Pub Date : 2024-05-09eCollection Date: 2024-01-01DOI: 10.1177/17562848241251600
Jennie Clough, Michael Colwill, Andrew Poullis, Richard Pollok, Kamal Patel, Sailish Honap
Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn's disease (CD), is a costly condition in terms of morbidity and healthcare utilization, with an increasing prevalence now approaching 1% in the Western world. Endoscopic assessment of IBD remains the gold standard for diagnosis, evaluation of treatment response and determination of post-operative recurrence, but is expensive and invasive. Biomarkers can facilitate non-invasive disease assessment, with C-reactive protein and faecal calprotectin as the most widely available biomarkers in current clinical practice. This narrative review summarizes the evidence for their use in both UC and CD and offers practical guidance for healthcare providers taking into account the limitations of biomarker interpretation. We present evidence for the future use of novel biomarkers in IBD and discuss how biomarker discovery could deliver the goal of precision medicine in IBD.
炎症性肠病(IBD)包括溃疡性结肠炎(UC)和克罗恩病(CD),是一种在发病率和医疗保健使用方面代价高昂的疾病,目前在西方国家的发病率已接近 1%。IBD 的内镜评估仍是诊断、评估治疗反应和确定术后复发的金标准,但费用昂贵且具有侵入性。生物标志物可促进非侵入性疾病评估,其中 C 反应蛋白和粪便钙蛋白是目前临床实践中最广泛使用的生物标志物。这篇叙述性综述总结了在 UC 和 CD 中使用这两种生物标记物的证据,并在考虑到生物标记物解读局限性的基础上为医疗服务提供者提供了实用指导。我们提出了未来在 IBD 中使用新型生物标记物的证据,并讨论了生物标记物的发现如何实现 IBD 精准医疗的目标。
{"title":"Biomarkers in inflammatory bowel disease: a practical guide.","authors":"Jennie Clough, Michael Colwill, Andrew Poullis, Richard Pollok, Kamal Patel, Sailish Honap","doi":"10.1177/17562848241251600","DOIUrl":"10.1177/17562848241251600","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn's disease (CD), is a costly condition in terms of morbidity and healthcare utilization, with an increasing prevalence now approaching 1% in the Western world. Endoscopic assessment of IBD remains the gold standard for diagnosis, evaluation of treatment response and determination of post-operative recurrence, but is expensive and invasive. Biomarkers can facilitate non-invasive disease assessment, with C-reactive protein and faecal calprotectin as the most widely available biomarkers in current clinical practice. This narrative review summarizes the evidence for their use in both UC and CD and offers practical guidance for healthcare providers taking into account the limitations of biomarker interpretation. We present evidence for the future use of novel biomarkers in IBD and discuss how biomarker discovery could deliver the goal of precision medicine in IBD.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11085009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-23eCollection Date: 2024-01-01DOI: 10.1177/17562848241242700
Francesca Bello, Samer Muhsen, Haider Sabhan, Alexandra Borin, Fredrik Johansson, Charlotte Höög, Ole Forsberg, Christina Wennerström, Charlotte Söderman, Mikael Lördal, Sven Almer
Background: Ustekinumab is used to treat inflammatory bowel disease mainly in patients failing anti-tumour necrosis factor (TNF)-agents.
Objectives: To provide real-world data in unselected patients with Crohn's disease (CD), treated with ustekinumab.
Design: Longitudinal retrospective study at four hospitals in Stockholm, Sweden.
Methods: Disease activity (Harvey-Bradshaw index and physician global assessment), laboratory parameters, endoscopic findings and drug persistence were assessed. Follow-up data were obtained in patients that stopped ustekinumab.
Results: In total, 322 patients (median age 38 years, 48% women) were included. All had luminal disease and 22% also fistulizing disease. A total of 271 (84%) had failed ⩾1 and 148 (46%) ⩾2 anti-TNF drugs; 34% failed vedolizumab. At inclusion, 93% had active disease; 28% were on oral corticosteroids and 18% on thiopurines. The median follow-up on treatment was 13.5 months; overall 67% were followed at least 24 months. By intention to treat analysis, response rate at 3 and 12 months was 43% and 42%, respectively. Among patients with ongoing ustekinumab, 19% were in steroid-free remission at 3 months and 64% at 12 months. The median faecal calprotectin level decreased from 460 µg/g at baseline to 156 µg/g at 3 months and was 182 µg/g at 12 months. C-reactive protein remained stable at 4 mg/L whereas serum albumin increased slightly. About 31% of patients were withdrawn during the first 12 months, mainly due to persisting disease activity 21%, adverse events 5%, bowel surgery 0.6% or malignancy 0.3%. The overall persistence on ustekinumab was 88%, 51%, 34% and 20% at 3, 12, 24 and 36 months, respectively. Within 12 months following withdrawal of ustekinumab in 121 patients, 64% had active disease most of the time, 68% needed another biologic and 24% underwent surgery.
Conclusion: Among difficult-to-treat patients with CD, ustekinumab was effective in the majority, with high drug persistence at 12 and 24 months in combination with a favourable safety profile.
