{"title":"Editorial: Remission Ambition—How Far Should We Push in Older Adults?","authors":"Gloria Lin, Brigid S. Boland","doi":"10.1111/apt.70463","DOIUrl":"https://doi.org/10.1111/apt.70463","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"6 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145554696","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}
{"title":"Editorial: Remission Ambition—How Far Should We Push in Older Adults? Authors' Reply","authors":"Catherine Z. Tang, Adam S. Faye","doi":"10.1111/apt.70471","DOIUrl":"https://doi.org/10.1111/apt.70471","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"128 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145554744","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}
BACKGROUNDImmunogenic response to hepatitis B virus (HBV) vaccine in patients with inflammatory bowel disease (IBD) is variable and often suboptimal.AIMTo compare the immunogenicity of standard-dose (20 μg) vs. double-dose (40 μg) HBV vaccination in patients with IBD.METHODSWe randomised patients with IBD 1:1 to receive standard- or double-dose HBV vaccine at 0, 1 and 6 months. Anti-HBs titres were measured 1 month after the third dose. The primary outcome was an adequate immune response (AIR; anti-HBs titre > 10 IU/L). Secondary outcomes included an effective immune response (EIR; anti-HBs titre > 100 IU/L) and seroconversion stratified by disease activity.RESULTSWe randomised 45 patients to the standard-dose and 43 to the double-dose. Overall, 63 patients (71.6%) achieved AIR, and 51 (57.9%) achieved EIR. Both AIR (88.4% vs. 55.6%, p = 0.001) and EIR (69.8% vs. 46.7%, p = 0.028) rates were significantly higher with the double-dose. Among patients receiving immunosuppressive therapy, double-dose vaccination demonstrated significantly higher AIR (87.5% vs. 45.2%, p < 0.001) and EIR (65.6% vs. 35.5%, p = 0.017), while differences were not significant in those without immunosuppression. On multivariable analysis, predictors of AIR included double-dose vaccination (odds ratio [OR] 11.63; 95% confidence interval [CI] 2.63-51.46) and anti-TNFs (OR 0.03; 95% CI 0.002-0.6). Double-dose vaccination was also associated with higher odds of achieving EIR (OR 3.52; 95% CI 1.04-11.92).CONCLUSIONSDouble-dose HBV vaccination significantly improved AIR and EIR over standard-dose. These findings support a double-dose strategy to optimize seroconversion in patients with IBD, especially those receiving immunosuppressive therapy.
背景：炎症性肠病（IBD）患者对乙型肝炎病毒（HBV）疫苗的免疫原性反应是可变的，而且往往不是最佳的。目的比较标准剂量（20 μg）与双剂量（40 μg） HBV疫苗接种对IBD患者的免疫原性。方法：我们将IBD患者按1:1随机分组，分别在0、1和6个月时接受标准剂量或双剂量HBV疫苗。第三次给药后1个月测定抗hbs滴度。主要结果是足够的免疫应答（AIR；抗hbs滴度bbb10 IU/L）。次要结果包括有效的免疫应答（EIR；抗hbs滴度> 100 IU/L）和按疾病活动性分层的血清转化。结果将45例患者随机分为标准剂量组和43例双剂量组。总体而言，63例（71.6%）患者达到AIR， 51例（57.9%）患者达到EIR。AIR （88.4% vs. 55.6%, p = 0.001）和EIR （69.8% vs. 46.7%, p = 0.028）均显著高于双剂量组。在接受免疫抑制治疗的患者中，双剂量疫苗接种显著提高了AIR （87.5% vs. 45.2%, p < 0.001）和EIR (65.6% vs. 35.5%, p = 0.017)，而在未接受免疫抑制治疗的患者中差异无统计学意义。在多变量分析中，AIR的预测因子包括双剂量疫苗接种（优势比[OR] 11.63； 95%可信区间[CI] 2.63-51.46）和抗tnf （OR 0.03; 95% CI 0.002-0.6）。双剂量疫苗接种也与较高的EIR发生率相关（OR 3.52; 95% CI 1.04-11.92）。结论与标准剂量相比，双剂量HBV疫苗接种可显著提高AIR和EIR。这些发现支持双剂量策略来优化IBD患者的血清转化，特别是那些接受免疫抑制治疗的患者。
