Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00383-2
Eline M L van der Does de Willebois, Willem A Bemelman, Christianne J Buskens
No Abstract
没有抽象的
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Pub Date : 2024-12-11DOI: 10.1016/s2468-1253(24)00400-x
Click B, Holubar SD. Targeting the mesentery with surgery in ileocolic Crohn's disease: where do we stand? Lancet Gastroenterol Hepatol 2024; 9: 774–75—In this Comment, the last sentence of the third paragraph should read “While previously described extended mesenteric excision approaches incorporate a high ligation of the ileocolic pedicle, van der Does de Willebois and colleagues assess a modified approach that spares the ileocolic trunk.” The first sentence of the fourth paragraph should read “In the SPICY trial, a total of 139 surgically-naive patients with ileal or ileocolonic Crohn's disease were randomly assigned to either extended mesenteric excision sparing the ileocolic trunk or a traditional side-to-side anastomosis with a mesenteric sparing approach.” The second sentence of the last paragraph should read “Furthermore, whether the extended mesenteric excision approach in SPICY, which spares the ileocolic trunk, differs from an approach that takes the trunk is unknown and deserves exploration.” These corrections have been made to the online version as of Dec 11, 2024.
单击B， Holubar SD。针对肠系膜手术治疗回结肠性克罗恩病：进展如何？Lancet Gastroenterol Hepatol 2024；[09:774 - 75]在这篇评论中，第三段的最后一句话应该是：“虽然先前描述的扩展肠系膜切除入路包括高度结扎回结肠蒂，但van der Does de Willebois及其同事评估了一种保留回结肠干的改良入路。”第四段的第一句话应该是：“在SPICY试验中，共有139例手术初始的回肠或回结肠克罗恩病患者被随机分配到保留回肠结肠干的扩展肠系膜切除或保留肠系膜的传统侧对侧吻合。”最后一段的第二句应该是“此外，在麻风手术中，保留回结肠干的扩展肠系膜切除入路与切除回结肠干的入路是否不同尚不清楚，值得探讨。”这些更正已于2024年12月11日对在线版本进行了修改。
{"title":"Correction to Lancet Gastroenterol Hepatol 2024; 9: 774–75","authors":"","doi":"10.1016/s2468-1253(24)00400-x","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00400-x","url":null,"abstract":"<em>Click B, Holubar SD. Targeting the mesentery with surgery in ileocolic Crohn's disease: where do we stand?</em> Lancet Gastroenterol Hepatol <em>2024;</em> 9: <em>774–75</em>—In this Comment, the last sentence of the third paragraph should read “While previously described extended mesenteric excision approaches incorporate a high ligation of the ileocolic pedicle, van der Does de Willebois and colleagues assess a modified approach that spares the ileocolic trunk.” The first sentence of the fourth paragraph should read “In the SPICY trial, a total of 139 surgically-naive patients with ileal or ileocolonic Crohn's disease were randomly assigned to either extended mesenteric excision sparing the ileocolic trunk or a traditional side-to-side anastomosis with a mesenteric sparing approach.” The second sentence of the last paragraph should read “Furthermore, whether the extended mesenteric excision approach in SPICY, which spares the ileocolic trunk, differs from an approach that takes the trunk is unknown and deserves exploration.” These corrections have been made to the online version as of Dec 11, 2024.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"239 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809531","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 : 2024-12-11DOI: 10.1016/s2468-1253(24)00392-3
Rob Brierley
Section snippets
Semaglutide for MASH
Semaglutide 2·4 mg once a week demonstrated significantly greater improvements in histology and fibrosis than did placebo in participants with metabolic dysfunction-associated steatohepatitis (MASH) with F2–F3 fibrosis, according to data from the phase 3 ESSENCE trial. Although the trial is ongoing, Phil Newsome (London, UK) presented data from the prespecified interim analysis at week 72 of the first 800 participants, of whom 534 had been randomly assigned to receive semaglutide and 266 had
Optimising steroid use in severe alcohol-associated hepatitis
Tapering the dose of corticosteroids is safer and just as efficacious as conventional fixed-dose corticosteroids for severe alcohol-associated hepatitis, according to results from the STASH trial, presented by Anand Kulkarni (Hyderabad, India). Patients with severe alcohol-associated hepatitis were randomly assigned to receive either a fixed-dose or tapering regimen. Patients in each group initially received 40 mg prednisolone a day for 7 days. Patients in the fixed dose group with a Lille
CM-101 in primary sclerosing cholangitis
CM-101, an anti-CCL24 monoclonal antibody, exhibited promising activity in patients with primary sclerosing cholangitis and had a safety profile similar to placebo, according to data from the phase 2 SPRING study. In this placebo-controlled trial, presented by Christopher Bowlus (Davis, CA, USA), patients with primary sclerosing cholangitis were randomly assigned to receive either CM-101 at 10 mg/kg (n=25), CM-101 at 20 mg/kg (n=31), or placebo (n=21) every 3 weeks for 15 weeks.