{"title":"Long-term real-world data of ustekinumab in Crohn's disease: the Stockholm ustekinumab study.","authors":"Francesca Bello, Samer Muhsen, Haider Sabhan, Alexandra Borin, Fredrik Johansson, Charlotte Höög, Ole Forsberg, Christina Wennerström, Charlotte Söderman, Mikael Lördal, Sven Almer","doi":"10.1177/17562848241242700","DOIUrl":"https://doi.org/10.1177/17562848241242700","url":null,"abstract":"<p><strong>Background: </strong>Ustekinumab is used to treat inflammatory bowel disease mainly in patients failing anti-tumour necrosis factor (TNF)-agents.</p><p><strong>Objectives: </strong>To provide real-world data in unselected patients with Crohn's disease (CD), treated with ustekinumab.</p><p><strong>Design: </strong>Longitudinal retrospective study at four hospitals in Stockholm, Sweden.</p><p><strong>Methods: </strong>Disease activity (Harvey-Bradshaw index and physician global assessment), laboratory parameters, endoscopic findings and drug persistence were assessed. Follow-up data were obtained in patients that stopped ustekinumab.</p><p><strong>Results: </strong>In total, 322 patients (median age 38 years, 48% women) were included. All had luminal disease and 22% also fistulizing disease. A total of 271 (84%) had failed ⩾1 and 148 (46%) ⩾2 anti-TNF drugs; 34% failed vedolizumab. At inclusion, 93% had active disease; 28% were on oral corticosteroids and 18% on thiopurines. The median follow-up on treatment was 13.5 months; overall 67% were followed at least 24 months. By intention to treat analysis, response rate at 3 and 12 months was 43% and 42%, respectively. Among patients with ongoing ustekinumab, 19% were in steroid-free remission at 3 months and 64% at 12 months. The median faecal calprotectin level decreased from 460 µg/g at baseline to 156 µg/g at 3 months and was 182 µg/g at 12 months. C-reactive protein remained stable at 4 mg/L whereas serum albumin increased slightly. About 31% of patients were withdrawn during the first 12 months, mainly due to persisting disease activity 21%, adverse events 5%, bowel surgery 0.6% or malignancy 0.3%. The overall persistence on ustekinumab was 88%, 51%, 34% and 20% at 3, 12, 24 and 36 months, respectively. Within 12 months following withdrawal of ustekinumab in 121 patients, 64% had active disease most of the time, 68% needed another biologic and 24% underwent surgery.</p><p><strong>Conclusion: </strong>Among difficult-to-treat patients with CD, ustekinumab was effective in the majority, with high drug persistence at 12 and 24 months in combination with a favourable safety profile.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11036920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-20eCollection Date: 2024-01-01DOI: 10.1177/17562848241237631
Wei Peng, Yangxun Pan, Lan Xie, Zhoutian Yang, Zhiwei Ye, Jinbin Chen, Juncheng Wang, Dandan Hu, Li Xu, Zhongguo Zhou, Minshan Chen, Aiping Fang, Yaojun Zhang
Background: Given the superior performance of various therapies over sorafenib in advanced hepatocellular carcinoma (HCC) and the absence of direct comparisons, it is crucial to explore the efficacy of these treatments in phase III randomized clinical trials.
Objectives: The goal is to identify which patients are most likely to benefit significantly from these emerging therapies, contributing to more personalized and informed clinical decision-making.
Design: Systematic review and network meta-analysis.
Data sources and methods: PubMed, Embase, ClinicalTrials.gov, and international conference databases have been searched from 1 January 2010 to 1 December 2023.
Results: After screening, 17 phase III trials encompassing 18 treatments were included. In the whole-population network meta-analysis, the newly first-line tremelimumab plus durvalumab (Tre + Du) was found to be comparable with atezolizumab plus bevacizumab (Atezo + Beva) in providing the best overall survival (OS) benefit [hazard ratio (HR) 1.35, 95% confidence interval (CI): 0.93-1.92]. Concerning OS benefits, sintilimab plus bevacizumab biosimilar (Sint + Beva), camrelizumab plus rivoceranib (Camre + Rivo), and lenvatinib plus pembrolizumab (Lenva + Pemb) appear to exhibit similar effects to Tre + Du and Atezo + Beva. In the context of progression-free survival, Atezo + Beva seemed to outperform Tre + Du (HR: 0.66 CI: 0.49-0.87), while the effects are comparable to Sint + Beva, Camre + Rivo, and Lenva + Pemb. Upon comparison between Asia-Pacific and non-Asia-Pacific cohorts, as well as between hepatitis B virus (HBV)-infected and non-HBV-infected populations, immune checkpoint inhibitor (ICI)-based treatments seemed to exhibit heightened efficacy in the Asia-Pacific group and among individuals with HBV infection. However, combined ICI-based therapies did not show more effectiveness than molecular-targeted drugs in patients without macrovascular invasion and/or extrahepatic spread. As for grades 3-5 adverse events, combined therapies showed comparable safety to sorafenib and lenvatinib.
Conclusion: Compared with sorafenib and lenvatinib, combination therapies based on ICIs significantly improved the prognosis of advanced HCC and demonstrated similar safety. At the same time, the optimal treatment approach should be tailored to individual patient characteristics, such as etiology, tumor staging, and serum alpha-fetoprotein levels. With lower incidence rates of treatment-related adverse events and non-inferior efficacy compared to sorafenib, ICI monotherapies should be prioritized as a first-line treatment approach for patients who are not suitable candidates for ICI-combined therapies.
