{"title":"Editorial: Understanding the Trade-Offs When Considering Positivity Threshold of Faecal Immunochemical Tests.","authors":"Thomas F Imperiale","doi":"10.1111/apt.18355","DOIUrl":"https://doi.org/10.1111/apt.18355","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491459","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}
Darren Jun Hao Tan, Nobuharu Tamaki, Beom Kyung Kim, Karn Wijarnpreecha, Majd Bassam Aboona, Claire Faulkner, Charlotte Kench, Shirin Salimi, Abdul-Hamid Sabih, Wen Hui Lim, Pojsakorn Danpanichkul, Benjamin Tay, Yiqing Teh, John Mok, Benjamin Nah, Cheng Han Ng, Mark Muthiah, Anand V Kulkarni, Sung Won Lee, Ken Liu, Rohit Loomba, Daniel Q Huang
Background: Major society guidelines recommend the fibrosis-4 index (FIB-4) as the initial step to risk stratifying people with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to evaluate the proportion of people with MASLD-related hepatocellular carcinoma (HCC) and a low FIB-4.
Methods: This cohort study included 613 consecutive adults (33% female) diagnosed with MASLD-related HCC from January 2008 to August 2023 at seven international centres in Australia, India, Japan, South Korea, Singapore and the United States. The primary objective was to determine the proportion of participants with a low FIB-4, defined as FIB-4 < 1.3, or < 2 if age > 65 years, in people without cirrhosis.
Results: The mean (±SD) age and body mass index were 71 (±11) years and 27 (±7) kg/m2, respectively. Overall, 235 participants (38%) did not have known cirrhosis. The median FIB-4 was 3.90 (IQR 2.42-6.42). A total of 78 participants (13%) had a low FIB-4. Among participants without known cirrhosis (n = 235), 62 participants (26%) had a low FIB-4. Participants with a low FIB-4 had larger median total tumour diameter (p < 0.001) and lower median serum alpha-fetoprotein (p = 0.005), compared to participants without a low FIB-4. Cirrhosis was associated with lower odds of low FIB-4, but not other factors such as male sex, type 2 diabetes, or obesity.
Conclusion: More than a quarter of those with MASLD-related HCC without cirrhosis have a low FIB-4. The proposed clinical care pathways may not identify these people for further evaluation.
{"title":"Prevalence of Low FIB-4 in MASLD-Related Hepatocellular Carcinoma: A Multicentre Study.","authors":"Darren Jun Hao Tan, Nobuharu Tamaki, Beom Kyung Kim, Karn Wijarnpreecha, Majd Bassam Aboona, Claire Faulkner, Charlotte Kench, Shirin Salimi, Abdul-Hamid Sabih, Wen Hui Lim, Pojsakorn Danpanichkul, Benjamin Tay, Yiqing Teh, John Mok, Benjamin Nah, Cheng Han Ng, Mark Muthiah, Anand V Kulkarni, Sung Won Lee, Ken Liu, Rohit Loomba, Daniel Q Huang","doi":"10.1111/apt.18346","DOIUrl":"https://doi.org/10.1111/apt.18346","url":null,"abstract":"<p><strong>Background: </strong>Major society guidelines recommend the fibrosis-4 index (FIB-4) as the initial step to risk stratifying people with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to evaluate the proportion of people with MASLD-related hepatocellular carcinoma (HCC) and a low FIB-4.</p><p><strong>Methods: </strong>This cohort study included 613 consecutive adults (33% female) diagnosed with MASLD-related HCC from January 2008 to August 2023 at seven international centres in Australia, India, Japan, South Korea, Singapore and the United States. The primary objective was to determine the proportion of participants with a low FIB-4, defined as FIB-4 < 1.3, or < 2 if age > 65 years, in people without cirrhosis.</p><p><strong>Results: </strong>The mean (±SD) age and body mass index were 71 (±11) years and 27 (±7) kg/m<sup>2</sup>, respectively. Overall, 235 participants (38%) did not have known cirrhosis. The median FIB-4 was 3.90 (IQR 2.42-6.42). A total of 78 participants (13%) had a low FIB-4. Among participants without known cirrhosis (n = 235), 62 participants (26%) had a low FIB-4. Participants with a low FIB-4 had larger median total tumour diameter (p < 0.001) and lower median serum alpha-fetoprotein (p = 0.005), compared to participants without a low FIB-4. Cirrhosis was associated with lower odds of low FIB-4, but not other factors such as male sex, type 2 diabetes, or obesity.</p><p><strong>Conclusion: </strong>More than a quarter of those with MASLD-related HCC without cirrhosis have a low FIB-4. The proposed clinical care pathways may not identify these people for further evaluation.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491462","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":"Letter: MASLD in people with HIV exhibits higher fibrosis stage despite lower disease activity than in matched controls","authors":"Junbin Yan, Yunmeng Nie, Shuo Zhang","doi":"10.1111/apt.18282","DOIUrl":"https://doi.org/10.1111/apt.18282","url":null,"abstract":"LINKED CONTENTThis article is linked to Allende et al paper. To view this article, visit <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://doi.org/10.1111/apt.18236\">https://doi.org/10.1111/apt.18236</jats:ext-link>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"34 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490310","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}