VK2809 for steatotic liver disease
The phase 2b VOYAGE trial examined the use of VK2809, a small molecule thyroid hormone receptor beta agonist prodrug that is selectively cleaved in hepatic tissue by cytochrome P450 3A4 to release a pharmacologically active metabolite, in individuals with biopsy-confirmed non-alcoholic fatty liver disease and fibrosis. Participants were randomly assigned to receive placebo or VK2809 at 1 mg/day, 2·5 mg/day, 5 mg/day, or 10 mg/day. Percentage change in MRI-PDFF at 3 months was –56·7% in the
{"title":"The Liver Meeting 2024","authors":"Rob Brierley","doi":"10.1016/s2468-1253(24)00392-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00392-3","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Semaglutide for MASH</h2>Semaglutide 2·4 mg once a week demonstrated significantly greater improvements in histology and fibrosis than did placebo in participants with metabolic dysfunction-associated steatohepatitis (MASH) with F2–F3 fibrosis, according to data from the phase 3 ESSENCE trial. Although the trial is ongoing, Phil Newsome (London, UK) presented data from the prespecified interim analysis at week 72 of the first 800 participants, of whom 534 had been randomly assigned to receive semaglutide and 266 had</section></section><section><section><h2>Optimising steroid use in severe alcohol-associated hepatitis</h2>Tapering the dose of corticosteroids is safer and just as efficacious as conventional fixed-dose corticosteroids for severe alcohol-associated hepatitis, according to results from the STASH trial, presented by Anand Kulkarni (Hyderabad, India). Patients with severe alcohol-associated hepatitis were randomly assigned to receive either a fixed-dose or tapering regimen. Patients in each group initially received 40 mg prednisolone a day for 7 days. Patients in the fixed dose group with a Lille</section></section><section><section><h2>CM-101 in primary sclerosing cholangitis</h2>CM-101, an anti-CCL24 monoclonal antibody, exhibited promising activity in patients with primary sclerosing cholangitis and had a safety profile similar to placebo, according to data from the phase 2 SPRING study. In this placebo-controlled trial, presented by Christopher Bowlus (Davis, CA, USA), patients with primary sclerosing cholangitis were randomly assigned to receive either CM-101 at 10 mg/kg (n=25), CM-101 at 20 mg/kg (n=31), or placebo (n=21) every 3 weeks for 15 weeks.</section></section><section><section><h2>VK2809 for steatotic liver disease</h2>The phase 2b VOYAGE trial examined the use of VK2809, a small molecule thyroid hormone receptor beta agonist prodrug that is selectively cleaved in hepatic tissue by cytochrome P450 3A4 to release a pharmacologically active metabolite, in individuals with biopsy-confirmed non-alcoholic fatty liver disease and fibrosis. Participants were randomly assigned to receive placebo or VK2809 at 1 mg/day, 2·5 mg/day, 5 mg/day, or 10 mg/day. Percentage change in MRI-PDFF at 3 months was –56·7% in the</section></section>","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"29 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809968","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 : 2024-12-11DOI: 10.1016/s2468-1253(24)00401-1
Janssen HLA, Lim Y-S, Lampertico P, et al. Switching to tenofovir alafenamide in patients with virologically suppressed chronic hepatitis B and renal or hepatic impairment: final week 96 results from an open-label, multicentre, phase 2 study. Lancet Gastroenterol Hepatol 2024; 9: 718–33—In this Article, the label for previous other oral antiviral in figure 3B should have read 0·04; the label for previous tenofovir disproxil fumarate in figure 4C should have read 1·09%; and the label for tenofovir alafenamide in figure 4C should have read 0·28%. These corrections have been made to the online version as of Dec 11, 2024.