{"title":"The emerging therapies are reshaping the first-line treatment for advanced hepatocellular carcinoma: a systematic review and network meta-analysis.","authors":"Wei Peng, Yangxun Pan, Lan Xie, Zhoutian Yang, Zhiwei Ye, Jinbin Chen, Juncheng Wang, Dandan Hu, Li Xu, Zhongguo Zhou, Minshan Chen, Aiping Fang, Yaojun Zhang","doi":"10.1177/17562848241237631","DOIUrl":"https://doi.org/10.1177/17562848241237631","url":null,"abstract":"<p><strong>Background: </strong>Given the superior performance of various therapies over sorafenib in advanced hepatocellular carcinoma (HCC) and the absence of direct comparisons, it is crucial to explore the efficacy of these treatments in phase III randomized clinical trials.</p><p><strong>Objectives: </strong>The goal is to identify which patients are most likely to benefit significantly from these emerging therapies, contributing to more personalized and informed clinical decision-making.</p><p><strong>Design: </strong>Systematic review and network meta-analysis.</p><p><strong>Data sources and methods: </strong>PubMed, Embase, ClinicalTrials.gov, and international conference databases have been searched from 1 January 2010 to 1 December 2023.</p><p><strong>Results: </strong>After screening, 17 phase III trials encompassing 18 treatments were included. In the whole-population network meta-analysis, the newly first-line tremelimumab plus durvalumab (Tre + Du) was found to be comparable with atezolizumab plus bevacizumab (Atezo + Beva) in providing the best overall survival (OS) benefit [hazard ratio (HR) 1.35, 95% confidence interval (CI): 0.93-1.92]. Concerning OS benefits, sintilimab plus bevacizumab biosimilar (Sint + Beva), camrelizumab plus rivoceranib (Camre + Rivo), and lenvatinib plus pembrolizumab (Lenva + Pemb) appear to exhibit similar effects to Tre + Du and Atezo + Beva. In the context of progression-free survival, Atezo + Beva seemed to outperform Tre + Du (HR: 0.66 CI: 0.49-0.87), while the effects are comparable to Sint + Beva, Camre + Rivo, and Lenva + Pemb. Upon comparison between Asia-Pacific and non-Asia-Pacific cohorts, as well as between hepatitis B virus (HBV)-infected and non-HBV-infected populations, immune checkpoint inhibitor (ICI)-based treatments seemed to exhibit heightened efficacy in the Asia-Pacific group and among individuals with HBV infection. However, combined ICI-based therapies did not show more effectiveness than molecular-targeted drugs in patients without macrovascular invasion and/or extrahepatic spread. As for grades 3-5 adverse events, combined therapies showed comparable safety to sorafenib and lenvatinib.</p><p><strong>Conclusion: </strong>Compared with sorafenib and lenvatinib, combination therapies based on ICIs significantly improved the prognosis of advanced HCC and demonstrated similar safety. At the same time, the optimal treatment approach should be tailored to individual patient characteristics, such as etiology, tumor staging, and serum alpha-fetoprotein levels. With lower incidence rates of treatment-related adverse events and non-inferior efficacy compared to sorafenib, ICI monotherapies should be prioritized as a first-line treatment approach for patients who are not suitable candidates for ICI-combined therapies.</p><p><strong>Trial registration: </strong>PROSPERO, CRD42022288172.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: For patients with human epidermal growth factor receptor-2 (HER2)-positive advanced or metastatic gastric cancer who have progressed on first-line trastuzumab therapy, the clinical value of the continuous use of trastuzumab beyond progression (TBP) is controversial.
Objectives: The present study was conducted to evaluate the efficacy and explore new treatment strategies of TBP for patients with trastuzumab-resistant HER2-positive advanced or metastatic gastric cancer in the era of cancer immunotherapy.
Design: Retrospective analysis.
Methods: Patients with HER2-positive advanced or metastatic gastric cancer who have failed first-line treatment based on trastuzumab-targeted therapy from June 2019 to December 2020 were retrospectively analyzed. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. Survival curves of patients were estimated by the Kaplan-Meier method and compared using the log-rank test.
Results: In all, 30 patients received TBP with chemotherapy, immunotherapy, or anti-angiogenic therapy, and the other 26 patients received treatment of physician's choice without trastuzumab. The median PFS in the TBP and non-TBP population was 6.0 [95% confidence interval (CI) = 3.8-8.2] and 3.5 (95% CI = 2.2-4.8) months, respectively (p = 0.038), and the median OS was 12.3 (95% CI = 10.4-14.2) and 9.0 (95% CI = 6.6-11.4) months (p = 0.008). The patients who received TBP treatment had more favorable PFS and OS than the non-TBP population. In the TBP group, patients who received trastuzumab plus chemotherapy and immunotherapy had higher ORR (40.0% versus 16.7%), DCR (90.0% versus 50.0%), and showed a significant improvement in PFS (7.0 versus 1.9 m) compared to TBP with chemotherapy alone. Subgroup analysis suggested that patients with male, HER2 positive with immunohistochemistry score 3+ and PFS of first-line treatment less than 6 months had a greater benefit from TBP. The incidence of Grade 3-4 adverse events in the TBP and non-TBP groups was 43.3% and 38.5%.
Conclusion: The continuous use of TBP improves PFS and OS in patients with trastuzumab-resistant HER2-positive advanced or metastatic gastric cancer with well-tolerated toxicity. In the era of immunotherapy, TBP combined with chemotherapy and immunotherapy may further enhance the clinical benefit and provide a new treatment strategy.
Trial registration: This study is a retrospective study, which does not require clinical registration.