Karl Mårild, Tereza Lerchova, Malin Östensson, Henrik Imberg, Ketil Størdal, Johnny Ludvigsson
BackgroundChildhood antibiotic use has been associated with inflammatory bowel disease (IBD), although the potential contribution of infection frequency remains uncertain.AimsTo explore the association between early‐life infections, antibiotics and IBD development.MethodsWe used population‐based data from ABIS (Sweden) and MoBa (Norway) cohorts following children from birth (1997–2009) until 2021. Prospectively collected questionnaires identified infection frequency (any, gastrointestinal and respiratory) and antibiotics (any, penicillin and non‐penicillin) until age 3. IBD diagnosis required ≥ 2 records in national health registries. Cohort‐specific hazard ratios (aHR), adjusted for parental education, smoking and IBD were estimated and pooled using a random‐effects model. Antibiotic analyses were adjusted for infection frequency.ResultsThere were 103,046 children (11,872 ABIS and 91,174 MoBa), contributing to 1,663,898 person‐years of follow‐up, during which 395 were diagnosed with IBD. The frequency of any infection at 0 to < 1 and 1 to < 3 years showed a pooled aHR of 1.01 (95% confidence interval [CI] = 0.96–1.07) and 1.00 (95% CI = 0.99–1.01) per additional infection for IBD. Adjusting for infections, any versus no antibiotics in the first year was associated with IBD (pooled aHR = 1.33 [95% CI = 1.01–1.76]). The aHR for additional antibiotic course was 1.17 (95% CI = 0.96–1.44), driven by penicillin (per additional course, aHR = 1.28 [95% CI = 1.02–1.60]). Although antibiotics at 1 to < 3 years did not show an association with IBD or Crohn's disease, non‐penicillin antibiotics were associated with ulcerative colitis (per additional course, aHR = 1.95 [95% CI = 1.38–2.75]).ConclusionEarly‐life antibiotic use was, a significant risk factor for childhood and early adult‐onset IBD, independent of infection frequency.
{"title":"Early‐Life Infections, Antibiotics and Later Risk of Childhood and Early Adult‐Onset Inflammatory Bowel Disease: Pooled Analysis of Two Scandinavian Birth Cohorts","authors":"Karl Mårild, Tereza Lerchova, Malin Östensson, Henrik Imberg, Ketil Størdal, Johnny Ludvigsson","doi":"10.1111/apt.18358","DOIUrl":"https://doi.org/10.1111/apt.18358","url":null,"abstract":"BackgroundChildhood antibiotic use has been associated with inflammatory bowel disease (IBD), although the potential contribution of infection frequency remains uncertain.AimsTo explore the association between early‐life infections, antibiotics and IBD development.MethodsWe used population‐based data from ABIS (Sweden) and MoBa (Norway) cohorts following children from birth (1997–2009) until 2021. Prospectively collected questionnaires identified infection frequency (any, gastrointestinal and respiratory) and antibiotics (any, penicillin and non‐penicillin) until age 3. IBD diagnosis required ≥ 2 records in national health registries. Cohort‐specific hazard ratios (aHR), adjusted for parental education, smoking and IBD were estimated and pooled using a random‐effects model. Antibiotic analyses were adjusted for infection frequency.ResultsThere were 103,046 children (11,872 ABIS and 91,174 MoBa), contributing to 1,663,898 person‐years of follow‐up, during which 395 were diagnosed with IBD. The frequency of any infection at 0 to < 1 and 1 to < 3 years showed a pooled aHR of 1.01 (95% confidence interval [CI] = 0.96–1.07) and 1.00 (95% CI = 0.99–1.01) per additional infection for IBD. Adjusting for infections, any versus no antibiotics in the first year was associated with IBD (pooled aHR = 1.33 [95% CI = 1.01–1.76]). The aHR for additional antibiotic course was 1.17 (95% CI = 0.96–1.44), driven by penicillin (per additional course, aHR = 1.28 [95% CI = 1.02–1.60]). Although antibiotics at 1 to < 3 years did not show an association with IBD or Crohn's disease, non‐penicillin antibiotics were associated with ulcerative colitis (per additional course, aHR = 1.95 [95% CI = 1.38–2.75]).ConclusionEarly‐life antibiotic use was, a significant risk factor for childhood and early adult‐onset IBD, independent of infection frequency.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"96 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490372","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}
Early identification of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) holds crucial importance in guiding clinical management and reducing mortality. However, existing scoring systems often overlook patient's underlying clinical condition, which significantly impacts prognosis.