{"title":"Clinical Trial: Immunogenicity of Double-Dose Versus Standard-Dose of Hepatitis B Virus Vaccine in Inflammatory Bowel Disease.","authors":"Anupam Kumar Singh,Roop Kishor Soni,Vaneet Jearth,Ashutosh Ishan Yadav,Chhagan Lal Birda,Abhirup Chatterjee,Jimil Shah,Ritin Mohindra,Amol N Patil,Vikas Suri,Vishal Sharma,Arun Kumar Sharma,Usha Dutta","doi":"10.1111/apt.70470","DOIUrl":"https://doi.org/10.1111/apt.70470","url":null,"abstract":"BACKGROUNDImmunogenic response to hepatitis B virus (HBV) vaccine in patients with inflammatory bowel disease (IBD) is variable and often suboptimal.AIMTo compare the immunogenicity of standard-dose (20 μg) vs. double-dose (40 μg) HBV vaccination in patients with IBD.METHODSWe randomised patients with IBD 1:1 to receive standard- or double-dose HBV vaccine at 0, 1 and 6 months. Anti-HBs titres were measured 1 month after the third dose. The primary outcome was an adequate immune response (AIR; anti-HBs titre > 10 IU/L). Secondary outcomes included an effective immune response (EIR; anti-HBs titre > 100 IU/L) and seroconversion stratified by disease activity.RESULTSWe randomised 45 patients to the standard-dose and 43 to the double-dose. Overall, 63 patients (71.6%) achieved AIR, and 51 (57.9%) achieved EIR. Both AIR (88.4% vs. 55.6%, p = 0.001) and EIR (69.8% vs. 46.7%, p = 0.028) rates were significantly higher with the double-dose. Among patients receiving immunosuppressive therapy, double-dose vaccination demonstrated significantly higher AIR (87.5% vs. 45.2%, p < 0.001) and EIR (65.6% vs. 35.5%, p = 0.017), while differences were not significant in those without immunosuppression. On multivariable analysis, predictors of AIR included double-dose vaccination (odds ratio [OR] 11.63; 95% confidence interval [CI] 2.63-51.46) and anti-TNFs (OR 0.03; 95% CI 0.002-0.6). Double-dose vaccination was also associated with higher odds of achieving EIR (OR 3.52; 95% CI 1.04-11.92).CONCLUSIONSDouble-dose HBV vaccination significantly improved AIR and EIR over standard-dose. These findings support a double-dose strategy to optimize seroconversion in patients with IBD, especially those receiving immunosuppressive therapy.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"54 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559211","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}
Arno Furquim d’Almeida, Axelle Vanderlinden, Stefan Bourgeois, Jean‐Pierre Mulkay, Thomas Sersté, Mathieu Struyve, Baro Deressa, Dirk Sprengers, Marie de Vos, Jos Callens, Bao Shihao, Hendrik Reynaert, Pierre Deltenre, Filip Janssens, Sergio Negrin‐Dastis, Peter Stärkel, Hans Orlent, Guy Van Roey, Xavier Verhelst, Christophe Moreno, Jean Delwaide, Christophe Van Steenkiste, Wim Verlinden, Isabelle Colle, Marie‐Laure Plissonnier, Benoît Kabamba Mukadi, Barbara Testoni, Fabien Zoulim, Veerle Matheeussen, Thomas Vanwolleghem
Background Nucleos(t)ide analogue (NUC) cessation can induce a functional cure in chronic hepatitis B virus (HBV) infections, but severe post‐cessation virologic relapses (SVRel) and severe biochemical flares (SBF) frequently occur. Aims To identify predictive biomarkers for patients at highest risk for SVRel and SBF. Methods In the multicentre prospective COIN‐B trial, start‐of‐treatment HBeAg‐negative, long‐term virologically suppressed patients without advanced fibrosis are followed up for 72 weeks after NUC cessation. We performed a predefined exploratory analysis of the associations between HBV genotype, or end‐of‐treatment (EOT) biomarkers (HBcrAg, HBV RNA, HBsAg, and anti‐HBc IgG) and SVRel (HBV DNA > 5 log IU/mL) or SBF (ALT > 10× ULN) within 48 weeks post‐cessation. Results Of 91 recruited patients, 85 completed 48 weeks of follow‐up. SVRel and SBF occurred in 36 (42.4%) and 21 (24.7%) patients, respectively. Genotypes C, D, and E were associated with higher relapse and flare rates, whereas none of the 18 genotype A patients developed SBF. In multivariate analysis, SVRel was independently associated with detectable HBcrAg (aOR 3.93, p = 0.01), and SBF with non‐A genotype (aOR 19.03, p = 0.018), detectable HBV RNA (aOR 7.84, p = 0.005), and lower anti‐HBc IgG levels (aOR 0.31, p = 0.016). A risk stratification tool, the COBRA score, was developed incorporating HBcrAg, HBV RNA, and anti‐HBc IgG. A score ≥ 2 identified patients at increased risk, with 80.0% sensitivity and 90.7% NPV for SBF. Conclusions HBV genotype and EOT biomarkers, including HBcrAg, HBV RNA, and anti‐HBc IgG predict SVRel and SBF following NUC cessation. The COBRA score enables pragmatic, individualised risk stratification. Trial Registration ClinicalTrials.gov identifier: NCT04779970, EudraCT: 2021‐001003‐32