{"title":"In era of immunotherapy: the value of trastuzumab beyond progression in patients with trastuzumab-resistant HER2-positive advanced or metastatic gastric cancer.","authors":"Hui Wang, Caiyun Nie, Weifeng Xu, Jing Li, He Gou, Huifang Lv, Beibei Chen, Jianzheng Wang, Yingjun Liu, Yunduan He, Jing Zhao, Xiaobing Chen","doi":"10.1177/17562848241245455","DOIUrl":"https://doi.org/10.1177/17562848241245455","url":null,"abstract":"<p><strong>Background: </strong>For patients with human epidermal growth factor receptor-2 (HER2)-positive advanced or metastatic gastric cancer who have progressed on first-line trastuzumab therapy, the clinical value of the continuous use of trastuzumab beyond progression (TBP) is controversial.</p><p><strong>Objectives: </strong>The present study was conducted to evaluate the efficacy and explore new treatment strategies of TBP for patients with trastuzumab-resistant HER2-positive advanced or metastatic gastric cancer in the era of cancer immunotherapy.</p><p><strong>Design: </strong>Retrospective analysis.</p><p><strong>Methods: </strong>Patients with HER2-positive advanced or metastatic gastric cancer who have failed first-line treatment based on trastuzumab-targeted therapy from June 2019 to December 2020 were retrospectively analyzed. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. Survival curves of patients were estimated by the Kaplan-Meier method and compared using the log-rank test.</p><p><strong>Results: </strong>In all, 30 patients received TBP with chemotherapy, immunotherapy, or anti-angiogenic therapy, and the other 26 patients received treatment of physician's choice without trastuzumab. The median PFS in the TBP and non-TBP population was 6.0 [95% confidence interval (CI) = 3.8-8.2] and 3.5 (95% CI = 2.2-4.8) months, respectively (<i>p</i> = 0.038), and the median OS was 12.3 (95% CI = 10.4-14.2) and 9.0 (95% CI = 6.6-11.4) months (<i>p</i> = 0.008). The patients who received TBP treatment had more favorable PFS and OS than the non-TBP population. In the TBP group, patients who received trastuzumab plus chemotherapy and immunotherapy had higher ORR (40.0% <i>versus</i> 16.7%), DCR (90.0% <i>versus</i> 50.0%), and showed a significant improvement in PFS (7.0 <i>versus</i> 1.9 m) compared to TBP with chemotherapy alone. Subgroup analysis suggested that patients with male, HER2 positive with immunohistochemistry score 3+ and PFS of first-line treatment less than 6 months had a greater benefit from TBP. The incidence of Grade 3-4 adverse events in the TBP and non-TBP groups was 43.3% and 38.5%.</p><p><strong>Conclusion: </strong>The continuous use of TBP improves PFS and OS in patients with trastuzumab-resistant HER2-positive advanced or metastatic gastric cancer with well-tolerated toxicity. In the era of immunotherapy, TBP combined with chemotherapy and immunotherapy may further enhance the clinical benefit and provide a new treatment strategy.</p><p><strong>Trial registration: </strong>This study is a retrospective study, which does not require clinical registration.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11010747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-09eCollection Date: 2024-01-01DOI: 10.1177/17562848241237196
Anthony J Lembo, Susan Edelstein, David P Rosenbaum, Ceciel Rooker, Jeffrey D Roberts, William D Chey
{"title":"Long-term safety of tenapanor in people with irritable bowel syndrome with constipation from the T3MPO-3 study: plain language summary of publication.","authors":"Anthony J Lembo, Susan Edelstein, David P Rosenbaum, Ceciel Rooker, Jeffrey D Roberts, William D Chey","doi":"10.1177/17562848241237196","DOIUrl":"https://doi.org/10.1177/17562848241237196","url":null,"abstract":"","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11005483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-29eCollection Date: 2024-01-01DOI: 10.1177/17562848241239580
Meiling Liu, Siyi Guo, Liang Wang
Background: Despite numerous metabolomic studies on ulcerative colitis (UC), the results have been highly variable, making it challenging to identify key metabolic abnormalities in UC.
Objectives: This study aims to uncover key metabolites and metabolic pathways in UC by analyzing existing metabolomics data.
Design: A systematic review.
Data sources and methods: We conducted a comprehensive search in databases (PubMed, Cochrane Library, Embase, and Web of Science) and relevant study references for metabolomic research on UC up to 28 December 2022. Significant metabolite differences between UC patients and controls were identified, followed by an analysis of relevant metabolic pathways.
Results: This review incorporated 78 studies, identifying 2868 differentially expressed metabolites between UC patients and controls. The metabolites were predominantly from 'lipids and lipid-like molecules' and 'organic acids and derivatives' superclasses. We found 101 metabolites consistently altered in multiple datasets within the same sample type and 78 metabolites common across different sample types. Of these, 62 metabolites exhibited consistent regulatory trends across various datasets or sample types. Pathway analysis revealed 22 significantly altered metabolic pathways, with 6 pathways being recurrently enriched across different sample types.
Conclusion: This study elucidates key metabolic characteristics in UC, offering insights into molecular mechanisms and biomarker discovery for the disease. Future research could focus on validating these findings and exploring their clinical applications.