Croft A, Okano S, Hartel G, Lord A, Walker G, Tambakis G, et al. A personalised algorithm predicting the risk of intravenous corticosteroid failure in acute ulcerative colitis. Aliment Pharmacol Ther. 2024; 60: 921–933. https://doi.org/10.1111/apt.18190.
The units of measurement used to describe C-reactive protein (CRP) concentration in this manuscript were incorrectly reported as mg/mL. This should have read mg/L. This error did not affect the calculation or subsequent validation of the partial and full Risk of Rescue (ROR) scores, which are available for use at www.severecolitis.com.
{"title":"Correction to ‘A Personalised Algorithm Predicting the Risk of Intravenous Corticosteroid Failure in Acute Ulcerative Colitis’","authors":"","doi":"10.1111/apt.18357","DOIUrl":"https://doi.org/10.1111/apt.18357","url":null,"abstract":"<p>Croft A, Okano S, Hartel G, Lord A, Walker G, Tambakis G, et al. A personalised algorithm predicting the risk of intravenous corticosteroid failure in acute ulcerative colitis. <i>Aliment Pharmacol Ther</i>. 2024; 60: 921–933. https://doi.org/10.1111/apt.18190.</p>\u0000<p>The units of measurement used to describe C-reactive protein (CRP) concentration in this manuscript were incorrectly reported as mg/mL. This should have read mg/L. This error did not affect the calculation or subsequent validation of the partial and full Risk of Rescue (ROR) scores, which are available for use at www.severecolitis.com.</p>\u0000<p>The authors apologise for this error.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"35 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490051","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":"Letter: The Essential Role of Social Workers in Reducing Socioeconomic Disparities in Chronic Liver Disease-Author's Reply.","authors":"Eunice Yewon Lee,Linda Henry,Mindie H Nguyen","doi":"10.1111/apt.18352","DOIUrl":"https://doi.org/10.1111/apt.18352","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"1 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489732","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}
Tom van Gils, Hans Törnblom, Jóhann P. Hreinsson, Börje Jonefjäll, Hans Strid, Magnus Simrén
Abdominal pain can be an overlooked symptom in patients with ulcerative colitis (UC).
腹痛可能是溃疡性结肠炎（UC）患者被忽视的症状。
{"title":"Factors Associated With Abdominal Pain in Patients With Active and Quiescent Ulcerative Colitis: A Multicohort Study","authors":"Tom van Gils, Hans Törnblom, Jóhann P. Hreinsson, Börje Jonefjäll, Hans Strid, Magnus Simrén","doi":"10.1111/apt.18344","DOIUrl":"https://doi.org/10.1111/apt.18344","url":null,"abstract":"Abdominal pain can be an overlooked symptom in patients with ulcerative colitis (UC).","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"90 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488791","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":"Letter: The Essential Role of Social Workers in Reducing Socioeconomic Disparities in Chronic Liver Disease","authors":"Qiong Yi, GuangYao Wang, ZongXiang Yue","doi":"10.1111/apt.18307","DOIUrl":"https://doi.org/10.1111/apt.18307","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"13 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488792","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}
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