salvatore Petta , Elisabetta Bugianesi , Masato Yoneda , Ming-Hua Zheng , Hannes Hagström , Jérôme Boursier , José Luis Calleja , George Boon-Bee Goh , Wah-Kheong Chan , Seung Up Kim

Background & Aims

It is unclear that which cardiometabolic risk factors (CMRFs) are significantly associated with hepatocellular carcinoma (HCC) development in metabolic dysfunction–associated steatotic liver disease (MASLD). We aimed to develop and validate a novel CMRF-based HCC risk prediction model in MASLD.

Methods

This multicenter cohort study recruited 77,677 MASLD patients from 20 medical centers in Korea and other Asian and Western countries (2004–2023). A novel CMRF-based HCC risk prediction model (MASLD-HCC score) was developed based on time-varying Cox multivariable analysis in a training cohort (n = 36,800, Korea), which was validated internally (n = 36,799, Korea) and externally (n = 4078, 11 other Asia and Western countries).

Results

In the training cohort, 71 (0.2%) patients developed HCC (median follow-up 5.1 years). Overweight/obesity or central obesity and prediabetes/diabetes were independently associated with HCC development, along with age, sex, and platelets. The MASLD-HCC score with these 5 risk factors showed a Harrell’s C-index of 0.84 for HCC development, which was maintained in the internal (C-index 0.83) and external validation cohorts (C-index 0.93), and the model was well calibrated. Decision curve analyses showed that patients had positive net benefits from the model. When stratified by the MASLD-HCC score, the risk of HCC development in the high-risk group was significantly higher than the low-risk group (training: subdistribution hazard ratio [sHR], 11.44; 95% confidence interval [CI], 7.10–18.41; internal validation: sHR, 12.36; 95% CI, 7.72–19.79; external validation: sHR, 56.84; 95% CI, 12.88–250.73; all P < .001).

Conclusions

Overweight/obesity or central obesity and prediabetes/diabetes with fibrotic burden were significantly associated with the increased HCC risk in MASLD. The MASLD-HCC score may enable physicians to stratify the HCC risk.

背景和目的：目前尚不清楚哪些心脏代谢危险因素（CMRFs）与代谢功能障碍相关脂肪变性肝病（MASLD）中肝细胞癌（HCC）的发展显著相关。我们旨在开发并验证一种新的基于cmrf的MASLD HCC风险预测模型。方法：本多中心队列研究从韩国及其他亚洲和西方国家的20个医疗中心招募了77,677例MASLD患者（2004-2023）。基于时变Cox多变量分析，在培训队列（n=36,800，韩国）中建立了一种新的基于cmrf的HCC风险预测模型（MASLD-HCC评分），并在内部（n=36,799，韩国）和外部（n=4,078，其他11个亚洲和西方国家）进行了验证。结果：在培训队列中，71例（0.2%）患者发生HCC（中位随访时间为5.1年）。超重/肥胖或中心性肥胖和糖尿病前期/糖尿病与HCC的发展、年龄、性别和血小板独立相关。结合这五个危险因素的MASLD-HCC评分显示，HCC发展的Harrell C-index为0.84，在内部验证队列（C-index 0.83）和外部验证队列（C-index 0.93）中保持不变，并且模型校准良好。决策曲线分析表明，患者从该模型中获得了正的净收益。按MASLD-HCC评分分层时，高危组发生HCC的风险显著高于低危组(训练：亚分布风险比[sHR]=11.44, 95%可信区间[CI]= 7.10-18.41；内部验证：sHR=12.36, 95% CI=7.72 ~ 19.79；外部验证：sHR=56.84, 95% CI=12.88 ~ 250.73；结论：超重/肥胖或中心性肥胖和糖尿病前期/糖尿病合并纤维化负担与MASLD中HCC风险增加显著相关。MASLD-HCC评分可以使医生对HCC风险进行分层。

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