{"title":"Systematic review of metabolomic alterations in ulcerative colitis: unveiling key metabolic signatures and pathways.","authors":"Meiling Liu, Siyi Guo, Liang Wang","doi":"10.1177/17562848241239580","DOIUrl":"10.1177/17562848241239580","url":null,"abstract":"<p><strong>Background: </strong>Despite numerous metabolomic studies on ulcerative colitis (UC), the results have been highly variable, making it challenging to identify key metabolic abnormalities in UC.</p><p><strong>Objectives: </strong>This study aims to uncover key metabolites and metabolic pathways in UC by analyzing existing metabolomics data.</p><p><strong>Design: </strong>A systematic review.</p><p><strong>Data sources and methods: </strong>We conducted a comprehensive search in databases (PubMed, Cochrane Library, Embase, and Web of Science) and relevant study references for metabolomic research on UC up to 28 December 2022. Significant metabolite differences between UC patients and controls were identified, followed by an analysis of relevant metabolic pathways.</p><p><strong>Results: </strong>This review incorporated 78 studies, identifying 2868 differentially expressed metabolites between UC patients and controls. The metabolites were predominantly from 'lipids and lipid-like molecules' and 'organic acids and derivatives' superclasses. We found 101 metabolites consistently altered in multiple datasets within the same sample type and 78 metabolites common across different sample types. Of these, 62 metabolites exhibited consistent regulatory trends across various datasets or sample types. Pathway analysis revealed 22 significantly altered metabolic pathways, with 6 pathways being recurrently enriched across different sample types.</p><p><strong>Conclusion: </strong>This study elucidates key metabolic characteristics in UC, offering insights into molecular mechanisms and biomarker discovery for the disease. Future research could focus on validating these findings and exploring their clinical applications.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28eCollection Date: 2024-01-01DOI: 10.1177/17562848241241227
Ming-Ling Chang, Jur-Shan Cheng, Puo-Hsien Le, Wei-Ting Chen, Hsin-Ping Ku, Rong-Nan Chien
Background: How antimitochondrial antibody (AMA)-positive patients evolve to have primary biliary cholangitis (PBC) in viral hepatitis-endemic areas is unknown.
Objectives: We aimed to investigate this evolution in Taiwan.
Design/methods: A 16-year medical center-based cohort study of 2,095,628 subjects was conducted in Taiwan, an Asian country endemic to viral hepatitis. AMA-positive subjects were those with positive AMA with alkaline phosphatase (ALP) ⩽1.5 times the upper limit of normal (ULN), and PBC was defined as positive AMA with ALP >1.5 × ULN.
Results: AMA-positive subjects had a lower average age- and sex-adjusted prevalence than PBC patients (4.68/105versus 11.61/105, p = 0.0002), but their incidence was comparable (0.99/105versus 1.12/105, p = 0.36). The former group had a borderline significantly lower mean age (56.59 years versus 58.10 years, p = 0.06) and a lower female-to-male ratio (2.85:1 versus 5.44:1, p < 0.0001). Both AMA-positive subjects (prevalence change: 20.0%, p < 0.01; incidence change: -9.2%, p < 0.01) and PBC patients (prevalence change: 14.6%, p < 0.01; incidence change: -4.7%, p< 0.01) prevalence rate increased but the incidence rate decreased. Among the 423 AMA-positive subjects, 77 (18.2%) developed PBC, for a mean duration of 1.757 years. Compared with AMA-positive subjects, PBC patients had similar concurrent chronic hepatitis B (CHB) rates (2.7% versus 4.3%, p = 0.197) but lower chronic hepatitis C (CHC) rates (3.69% versus 15.60%, p < 0.01).
Conclusion: PBC was more prevalent than AMA-positive subjects, and PBC patients had a higher female-to-male ratio than AMA-positive subjects, of whom 18.2% developed PBC (mean lag: 1.757 years). Upward trends in prevalence rates and downward trends in incidence rates were noted for both AMA-positive subjects and PBC. CHB was rare, CHC was more prevalent among PBC patients than the general population, and CHC was less prevalent among PBC than among AMA-positive subjects.
背景:在病毒性肝炎流行地区,抗线粒体抗体(AMA)阳性患者是如何演变为原发性胆汁性胆管炎的?在病毒性肝炎流行地区,抗线粒体抗体(AMA)阳性患者如何演变为原发性胆汁性胆管炎(PBC)尚不清楚:设计/方法:一项为期 16 年、以医疗中心为基础的队列研究:我们在病毒性肝炎流行的亚洲国家台湾开展了一项为期 16 年、以医疗中心为基础的队列研究,共纳入 2,095,628 名受试者。AMA阳性受试者是指AMA阳性且碱性磷酸酶(ALP)⩽1.5倍于正常值上限(ULN)的受试者,PBC是指AMA阳性且ALP >1.5 × ULN的受试者:经年龄和性别调整后,AMA 阳性受试者的平均患病率低于 PBC 患者(4.68/105 对 11.61/105,p = 0.0002),但两者的发病率相当(0.99/105 对 1.12/105,p = 0.36)。前者的平均年龄略低(56.59 岁对 58.10 岁,p = 0.06),男女比例较低(2.85:1 对 5.44:1,p p p p 0.01),患病率有所上升,但发病率有所下降。在 423 名 AMA 阳性受试者中,有 77 人(18.2%)发展为 PBC,平均病程为 1.757 年。与 AMA 阳性受试者相比,PBC 患者的慢性乙型肝炎(CHB)并发率相似(2.7% 对 4.3%,P = 0.197),但慢性丙型肝炎(CHC)并发率较低(3.69% 对 15.60%,P 结论:PBC 的发病率高于 AMA 阳性受试者:PBC的发病率高于AMA阳性受试者,PBC患者的男女比例高于AMA阳性受试者,其中18.2%的患者发展为PBC(平均滞后时间:1.757年)。AMA阳性受试者和PBC的患病率呈上升趋势,发病率呈下降趋势。CHB很少见,CHC在PBC患者中的发病率高于普通人群,而CHC在PBC患者中的发病率低于AMA阳性受试者。