背景：停止使用核苷类似物（NUC）可以诱导慢性乙型肝炎病毒（HBV）感染的功能性治愈，但经常发生严重的戒烟后病毒学复发（SVRel）和严重的生化发作（SBF）。目的确定SVRel和SBF最高风险患者的预测性生物标志物。方法在多中心前瞻性COIN - B试验中，开始治疗的HBeAg阴性、长期病毒学抑制的无晚期纤维化患者在NUC停止后随访72周。我们对停药后48周内HBV基因型或治疗结束（EOT）生物标志物（HBcrAg、HBV RNA、HBsAg和抗HBc IgG）与SVRel （HBV DNA > 5 log IU/mL）或SBF （ALT > 10× ULN）之间的相关性进行了预先定义的探索性分析。结果在91名被招募的患者中，85名完成了48周的随访。SVRel和SBF分别发生36例（42.4%）和21例（24.7%）。基因型C、D和E与较高的复发和爆发率相关，而18例基因型A患者均未发生SBF。在多变量分析中，SVRel与可检测的HBcrAg （aOR 3.93, p = 0.01）、非A基因型SBF （aOR 19.03, p = 0.018）、可检测的HBV RNA （aOR 7.84, p = 0.005）和较低的抗HBc IgG水平（aOR 0.31, p = 0.016）独立相关。我们开发了一种风险分层工具，即COBRA评分，纳入HBcrAg、HBV RNA和抗HBc IgG。评分≥2分表明患者风险增加，SBF的敏感性为80.0%，NPV为90.7%。结论：HBV基因型和EOT生物标志物，包括HBcrAg、HBV RNA和抗HBc IgG，可预测NUC停止后的SVRel和SBF。COBRA评分可以实现实用的、个性化的风险分层。临床试验注册：ClinicalTrials.gov编号：NCT04779970，草案编号：2021‐001003‐32
{"title":"Clinical Trial: Hepatitis B Virus Genotype and a Combination of End‐of‐Treatment Biomarkers Predict Severe Flares After Nucleos(t)ide Analogue Cessation","authors":"Arno Furquim d’Almeida, Axelle Vanderlinden, Stefan Bourgeois, Jean‐Pierre Mulkay, Thomas Sersté, Mathieu Struyve, Baro Deressa, Dirk Sprengers, Marie de Vos, Jos Callens, Bao Shihao, Hendrik Reynaert, Pierre Deltenre, Filip Janssens, Sergio Negrin‐Dastis, Peter Stärkel, Hans Orlent, Guy Van Roey, Xavier Verhelst, Christophe Moreno, Jean Delwaide, Christophe Van Steenkiste, Wim Verlinden, Isabelle Colle, Marie‐Laure Plissonnier, Benoît Kabamba Mukadi, Barbara Testoni, Fabien Zoulim, Veerle Matheeussen, Thomas Vanwolleghem","doi":"10.1111/apt.70465","DOIUrl":"https://doi.org/10.1111/apt.70465","url":null,"abstract":"Background Nucleos(t)ide analogue (NUC) cessation can induce a functional cure in chronic hepatitis B virus (HBV) infections, but severe post‐cessation virologic relapses (SVRel) and severe biochemical flares (SBF) frequently occur. Aims To identify predictive biomarkers for patients at highest risk for SVRel and SBF. Methods In the multicentre prospective COIN‐B trial, start‐of‐treatment HBeAg‐negative, long‐term virologically suppressed patients without advanced fibrosis are followed up for 72 weeks after NUC cessation. We performed a predefined exploratory analysis of the associations between HBV genotype, or end‐of‐treatment (EOT) biomarkers (HBcrAg, HBV RNA, HBsAg, and anti‐HBc IgG) and SVRel (HBV DNA > 5 log IU/mL) or SBF (ALT > 10× ULN) within 48 weeks post‐cessation. Results Of 91 recruited patients, 85 completed 48 weeks of follow‐up. SVRel and SBF occurred in 36 (42.4%) and 21 (24.7%) patients, respectively. Genotypes C, D, and E were associated with higher relapse and flare rates, whereas none of the 18 genotype A patients developed SBF. In multivariate analysis, SVRel was independently associated with detectable HBcrAg (aOR 3.93, <jats:italic>p</jats:italic> = 0.01), and SBF with non‐A genotype (aOR 19.03, <jats:italic>p</jats:italic> = 0.018), detectable HBV RNA (aOR 7.84, <jats:italic>p</jats:italic> = 0.005), and lower anti‐HBc IgG levels (aOR 0.31, <jats:italic>p</jats:italic> = 0.016). A risk stratification tool, the COBRA score, was developed incorporating HBcrAg, HBV RNA, and anti‐HBc IgG. A score ≥ 2 identified patients at increased risk, with 80.0% sensitivity and 90.7% NPV for SBF. Conclusions HBV genotype and EOT biomarkers, including HBcrAg, HBV RNA, and anti‐HBc IgG predict SVRel and SBF following NUC cessation. The COBRA score enables pragmatic, individualised risk stratification. Trial Registration ClinicalTrials.gov identifier: NCT04779970, EudraCT: 2021‐001003‐32","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"68 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145553261","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}