{"title":"Correction to Lancet Gastroenterol Hepatol 2024; 9: 718–33","authors":"","doi":"10.1016/s2468-1253(24)00401-1","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00401-1","url":null,"abstract":"<em>Janssen HLA, Lim Y-S, Lampertico P, et al. Switching to tenofovir alafenamide in patients with virologically suppressed chronic hepatitis B and renal or hepatic impairment: final week 96 results from an open-label, multicentre, phase 2 study.</em> Lancet Gastroenterol Hepatol <em>2024;</em> 9: <em>718–33</em>—In this Article, the label for previous other oral antiviral in figure 3B should have read 0·04; the label for previous tenofovir disproxil fumarate in figure 4C should have read 1·09%; and the label for tenofovir alafenamide in figure 4C should have read 0·28%. These corrections have been made to the online version as of Dec 11, 2024.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"538 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809530","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 : 2024-12-09DOI: 10.1016/s2468-1253(24)00351-0
Andreas A Schnitzbauer
No Abstract
没有抽象的
{"title":"Hypovolaemic phlebotomy to reduce the need for perioperative transfusion: a price worth paying?","authors":"Andreas A Schnitzbauer","doi":"10.1016/s2468-1253(24)00351-0","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00351-0","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"148 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142797535","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 : 2024-12-09DOI: 10.1016/s2468-1253(24)00307-8
Guillaume Martel, François Martin Carrier, Christopher Wherrett, Tori Lenet, Katlin Mallette, Karine Brousseau, Leah Monette, Aklile Workneh, Monique Ruel, Elham Sabri, Heather Maddison, Melanie Tokessy, Patrick B Y Wong, Franck Vandenbroucke-Menu, Luc Massicotte, Michaël Chassé, Yves Collin, Michel-Antoine Perrault, Élodie Hamel-Perreault, Jeieung Park, Dean A Fergusson
<h3>Background</h3>Blood loss and subsequent red blood cell transfusions are common in liver surgery. Hypovolaemic phlebotomy is associated with decreased red blood cell transfusion in observational studies. This trial aimed to investigate whether hypovolaemic phlebotomy is superior to usual care in reducing red blood cell transfusions in patients undergoing liver resection.<h3>Methods</h3>PRICE-2 was a multicentre, single-blind, superiority randomised controlled trial. Patients at a higher risk of blood loss undergoing liver resection for any indication at four Canadian academic tertiary-care hospitals were randomised to receive hypovolaemic phlebotomy or usual care. Hypovolaemic phlebotomy consisted of the removal of 7–10 mL/kg of whole blood, without volume replacement, before liver transection. Patients were randomised centrally using permuted blocks of randomly variable length, stratified by centre. The randomisation sequence was computer-generated by an independent statistician. Surgeons, patients, and outcome assessors were masked to treatment allocation. The primary outcome was perioperative red blood cell transfusion to 30 days post-randomisation, analysed in all randomly assigned patients who underwent liver resection. PRICE-2 trial was registered with <span><span>ClinicalTrials.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> (<span><span>NCT03651154</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>) and is completed.<h3>Findings</h3>Between Oct 1, 2018, and Jan 13, 2023, 486 individuals were randomly assigned to receive hypovolaemic phlebotomy (n=245) or usual care (n=241). 22 individuals in the hypovolaemic phlebotomy group and 18 in the usual care group did not undergo liver resection and were thus excluded from the primary analysis population. 223 patients were included in the hypovolaemic phlebotomy group (mean age 61·4 years [SD 13·0]; 137 [61%] men) and 223 in the control group (62·1 years [12·1]; 114 [51%]). 17 (8%) of 223 patients allocated to hypovolaemic phlebotomy and 36 (16%) of 223 patients allocated to usual care had a perioperative red blood cell transfusion by 30 days (difference –8·8 percentage points [95% CI –14·8 to –2·8]; adjusted risk ratio [aRR] 0·47 [95% CI 0·27 to 0·82]). Severe complications to 30 days occurred in 37 (17%) patients allocated to hypovolaemic phlebotomy and 36 (16%) allocated to usual care (aRR 1·06 [95% CI 0·70–1·61]). Overall complications to 30 days occurred in 135 (61%) of 223 patients allocated to hypovolaemic phlebotomy and 116 (52%) of 223 patients allocated to usual care (1·08 [0·92–1·25]). There was no postoperative mortality to 90 days.<h3>Interpretation</h3>In p