{"title":"Evolutionary relationship between antimitochondrial antibody positivity and primary biliary cholangitis in Taiwan: a 16-year hospital cohort study.","authors":"Ming-Ling Chang, Jur-Shan Cheng, Puo-Hsien Le, Wei-Ting Chen, Hsin-Ping Ku, Rong-Nan Chien","doi":"10.1177/17562848241241227","DOIUrl":"10.1177/17562848241241227","url":null,"abstract":"<p><strong>Background: </strong>How antimitochondrial antibody (AMA)-positive patients evolve to have primary biliary cholangitis (PBC) in viral hepatitis-endemic areas is unknown.</p><p><strong>Objectives: </strong>We aimed to investigate this evolution in Taiwan.</p><p><strong>Design/methods: </strong>A 16-year medical center-based cohort study of 2,095,628 subjects was conducted in Taiwan, an Asian country endemic to viral hepatitis. AMA-positive subjects were those with positive AMA with alkaline phosphatase (ALP) ⩽1.5 times the upper limit of normal (ULN), and PBC was defined as positive AMA with ALP >1.5 × ULN.</p><p><strong>Results: </strong>AMA-positive subjects had a lower average age- and sex-adjusted prevalence than PBC patients (4.68/10<sup>5</sup> <i>versus</i> 11.61/10<sup>5</sup>, <i>p</i> = 0.0002), but their incidence was comparable (0.99/10<sup>5</sup> <i>versus</i> 1.12/10<sup>5</sup>, <i>p</i> = 0.36). The former group had a borderline significantly lower mean age (56.59 years <i>versus</i> 58.10 years, <i>p</i> = 0.06) and a lower female-to-male ratio (2.85:1 <i>versus</i> 5.44:1, <i>p</i> < 0.0001). Both AMA-positive subjects (prevalence change: 20.0%, <i>p</i> < 0.01; incidence change: -9.2%, <i>p</i> < 0.01) and PBC patients (prevalence change: 14.6%, <i>p</i> < 0.01; incidence change: -4.7%, <i>p</i> <i><</i> 0.01) prevalence rate increased but the incidence rate decreased. Among the 423 AMA-positive subjects, 77 (18.2%) developed PBC, for a mean duration of 1.757 years. Compared with AMA-positive subjects, PBC patients had similar concurrent chronic hepatitis B (CHB) rates (2.7% <i>versus</i> 4.3%, <i>p</i> = 0.197) but lower chronic hepatitis C (CHC) rates (3.69% <i>versus</i> 15.60%, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>PBC was more prevalent than AMA-positive subjects, and PBC patients had a higher female-to-male ratio than AMA-positive subjects, of whom 18.2% developed PBC (mean lag: 1.757 years). Upward trends in prevalence rates and downward trends in incidence rates were noted for both AMA-positive subjects and PBC. CHB was rare, CHC was more prevalent among PBC patients than the general population, and CHC was less prevalent among PBC than among AMA-positive subjects.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-24eCollection Date: 2024-01-01DOI: 10.1177/17562848241239547
Whitfield L Knapple, David S Yoho, Alexander Sheh, Joan Thul, Paul Feuerstadt
Background: Fecal microbiota, live-jslm (RBL; REBYOTA®), is the first Food and Drug Administration (FDA)-approved, single-dose, rectally administered, microbiota-based live biotherapeutic product for preventing Clostridioides difficile infection (CDI) recurrence. Alternative routes of administration are of clinical interest.
Objectives: Evaluate the safety and efficacy of RBL administration via colonoscopy.
Design: Retrospective analysis of electronic medical records of participants administered RBL via colonoscopy under FDA enforcement discretion.
Methods: The number of participants with treatment and/or procedure-emergent adverse events (TEAEs) was evaluated. Treatment success and sustained clinical response, defined as the absence of CDI recurrence within 8 weeks and 6 months, respectively, were evaluated.
Results: TEAEs were experienced by 75% (6/8) of participants; most were mild to moderate in severity, and none due to RBL or its administration. Most participants had treatment success (80%; 8/10); 75% (6/8) had sustained clinical response.
Conclusion: Real-world safety and efficacy of RBL administered via colonoscopy were consistent with clinical trials of rectally administered RBL.
{"title":"Retrospective subgroup analysis of fecal microbiota, live-jslm (REBYOTA<sup>®</sup>) administered by colonoscopy under enforcement discretion for the prevention of recurrent <i>Clostridioides difficile</i> infection.","authors":"Whitfield L Knapple, David S Yoho, Alexander Sheh, Joan Thul, Paul Feuerstadt","doi":"10.1177/17562848241239547","DOIUrl":"10.1177/17562848241239547","url":null,"abstract":"<p><strong>Background: </strong>Fecal microbiota, live-jslm (RBL; REBYOTA<sup>®</sup>), is the first Food and Drug Administration (FDA)-approved, single-dose, rectally administered, microbiota-based live biotherapeutic product for preventing <i>Clostridioides difficile</i> infection (CDI) recurrence. Alternative routes of administration are of clinical interest.</p><p><strong>Objectives: </strong>Evaluate the safety and efficacy of RBL administration <i>via</i> colonoscopy.</p><p><strong>Design: </strong>Retrospective analysis of electronic medical records of participants administered RBL <i>via</i> colonoscopy under FDA enforcement discretion.</p><p><strong>Methods: </strong>The number of participants with treatment and/or procedure-emergent adverse events (TEAEs) was evaluated. Treatment success and sustained clinical response, defined as the absence of CDI recurrence within 8 weeks and 6 months, respectively, were evaluated.</p><p><strong>Results: </strong>TEAEs were experienced by 75% (6/8) of participants; most were mild to moderate in severity, and none due to RBL or its administration. Most participants had treatment success (80%; 8/10); 75% (6/8) had sustained clinical response.</p><p><strong>Conclusion: </strong>Real-world safety and efficacy of RBL administered <i>via</i> colonoscopy were consistent with clinical trials of rectally administered RBL.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10962041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-22eCollection Date: 2024-01-01DOI: 10.1177/17562848241239590
Andrea Pasta, Filippo Pelizzaro, Elisa Marabotto, Francesco Calabrese, Elena Formisano, Shirin Djahandideh Sheijani, Giovanni Brandimarte, Giampiero Manes, Antonietta Gerarda Gravina, Edoardo Vincenzo Savarino
Background: Gastroesophageal reflux disease (GERD) is a challenging condition that involves different physicians, such as general practitioners (GPs), gastroenterologists, and ears, nose and throat (ENT) specialists. A common approach consists of proton-pump inhibitors (PPIs) administration. Adjunctive pharmacological treatment may have a role in the management of non-responders to PPIs.