{"title":"Editorial: Understanding How Social Determinants of Health Impact Mortality in MASLD —Insights From a National Analysis","authors":"Joyce Lui, Yesung Kweon, Mohamed I. Elsaid","doi":"10.1111/apt.70461","DOIUrl":"https://doi.org/10.1111/apt.70461","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"147 6 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535246","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}
Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Rohit Loomba, Aijaz Ahmed
{"title":"Editorial: Understanding How Social Determinants of Health Impact Mortality in MASLD —Insights From a National Analysis. Authors' Reply","authors":"Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Rohit Loomba, Aijaz Ahmed","doi":"10.1111/apt.70472","DOIUrl":"https://doi.org/10.1111/apt.70472","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"1 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535247","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}
{"title":"Editorial: Mitigating the Risk of Adverse Pregnancy Outcomes in Women With Inflammatory Bowel Disease and Chronic Liver Disease.","authors":"Yooyun Chung,Jeremy Shanika Nayagam","doi":"10.1111/apt.70444","DOIUrl":"https://doi.org/10.1111/apt.70444","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"1 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531137","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}
Jessica D Lee,Konstantinos Papamichael,Lauren T Grinspan,Adam S Cheifetz,Melissa Spiel,Tatyana Kushner,Loren G Rabinowitz
{"title":"Editorial: Mitigating the Risk of Adverse Pregnancy Outcomes in Women With Inflammatory Bowel Disease and Chronic Liver Disease-Authors' Reply.","authors":"Jessica D Lee,Konstantinos Papamichael,Lauren T Grinspan,Adam S Cheifetz,Melissa Spiel,Tatyana Kushner,Loren G Rabinowitz","doi":"10.1111/apt.70467","DOIUrl":"https://doi.org/10.1111/apt.70467","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"120 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531140","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}
Background Steatotic liver disease (SLD), which encompasses metabolic dysfunction‐associated SLD (MASLD), MASLD with increased alcohol intake (MetALD) and alcohol‐associated liver disease (ALD), is recognised as a risk factor for gastrointestinal cancers. However, the comparative risk of gastrointestinal cancers among MASLD, MetALD and ALD remains unclear. Methods We used a Japanese, nationwide, health insurance claims database between 2005 and 2024, encompassing approximately 10 million individuals and conducted a nationwide, population‐based cohort study including 978,607 patients with MASLD, 366,152 with MetALD, 152,721 with ALD and 4,884,398 control individuals. The primary outcome was the incidence of gastrointestinal cancers, including hepatocellular carcinoma (HCC), biliary tract cancer, oesophageal cancer, gastric cancer, colorectal cancer and pancreatic cancer. Results Compared to controls, the adjusted hazard ratios (HRs) for HCC ranged from 3.55 to 5.39 across the MASLD, MetALD and ALD and from 1.45 to 1.66 for biliary tract cancer. The risks of both HCC and biliary tract cancer were