Pub Date : 2025-01-23DOI: 10.1053/j.gastro.2024.11.008
Faisal S. Ali, Mindie H. Nguyen, Ruben Hernaez, Daniel Q. Huang, Julius Wilder, Alejandro Piscoya, Tracey G. Simon, Yngve Falck-Ytter
Background & Aims
Hepatitis B reactivation (HBVr) can occur due to a variety of immune-modulating exposures, including multiple drug classes and disease states. Antiviral prophylaxis can be effective in mitigating the risk of HBVr. In select cases, clinical monitoring without antiviral prophylaxis is sufficient for managing the risk of HBVr. This clinical practice guideline update aims to inform frontline health care practitioners by providing evidence-based practice recommendation for the management of HBVr in at-risk individuals.
Methods
The Grading of Recommendations Assessment, Development and Evaluation framework was used to assess evidence and make recommendations. The panel conducted a systematic evidence review to identify new studies since publication of the first version of this clinical practice guideline in 2014. The Evidence to Decision framework was used to develop recommendations regarding the role of antiviral prophylaxis and monitoring without antiviral prophylaxis for management of HBVr. Clinical recommendations were based on the balance between desirable and undesirable effects, patient values, costs, and health equity considerations.
Results
The panel agreed on 4 recommendations. Based on evidence and baseline risk assessment, the panel made a strong recommendation in favor of antiviral prophylaxis for individuals at high risk of HBVr. For individuals at moderate risk of HBVr, a conditional recommendation was made in favor of antiviral prophylaxis. For individuals at low risk of HBVr, a conditional recommendation was made in favor of monitoring alone without antiviral prophylaxis. Monitoring should be performed at 1- to 3-month intervals, and must include assessment of hepatitis B viral load in addition to assessment of alanine aminotransferase. For individuals deemed to be at-risk of HBVr, the panel agreed on a strong recommendation in favor of testing for HBV; given universal Centers for Disease Control and Prevention screening guidance for hepatitis B for all adults 18 years and older by testing for HBV surface antigen, hepatitis B surface antibody, and total hepatitis B core antibody, stratifying screening practices by magnitude of HBVr risk is no longer needed.
Conclusions
This document provides updated guidance for the management of HBVr in at-risk individuals. Limitations and gaps in the evidence are highlighted. This guideline is expected to require updating in 5 years from publication.
{"title":"AGA Clinical Practice Guideline on the Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals","authors":"Faisal S. Ali, Mindie H. Nguyen, Ruben Hernaez, Daniel Q. Huang, Julius Wilder, Alejandro Piscoya, Tracey G. Simon, Yngve Falck-Ytter","doi":"10.1053/j.gastro.2024.11.008","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.11.008","url":null,"abstract":"<h3>Background & Aims</h3>Hepatitis B reactivation (HBVr) can occur due to a variety of immune-modulating exposures, including multiple drug classes and disease states. Antiviral prophylaxis can be effective in mitigating the risk of HBVr. In select cases, clinical monitoring without antiviral prophylaxis is sufficient for managing the risk of HBVr. This clinical practice guideline update aims to inform frontline health care practitioners by providing evidence-based practice recommendation for the management of HBVr in at-risk individuals.<h3>Methods</h3>The Grading of Recommendations Assessment, Development and Evaluation framework was used to assess evidence and make recommendations. The panel conducted a systematic evidence review to identify new studies since publication of the first version of this clinical practice guideline in 2014. The Evidence to Decision framework was used to develop recommendations regarding the role of antiviral prophylaxis and monitoring without antiviral prophylaxis for management of HBVr. Clinical recommendations were based on the balance between desirable and undesirable effects, patient values, costs, and health equity considerations.