Objectives: We aimed to survey GPs and different medical specialists to investigate the medical approaches to patients reporting GERD symptoms. In addition, we examined the use of adjunctive pharmacological treatments in patients with GERD symptoms who do not respond to PPIs.
Design: Retrospective observational study.
Methods: A survey was conducted among a large sample of gastroenterologists, GPs, and ENT specialists. Symptoms were divided into typical and extraesophageal, and their severity and impact on quality of life were explored with the GERD Impact Scale and with Reflux Symptom Index (RSI). All therapies administered usually for GERD were investigated.
Results: A total of 6211 patients were analyzed in this survey. Patients with typical symptoms were 53.5%, while those with extraesophageal symptoms were 46.5%. The latter were more frequently reported by ENT patients (53.6%, p < 0.0001). The GSI was higher in patients followed by gastroenterologists (9 points) and GPs (9 points) than ENT specialists (8 points), but the RSI was higher in the ENT group (14.3 ± 6.93) than in GPs and gastroenterologist groups (10.36 ± 6.36 and 10.81 ± 7.30, p < 0.0001). Chest pain had the highest negative impact on quality of life (p < 0.0001). Of the 3025 patients who used PPIs, non-responders showed a lower GSI when treated with a combination of adjunctive pharmacological treatments and bioadhesive compounds, than with single-component drugs.
Conclusion: Patients with GERD referred to a gastroenterologist had more severe disease and poorer quality of life. The combination of adjunctive pharmacological treatments and bioadhesive compounds seems to be effective in the management of PPI refractory patients.
背景:胃食管反流病(GERD)是一种具有挑战性的疾病,涉及不同的医生,如全科医生(GP)、肠胃病专家和耳鼻喉科专家。常见的治疗方法包括服用质子泵抑制剂(PPIs)。对于质子泵抑制剂无效的患者,辅助药物治疗可能会起到一定的作用:我们的目的是对全科医生和不同的医学专家进行调查,以了解对报告有胃食管反流症状的患者采取的医疗方法。此外,我们还研究了对 PPIs 无应答的胃食管反流病患者使用辅助药物治疗的情况:设计:回顾性观察研究:方法:对胃肠病专家、全科医生和耳鼻喉科专家进行大样本调查。症状分为典型症状和食管外症状,并通过胃食管反流影响量表(GERD Impact Scale)和反流症状指数(RSI)探讨了症状的严重程度及其对生活质量的影响。对所有通常用于治疗胃食管反流病的疗法进行了调查:本次调查共分析了 6211 名患者。有典型症状的患者占 53.5%,有食道外症状的患者占 46.5%。后者更多由耳鼻喉科患者报告(53.6%,p p p p 结论:转诊至消化内科医生的胃食管反流病患者病情更严重,生活质量更差。在治疗 PPI 难治性患者时,将辅助药物治疗和生物黏附剂结合使用似乎很有效。
{"title":"Patient journey in gastroesophageal reflux disease: real-world perspectives from Italian gastroenterologists, primary care physicians, and ENT specialists.","authors":"Andrea Pasta, Filippo Pelizzaro, Elisa Marabotto, Francesco Calabrese, Elena Formisano, Shirin Djahandideh Sheijani, Giovanni Brandimarte, Giampiero Manes, Antonietta Gerarda Gravina, Edoardo Vincenzo Savarino","doi":"10.1177/17562848241239590","DOIUrl":"10.1177/17562848241239590","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux disease (GERD) is a challenging condition that involves different physicians, such as general practitioners (GPs), gastroenterologists, and ears, nose and throat (ENT) specialists. A common approach consists of proton-pump inhibitors (PPIs) administration. Adjunctive pharmacological treatment may have a role in the management of non-responders to PPIs.</p><p><strong>Objectives: </strong>We aimed to survey GPs and different medical specialists to investigate the medical approaches to patients reporting GERD symptoms. In addition, we examined the use of adjunctive pharmacological treatments in patients with GERD symptoms who do not respond to PPIs.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>A survey was conducted among a large sample of gastroenterologists, GPs, and ENT specialists. Symptoms were divided into typical and extraesophageal, and their severity and impact on quality of life were explored with the GERD Impact Scale and with Reflux Symptom Index (RSI). All therapies administered usually for GERD were investigated.</p><p><strong>Results: </strong>A total of 6211 patients were analyzed in this survey. Patients with typical symptoms were 53.5%, while those with extraesophageal symptoms were 46.5%. The latter were more frequently reported by ENT patients (53.6%, <i>p</i> < 0.0001). The GSI was higher in patients followed by gastroenterologists (9 points) and GPs (9 points) than ENT specialists (8 points), but the RSI was higher in the ENT group (14.3 ± 6.93) than in GPs and gastroenterologist groups (10.36 ± 6.36 and 10.81 ± 7.30, <i>p</i> < 0.0001). Chest pain had the highest negative impact on quality of life (<i>p</i> < 0.0001). Of the 3025 patients who used PPIs, non-responders showed a lower GSI when treated with a combination of adjunctive pharmacological treatments and bioadhesive compounds, than with single-component drugs.</p><p><strong>Conclusion: </strong>Patients with GERD referred to a gastroenterologist had more severe disease and poorer quality of life. The combination of adjunctive pharmacological treatments and bioadhesive compounds seems to be effective in the management of PPI refractory patients.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-21eCollection Date: 2024-01-01DOI: 10.1177/17562848241239606
Péter Bacsur, Panu Wetwittayakhlang, Tamás Resál, Emese Földi, Béla Vasas, Bernadett Farkas, Mariann Rutka, Talat Bessissow, Waqqas Afif, Anita Bálint, Anna Fábián, Renáta Bor, Zoltán Szepes, Klaudia Farkas, Peter L Lakatos, Tamás Molnár
Background: Different endoscopic scoring systems for assessing ulcerative colitis (UC) severity are available. However, most of them are not correlated with disease extent.