significantly elevated in all SLD subgroups compared to controls. For oesophageal, gastric and colorectal cancers, the aHRs ranged from 0.75 to 1.26 in MASLD, from 1.09 to 1.44 in MetALD and from 1.13 to 2.48 in ALD, indicating increasing risk with greater alcohol consumption. The risk of pancreatic cancer was comparable to that in controls for both MetALD and ALD. Conclusions Patients with SLD, including MASLD, MetALD and ALD, have a significantly higher risk of gastrointestinal cancers compared to the controls. The degree of risk varies according to the underlying liver disease subtype, particularly in relation to alcohol consumption. These findings underscore the importance of implementing risk‐stratified cancer screening strategies in patients with SLD.
{"title":"Gastrointestinal Cancer Risk in Steatotic Liver Diseases: MASLD , MetALD and ALD","authors":"Nobuharu Tamaki, Takefumi Kimura, Shun‐Ichi Wakabayashi, Naoki Tanaka, Namiki Izumi, Rohit Loomba, Masayuki Kurosaki","doi":"10.1111/apt.70466","DOIUrl":"https://doi.org/10.1111/apt.70466","url":null,"abstract":"Background Steatotic liver disease (SLD), which encompasses metabolic dysfunction‐associated SLD (MASLD), MASLD with increased alcohol intake (MetALD) and alcohol‐associated liver disease (ALD), is recognised as a risk factor for gastrointestinal cancers. However, the comparative risk of gastrointestinal cancers among MASLD, MetALD and ALD remains unclear. Methods We used a Japanese, nationwide, health insurance claims database between 2005 and 2024, encompassing approximately 10 million individuals and conducted a nationwide, population‐based cohort study including 978,607 patients with MASLD, 366,152 with MetALD, 152,721 with ALD and 4,884,398 control individuals. The <jats:italic>primary outcome</jats:italic> was the incidence of gastrointestinal cancers, including hepatocellular carcinoma (HCC), biliary tract cancer, oesophageal cancer, gastric cancer, colorectal cancer and pancreatic cancer. Results Compared to controls, the adjusted hazard ratios (HRs) for HCC ranged from 3.55 to 5.39 across the MASLD, MetALD and ALD and from 1.45 to 1.66 for biliary tract cancer. The risks of both HCC and biliary tract cancer were significantly elevated in all SLD subgroups compared to controls. For oesophageal, gastric and colorectal cancers, the aHRs ranged from 0.75 to 1.26 in MASLD, from 1.09 to 1.44 in MetALD and from 1.13 to 2.48 in ALD, indicating increasing risk with greater alcohol consumption. The risk of pancreatic cancer was comparable to that in controls for both MetALD and ALD. Conclusions Patients with SLD, including MASLD, MetALD and ALD, have a significantly higher risk of gastrointestinal cancers compared to the controls. The degree of risk varies according to the underlying liver disease subtype, particularly in relation to alcohol consumption. These findings underscore the importance of implementing risk‐stratified cancer screening strategies in patients with SLD.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"144 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515885","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}
Cathy Lu, Bram Verstockt, Michael W. Winter, Britt Christensen, Dan Carter, Floris de Voogd, Michael Dolinger, Thomas Goodsall, Maureen O'Brien, Ryan Rosentreter, the International Bowel Ultrasound (IBUS) Group, Mariangela Allocca, Rune Wilkens
Background
Intestinal ultrasonography (IUS) is increasingly utilised for diagnosing and monitoring IBD. Despite its cost-effectiveness, patient tolerance and suitability for serial bedside assessments, broad adoption has been limited by knowledge gaps in evidence, training and standardisation.