<h3>Results</h3>The panel agreed on 4 recommendations. Based on evidence and baseline risk assessment, the panel made a strong recommendation in favor of antiviral prophylaxis for individuals at high risk of HBVr. For individuals at moderate risk of HBVr, a conditional recommendation was made in favor of antiviral prophylaxis. For individuals at low risk of HBVr, a conditional recommendation was made in favor of monitoring alone without antiviral prophylaxis. Monitoring should be performed at 1- to 3-month intervals, and must include assessment of hepatitis B viral load in addition to assessment of alanine aminotransferase. For individuals deemed to be at-risk of HBVr, the panel agreed on a strong recommendation in favor of testing for HBV; given universal Centers for Disease Control and Prevention screening guidance for hepatitis B for all adults 18 years and older by testing for HBV surface antigen, hepatitis B surface antibody, and total hepatitis B core antibody, stratifying screening practices by magnitude of HBVr risk is no longer needed.<h3>Conclusions</h3>This document provides updated guidance for the management of HBVr in at-risk individuals. Limitations and gaps in the evidence are highlighted. This guideline is expected to require updating in 5 years from publication.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"32 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020914","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}
Pub Date : 2025-01-23DOI: 10.1053/s0016-5085(24)05813-x
No Abstract
没有抽象的
{"title":"Spotlight: Prevention and Treatment of Hepatitis B Virus Reactivation in At-Risk Individuals","authors":"","doi":"10.1053/s0016-5085(24)05813-x","DOIUrl":"https://doi.org/10.1053/s0016-5085(24)05813-x","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"8 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020917","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}
Pub Date : 2025-01-23DOI: 10.1053/s0016-5085(24)05811-6
No Abstract
没有抽象的
{"title":"Elsewhere in The AGA Journals (Preview Section)","authors":"","doi":"10.1053/s0016-5085(24)05811-6","DOIUrl":"https://doi.org/10.1053/s0016-5085(24)05811-6","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"33 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021075","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}
Pub Date : 2025-01-23DOI: 10.1053/j.gastro.2024.12.006
Sandra M. Quezada, Folasade P. May
<h2>Section snippets</h2><section><section><h2>Over 2 Years Covering a Broad Range of DEI Topics</h2>In our time as DEI section editors, we published 27 manuscripts in the DEI sections for <em>Gastroenterology</em> and <em>CGH</em> between July 2022 and September 2024. Most pieces (23) were copublished in the two journals, with 1 additional manuscript published solely in <em>Gastroenterology</em> and 3 published solely in <em>CGH</em>.As intended, the range of topics covered has been broad, encompassing subjects in both gastroenterology and hepatology. While most pieces are commentaries, the DEI section has also housed</section></section><section><section><h2>Views, Downloads, and Citations</h2>Between July 2022 and September 2024, the 27 published DEI section manuscripts were viewed or downloaded a total of 68,150 times combined for <em>Gastroenterology</em> and <em>CGH</em> (mean 1434 [range 231–3242]). Views and downloads per article ranged from 303 to 3242 for <em>Gastroenterology</em> (compared with 71 to 19,586 for non-DEI articles) and from 231 to 1577 for <em>CGH</em> (compared with 18 to 4928 for non-DEI articles). Articles in the DEI section were cited an average of 2.1 times (both journals combined) with a</section></section><section><section><h2>Social Media Engagement</h2>As