Objectives: Our study aimed to compare the predictive value of the PanMay score versus the endoscopic Mayo (MES), Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and Dublin score in predicting long-term outcomes of UC.
Design: This retrospective study enrolled consecutive UC patients who underwent colonoscopy before at least a 3-year follow-up.
Methods: The PanMayo, MES, UCEIS, and Dublin scores and the baseline clinical and demographic characteristics of the participants were assessed. Endpoints were disease flare that required novel biological therapy, colectomy, and hospitalization. Patients were stratified using baseline clinical activity.
Results: Approximately 62.8% of the 250 enrolled patients were in clinical remission. In these patients, the PanMayo, MES, and Dublin scores were positively associated with the risk of clinical flare. The MES score increased with clinical flare. The PanMayo score (>12 points), but not the MES score, was associated with the need for novel biological initiation and biological escalation. Furthermore, the Dublin and UCEIS scores of patients in remission who need novel biological treatment had a similar trend. Colectomy risk was associated with PanMayo and Dublin scores.
Conclusion: The combined endoscopic assessment of disease extent and severity can be more accurate in predicting outcomes among patients with UC. PanMayo score can be utilized in addition to the existing scoring systems, thereby leading to a more accurate examination.
Summary: UC endoscopic scores do not assess extension. Our study aimed to analyze the predictive value of the PanMayo score. Based on 250 patients, results showed that the long-term disease outcomes of UC could be predicted with the PanMayo score more accurately.
{"title":"Accuracy of the Pancolonic Modified Mayo Score in predicting the long-term outcomes of ulcerative colitis: a promising scoring system.","authors":"Péter Bacsur, Panu Wetwittayakhlang, Tamás Resál, Emese Földi, Béla Vasas, Bernadett Farkas, Mariann Rutka, Talat Bessissow, Waqqas Afif, Anita Bálint, Anna Fábián, Renáta Bor, Zoltán Szepes, Klaudia Farkas, Peter L Lakatos, Tamás Molnár","doi":"10.1177/17562848241239606","DOIUrl":"10.1177/17562848241239606","url":null,"abstract":"<p><strong>Background: </strong>Different endoscopic scoring systems for assessing ulcerative colitis (UC) severity are available. However, most of them are not correlated with disease extent.</p><p><strong>Objectives: </strong>Our study aimed to compare the predictive value of the PanMay score <i>versus</i> the endoscopic Mayo (MES), Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and Dublin score in predicting long-term outcomes of UC.</p><p><strong>Design: </strong>This retrospective study enrolled consecutive UC patients who underwent colonoscopy before at least a 3-year follow-up.</p><p><strong>Methods: </strong>The PanMayo, MES, UCEIS, and Dublin scores and the baseline clinical and demographic characteristics of the participants were assessed. Endpoints were disease flare that required novel biological therapy, colectomy, and hospitalization. Patients were stratified using baseline clinical activity.</p><p><strong>Results: </strong>Approximately 62.8% of the 250 enrolled patients were in clinical remission. In these patients, the PanMayo, MES, and Dublin scores were positively associated with the risk of clinical flare. The MES score increased with clinical flare. The PanMayo score (>12 points), but not the MES score, was associated with the need for novel biological initiation and biological escalation. Furthermore, the Dublin and UCEIS scores of patients in remission who need novel biological treatment had a similar trend. Colectomy risk was associated with PanMayo and Dublin scores.</p><p><strong>Conclusion: </strong>The combined endoscopic assessment of disease extent and severity can be more accurate in predicting outcomes among patients with UC. PanMayo score can be utilized in addition to the existing scoring systems, thereby leading to a more accurate examination.</p><p><strong>Summary: </strong>UC endoscopic scores do not assess extension. Our study aimed to analyze the predictive value of the PanMayo score. Based on 250 patients, results showed that the long-term disease outcomes of UC could be predicted with the PanMayo score more accurately.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}