Aims
To summarise key knowledge gaps in the assessment of luminal disease activity, postoperative recurrence, complications, pouch-related disorders and the use of IUS in paediatrics, contrast enhancement, elastography, as well as education, training and future applications involving artificial intelligence.
Methods
We conducted a systematic umbrella review, following PRISMA guidelines, to map the current landscape of high-quality evidence and identify gaps in IUS research relevant to IBD. We searched MEDLINE from inception to February 2025 for systematic reviews, meta-analyses and consensus statements. We extracted data from eligible studies on design, outcomes and identified research gaps. Gaps were categorised by insufficient information, bias, inconsistency or lack of relevant data.
Results
Sixty of 507 studies met inclusion criteria. Key gaps included lack of validated and standardised IUS activity indices for Crohn's disease and ulcerative colitis, limited evidence for IUS in post-operative recurrence, paediatric populations and perianal or pouch disease. Data on the use of contrast-enhanced ultrasound and elastography were sparse. Small sample sizes, heterogeneous designs and inadequate follow-up limited most studies. Training, competency assessment and integration of artificial intelligence remain underexplored.
Conclusions
Sizable gaps persist in the evidence base for IUS in IBD. Addressing these gaps through robust, multicentre studies and consensus-driven frameworks is essential to optimise the clinical and research utility of IUS in IBD management.
{"title":"Review Article: Extending the Frontiers of Intestinal Ultrasound Knowledge, Performance and Expansion","authors":"Cathy Lu, Bram Verstockt, Michael W. Winter, Britt Christensen, Dan Carter, Floris de Voogd, Michael Dolinger, Thomas Goodsall, Maureen O'Brien, Ryan Rosentreter, the International Bowel Ultrasound (IBUS) Group, Mariangela Allocca, Rune Wilkens","doi":"10.1111/apt.70449","DOIUrl":"10.1111/apt.70449","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intestinal ultrasonography (IUS) is increasingly utilised for diagnosing and monitoring IBD. Despite its cost-effectiveness, patient tolerance and suitability for serial bedside assessments, broad adoption has been limited by knowledge gaps in evidence, training and standardisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To summarise key knowledge gaps in the assessment of luminal disease activity, postoperative recurrence, complications, pouch-related disorders and the use of IUS in paediatrics, contrast enhancement, elastography, as well as education, training and future applications involving artificial intelligence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic umbrella review, following PRISMA guidelines, to map the current landscape of high-quality evidence and identify gaps in IUS research relevant to IBD. We searched MEDLINE from inception to February 2025 for systematic reviews, meta-analyses and consensus statements. We extracted data from eligible studies on design, outcomes and identified research gaps. Gaps were categorised by insufficient information, bias, inconsistency or lack of relevant data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty of 507 studies met inclusion criteria. Key gaps included lack of validated and standardised IUS activity indices for Crohn's disease and ulcerative colitis, limited evidence for IUS in post-operative recurrence, paediatric populations and perianal or pouch disease. Data on the use of contrast-enhanced ultrasound and elastography were sparse. Small sample sizes, heterogeneous designs and inadequate follow-up limited most studies. Training, competency assessment and integration of artificial intelligence remain underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sizable gaps persist in the evidence base for IUS in IBD. Addressing these gaps through robust, multicentre studies and consensus-driven frameworks is essential to optimise the clinical and research utility of IUS in IBD management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"63 1","pages":"40-56"},"PeriodicalIF":6.7,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145509657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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