section editors, we use social media to promote each accepted manuscript at the time of online publication. On the platform X (formerly known as Twitter), the average engagement rate for DEI posts from October 2022 to September 2024 was 1.97% (Hootsuite/X; data were current as of September 10, 2024). For context, Adobe’s 2022 guide to social media rates explains that, while goals might vary depending on the platform and size of the business, an engagement rate greater than 1% on X is</section></section><section><section><h2>DEI Within the AGA Journal Boards of Editors and Editorial Boards</h2>The AGA journals routinely monitor metrics for efforts related to DEI, including the diversity of each journal’s board of editors (BOE) and editorial board (EB). All data are self-reported by individuals in their AGA member profile and maintained in the AGA member database. Of note, data for sex, race, and ethnicity are not reported by many individuals, and geographic location is manually assigned based on the individual’s institution when missing.The BOE refers to the group of editors, led by</section></section><section><section><h2>Author Survey Results</h2>In addition to promoting content focused on GI health equity and equity in the GI workforce, another goal of the section was to amplify work created by underrepresented authors with expertise in these areas. Authors comprise a prestigious and broad cohort, including physicians and scientists in gastroenterology and hepatology subspecializing in colorectal cancer, liver disease, and inflammatory bowel disease among other areas, with overlapping foci on health disparities. We sought to learn from</section></section><secti
在我们作为DEI章节编辑的时间里，我们在2022年7月至2024年9月期间在胃肠病学和CGH的DEI章节发表了27篇手稿。大部分论文（23篇）在两种期刊上共同发表，另有1篇论文在胃肠病学杂志上单独发表，3篇论文在CGH杂志上单独发表。正如预期的那样，所涵盖的主题范围很广，包括胃肠病学和肝病学的主题。虽然大多数文章是评论，但DEI部分也有浏览、下载和引用。在2022年7月至2024年9月期间，胃肠病学和CGH的27篇发表的DEI部分手稿共被浏览或下载68,150次（平均1434次[范围231-3242]）。胃肠病学的每篇文章的阅读量和下载量从303到3242不等（非dei文章为71到19586），CGH的每篇文章的阅读量和下载量从231到1577不等（非dei文章为18到4928）。DEI部分的文章平均被引用2.1次（两种期刊加起来）。作为部分编辑，我们在在线出版时使用社交媒体来推广每篇被接受的手稿。在X平台（以前称为Twitter）上，从2022年10月到2024年9月，DEI帖子的平均参与率为1.97% (Hootsuite/X；数据截止到2024年9月10日)。作为背景，Adobe的2022年社交媒体率指南解释说，虽然目标可能因平台和业务规模而异，但在AGA期刊编辑委员会和编辑委员会内部，X isDEI的参与率超过1% AGA期刊定期监测与DEI相关的指标，包括每个期刊的编辑委员会（BOE）和编辑委员会（EB）的多样性。所有数据均由个人在其AGA成员档案中自我报告，并保存在AGA成员数据库中。值得注意的是，许多个人没有报告性别、种族和民族的数据，地理位置是根据个人所在机构手动分配的。BOE指的是由作者调查结果领导的编辑小组。除了促进以GI健康公平和GI劳动力公平为重点的内容外，该部分的另一个目标是扩大代表性不足的具有这些领域专业知识的作者的作品。作者包括一个享有盛誉和广泛的队列，包括胃肠病学和肝病学的医生和科学家，专门研究结直肠癌、肝脏疾病和炎症性肠病等领域，重点关注健康差距。我们很荣幸能够在过去的两年半里担任美国农业协会（AGA）的DEI部分编辑，并对我们的信任做出贡献，我们的目标是帮助AGA杂志的读者了解服务不足的人群和我们领域中持续存在的差异。当我们接近后半期时，我们受到了高读者参与度和积极的作者体验的鼓舞。我们设想该部分在其目的、内容和作者身份方面的持续增长和演变。作者感谢Gina Reitenauer和Nick Tomeo在数据采集和解释方面提供的帮助。sandra M. Quezada：概念化，数据收集和解释，起草，编辑。Folasade P. May：概念化，数据收集和解释，起草，编辑。
{"title":"Continuing the Commitment to Diversity, Equity, and Inclusion Within AGA Journals","authors":"Sandra M. Quezada, Folasade P. May","doi":"10.1053/j.gastro.2024.12.006","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.006","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Over 2 Years Covering a Broad Range of DEI Topics</h2>In our time as DEI section editors, we published 27 manuscripts in the DEI sections for <em>Gastroenterology</em> and <em>CGH</em> between July 2022 and September 2024. Most pieces (23) were copublished in the two journals, with 1 additional manuscript published solely in <em>Gastroenterology</em> and 3 published solely in <em>CGH</em>.As intended, the range of topics covered has been broad, encompassing subjects in both gastroenterology and hepatology. While most pieces are commentaries, the DEI section has also housed</section></section><section><section><h2>Views, Downloads, and Citations</h2>Between July 2022 and September 2024, the 27 published DEI section manuscripts were viewed or downloaded a total of 68,150 times combined for <em>Gastroenterology</em> and <em>CGH</em> (mean 1434 [range 231–3242]). Views and downloads per article ranged from 303 to 3242 for <em>Gastroenterology</em> (compared with 71 to 19,586 for non-DEI articles) and from 231 to 1577 for <em>CGH</em> (compared with 18 to 4928 for non-DEI articles). Articles in the DEI section were cited an average of 2.1 times (both journals combined) with a</section></section><section><section><h2>Social Media Engagement</h2>As section editors, we use social media to promote each accepted manuscript at the time of online publication. On the platform X (formerly known as Twitter), the average engagement rate for DEI posts from October 2022 to September 2024 was 1.97% (Hootsuite/X; data were current as of September 10, 2024). For context, Adobe’s 2022 guide to social media rates explains that, while goals might vary depending on the platform and size of the business, an engagement rate greater than 1% on X is</section></section><section><section><h2>DEI Within the AGA Journal Boards of Editors and Editorial Boards</h2>The AGA journals routinely monitor metrics for efforts related to DEI, including the diversity of each journal’s board of editors (BOE) and editorial board (EB). All data are self-reported by individuals in their AGA member profile and maintained in the AGA member database. Of note, data for sex, race, and ethnicity are not reported by many individuals, and geographic location is manually assigned based on the individual’s institution when missing.The BOE refers to the group of editors, led by</section></section><section><section><h2>Author Survey Results</h2>In addition to promoting content focused on GI health equity and equity in the GI workforce, another goal of the section was to amplify work created by underrepresented authors with expertise in these areas. Authors comprise a prestigious and broad cohort, including physicians and scientists in gastroenterology and hepatology subspecializing in colorectal cancer, liver disease, and inflammatory bowel disease among other areas, with overlapping foci on health disparities. We sought to learn from</section></section><secti","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"4 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020915","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}
Pub Date : 2025-01-22DOI: 10.1053/j.gastro.2024.12.035
Hyungjin Rhee, Myeong-Jin Kim, Do Young Kim, Chansik An, Wonseok Kang, Kyunghwa Han, Yun Ho Roh, Kwang-Hyub Han, Sang Hoon Ahn, Jin-Young Choi, Jun Yong Park, Yong Eun Chung, Seung Up Kim, Beom Kyung Kim, Sunyoung Lee, Hye Won Lee, Jae Seung Lee
Background & Aims
This study aimed to compare ultrasonography (US) and non-contrast magnetic resonance imaging (MRI) in the surveillance of hepatic malignancy.
Methods
We conducted a randomized, non-blinded, single-center trial at a single center in South Korea. Eligible individuals were aged 20–70 years with liver cirrhosis, Child–Pugh class A, and no history of liver cancer or other recent malignancy. Participants were randomized 1:1 to receive up to ten semiannual surveillance using US or non-contrast MRI with serum alpha-fetoprotein testing. The primary endpoints were the detection rates of Barcelona Clinic Liver Cancer [BCLC] stage 0 or A tumors, stage distribution at initial diagnosis, and false-positive referral rates.
Results
From June 2015 to November 2017, 416 patients were screened, and 414 were enrolled and assigned to the US (n=207) or MRI (n=207) group. In total, 23 participants in US group and 25 in MRI group were diagnosed with liver cancer by November 2022. The detection rates of BCLC stage 0 or A tumors were not different between the US and MRI groups (8% [95% confidence interval (CI), 5 – 13%] versus 12% [8 – 17%]). BCLC stage 0 tumors were more prevalent in the MRI group than in the US group (8% versus 3%). The MRI group had earlier BCLC stage (P=0.014) and lower false-positive referral rate (0.7% [95% CI, 0.4 – 1.2%] versus 3.1% [2.3 – 4.1%], P <0.001) compared to the US group.
Conclusions
Non-contrast MRI is a better alternative to US for the surveillance of cirrhotic patients offering earlier stage at initial diagnosis and lower false-positive referral rate. ClincalTrials.gov, NCT02514434.
{"title":"Non-contrast magnetic resonance imaging versus ultrasonography for hepatocellular carcinoma surveillance: A randomized, single-center trial","authors":"Hyungjin Rhee, Myeong-Jin Kim, Do Young Kim, Chansik An, Wonseok Kang, Kyunghwa Han, Yun Ho Roh, Kwang-Hyub Han, Sang Hoon Ahn, Jin-Young Choi, Jun Yong Park, Yong Eun Chung, Seung Up Kim, Beom Kyung Kim, Sunyoung Lee, Hye Won Lee, Jae Seung Lee","doi":"10.1053/j.gastro.2024.12.035","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.035","url":null,"abstract":"<h3>Background & Aims</h3>This study aimed to compare ultrasonography (US) and non-contrast magnetic resonance imaging (MRI) in the surveillance of hepatic malignancy.<h3>Methods</h3>We conducted a randomized, non-blinded, single-center trial at a single center in South Korea. Eligible individuals were aged 20–70 years with liver cirrhosis, Child–Pugh class A, and no history of liver cancer or other recent malignancy. Participants were randomized 1:1 to receive up to ten semiannual surveillance using US or non-contrast MRI with serum alpha-fetoprotein testing. The primary endpoints were the detection rates of Barcelona Clinic Liver Cancer [BCLC] stage 0 or A tumors, stage distribution at initial diagnosis, and false-positive referral rates.<h3>Results</h3>From June 2015 to November 2017, 416 patients were screened, and 414 were enrolled and assigned to the US (n=207) or MRI (n=207) group. In total, 23 participants in US group and 25 in MRI group were diagnosed with liver cancer by November 2022. The detection rates of BCLC stage 0 or A tumors were not different between the US and MRI groups (8% [95% confidence interval (CI), 5 – 13%] versus 12% [8 – 17%]). BCLC stage 0 tumors were more prevalent in the MRI group than in the US group (8% versus 3%). The MRI group had earlier BCLC stage (<em>P</em>=0.014) and lower false-positive referral rate (0.7% [95% CI, 0.4 – 1.2%] versus 3.1% [2.3 – 4.1%], <em>P</em> <0.001) compared to the US group.<h3>Conclusions</h3>Non-contrast MRI is a better alternative to US for the surveillance of cirrhotic patients offering earlier stage at initial diagnosis and lower false-positive referral rate. <span><span>ClincalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, NCT02514434.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"28 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992066","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}
Pub Date : 2025-01-20DOI: 10.1053/j.gastro.2024.12.022
David Y. Graham
No Abstract
没有抽象的
{"title":"Regarding the AGA Clinical Practice Update on Integrating Vonoprazan Into Clinical Practice","authors":"David Y. Graham","doi":"10.1053/j.gastro.2024.12.022","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.022","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"31 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990250","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}
Pub Date : 2025-01-17DOI: 10.1053/j.gastro.2025.01.007
Siyan Cao, Khai M. Nguyen, Marco Colonna
No Abstract
无摘要
{"title":"Reply to Li","authors":"Siyan Cao, Khai M. Nguyen, Marco Colonna","doi":"10.1053/j.gastro.2025.01.007","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.01.007","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"16 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988786","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}
Pub Date : 2025-01-16DOI: 10.1053/j.gastro.2024.12.024
Robert P. Hirten, Matteo Danieletto, Milagros Sanchez-Mayor, Jessica K. Whang, Kyung Won Lee, Kyle Landell, Micol Zweig, Drew Helmus, Thomas J. Fuchs, Zahi A. Fayad, Girish N. Nadkarni, Laurie Keefer, Mayte Suarez-Farinas, Bruce E. Sands
Background and Aims
Wearable devices capture physiological signals non-invasively and passively. Many of these parameters have been linked to inflammatory bowel disease (IBD) activity. We evaluated the associative ability of several physiological metrics with IBD flares and how they change before the development of flare.
Methods
Participants throughout the United States answered daily disease activity surveys and wore an Apple Watch, Fitbit or Oura Ring. These devices collected longitudinal heart rate (HR), resting heart rate (RHR), heart rate variability (HRV), steps, and oxygenation (SpO2). C-reactive protein, erythrocyte sedimentation rate and fecal calprotectin were collected as standard of care. Linear mixed-effect models were implemented to analyze HR, RHR, steps, and SpO2, while cosinor mixed-effect models were applied to HRV circadian features. Mixed effect logistic regression was used to determine the predictive ability of physiological metrics.
Results
309 participants were enrolled across 36 states. Circadian patterns of HRV significantly differed between periods of inflammatory flare and remission, and symptomatic flare and remission. Marginal means for HR and RHR were higher during periods of inflammatory flare and symptomatic flare. There was lower daily steps during inflammatory flares. HRV, HR, and RHR differentiated whether participants with symptoms had inflammation. HRV, HR, RHR, steps, and SpO2 were significantly altered up to 7 weeks prior to inflammatory and symptomatic flares.
Conclusions
Longitudinally collected physiological metrics from wearable devices can identify and change prior to IBD flares, suggesting their feasibility to monitor and predict IBD activity.
{"title":"Physiological Data Collected from Wearable Devices Identify and Predict Inflammatory Bowel Disease Flares","authors":"Robert P. Hirten, Matteo Danieletto, Milagros Sanchez-Mayor, Jessica K. Whang, Kyung Won Lee, Kyle Landell, Micol Zweig, Drew Helmus, Thomas J. Fuchs, Zahi A. Fayad, Girish N. Nadkarni, Laurie Keefer, Mayte Suarez-Farinas, Bruce E. Sands","doi":"10.1053/j.gastro.2024.12.024","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.024","url":null,"abstract":"<h3>Background and Aims</h3>Wearable devices capture physiological signals non-invasively and passively. Many of these parameters have been linked to inflammatory bowel disease (IBD) activity. We evaluated the associative ability of several physiological metrics with IBD flares and how they change before the development of flare.<h3>Methods</h3>Participants throughout the United States answered daily disease activity surveys and wore an Apple Watch, Fitbit or Oura Ring. These devices collected longitudinal heart rate (HR), resting heart rate (RHR), heart rate variability (HRV), steps, and oxygenation (SpO2). C-reactive protein, erythrocyte sedimentation rate and fecal calprotectin were collected as standard of care. Linear mixed-effect models were implemented to analyze HR, RHR, steps, and SpO2, while cosinor mixed-effect models were applied to HRV circadian features. Mixed effect logistic regression was used to determine the predictive ability of physiological metrics.<h3>Results</h3>309 participants were enrolled across 36 states. Circadian patterns of HRV significantly differed between periods of inflammatory flare and remission, and symptomatic flare and remission. Marginal means for HR and RHR were higher during periods of inflammatory flare and symptomatic flare. There was lower daily steps during inflammatory flares. HRV, HR, and RHR differentiated whether participants with symptoms had inflammation. HRV, HR, RHR, steps, and SpO2 were significantly altered up to 7 weeks prior to inflammatory and symptomatic flares.<h3>Conclusions</h3>Longitudinally collected physiological metrics from wearable devices can identify and change prior to IBD flares, suggesting their feasibility to monitor and predict IBD activity.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"54 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986880","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}
Pub Date : 2025-01-15DOI: 10.1053/j.gastro.2025.01.005
Joseph J. Zhao, Raghav Sundar
No Abstract
无摘要
{"title":"Reply to Wang et al","authors":"Joseph J. Zhao, Raghav Sundar","doi":"10.1053/j.gastro.2025.01.005","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.01.005","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"75 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986881","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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