背景：在肝脏手术中，失血和随后的红细胞输注是很常见的。在观察性研究中，低血容量放血术与红细胞输注减少有关。本试验旨在探讨低容性静脉切开术在减少肝切除术患者红细胞输注方面是否优于常规护理。方法price -2是一项多中心、单盲、优势随机对照试验。在加拿大四家学术三级医院中，因任何适应症而行肝切除术的失血风险较高的患者被随机分组，接受低血容量放血或常规治疗。低血容量静脉切开术包括在肝横断前不进行容量置换，抽取7-10 mL/kg全血。采用随机可变长度的排列块对患者进行中心随机分组，按中心分层。随机序列是由一位独立的统计学家用电脑生成的。外科医生、患者和结果评估者对治疗分配不知情。主要结局是随机分组后30天的围手术期红细胞输血，分析所有随机分配的接受肝切除术的患者。PRICE-2试验已在ClinicalTrials.gov注册（NCT03651154），并已完成。在2018年10月1日至2023年1月13日期间，486名患者被随机分配接受低血容量放血（n=245）或常规治疗（n=241）。低血容量放血组的22例患者和常规护理组的18例患者未行肝切除术，因此被排除在初步分析人群之外。低血容量放血组223例，平均年龄64.1岁[SD 13.0]；男性137例（61%），对照组223例（62.1岁，12.1岁）；114[51%])。223名低容性放血患者中有17名（8%）和223名常规护理患者中有36名（16%）在30天内进行了围手术期红细胞输注(差异为- 8.8个百分点[95% CI - 14.8至-2·8]；校正风险比[aRR] 0.47 [95% CI 0.27 ~ 0.82])。低血容量放血组37例（17%）患者出现严重并发症，常规护理组36例（16%）患者出现严重并发症（aRR 1.06 [95% CI 0.70 - 1.61]）。223例低血容量放血患者中有135例（61%）出现30天总并发症，223例常规护理患者中有116例（52%）出现并发症（1.08[0.92 - 0.25]）。术后90天无死亡。解释：在肝切除术患者中，低血容量静脉切开术减少了围手术期红细胞输注，改善了手术条件，与常规治疗相比，并发症发生率无统计学意义的增加。低血容量静脉切开术应被认为是肝切除术中出血风险较高的患者的常规应用。加拿大卫生研究所资助（PJT-156108）。
{"title":"Hypovolaemic phlebotomy in patients undergoing hepatic resection at higher risk of blood loss (PRICE-2): a randomised controlled trial","authors":"Guillaume Martel, François Martin Carrier, Christopher Wherrett, Tori Lenet, Katlin Mallette, Karine Brousseau, Leah Monette, Aklile Workneh, Monique Ruel, Elham Sabri, Heather Maddison, Melanie Tokessy, Patrick B Y Wong, Franck Vandenbroucke-Menu, Luc Massicotte, Michaël Chassé, Yves Collin, Michel-Antoine Perrault, Élodie Hamel-Perreault, Jeieung Park, Dean A Fergusson","doi":"10.1016/s2468-1253(24)00307-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00307-8","url":null,"abstract":"<h3>Background</h3>Blood loss and subsequent red blood cell transfusions are common in liver surgery. Hypovolaemic phlebotomy is associated with decreased red blood cell transfusion in observational studies. This trial aimed to investigate whether hypovolaemic phlebotomy is superior to usual care in reducing red blood cell transfusions in patients undergoing liver resection.<h3>Methods</h3>PRICE-2 was a multicentre, single-blind, superiority randomised controlled trial. Patients at a higher risk of blood loss undergoing liver resection for any indication at four Canadian academic tertiary-care hospitals were randomised to receive hypovolaemic phlebotomy or usual care. Hypovolaemic phlebotomy consisted of the removal of 7–10 mL/kg of whole blood, without volume replacement, before liver transection. Patients were randomised centrally using permuted blocks of randomly variable length, stratified by centre. The randomisation sequence was computer-generated by an independent statistician. Surgeons, patients, and outcome assessors were masked to treatment allocation. The primary outcome was perioperative red blood cell transfusion to 30 days post-randomisation, analysed in all randomly assigned patients who underwent liver resection. PRICE-2 trial was registered with <span><span>ClinicalTrials.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> (<span><span>NCT03651154</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>) and is completed.<h3>Findings</h3>Between Oct 1, 2018, and Jan 13, 2023, 486 individuals were randomly assigned to receive hypovolaemic phlebotomy (n=245) or usual care (n=241). 22 individuals in the hypovolaemic phlebotomy group and 18 in the usual care group did not undergo liver resection and were thus excluded from the primary analysis population. 223 patients were included in the hypovolaemic phlebotomy group (mean age 61·4 years [SD 13·0]; 137 [61%] men) and 223 in the control group (62·1 years [12·1]; 114 [51%]). 17 (8%) of 223 patients allocated to hypovolaemic phlebotomy and 36 (16%) of 223 patients allocated to usual care had a perioperative red blood cell transfusion by 30 days (difference –8·8 percentage points [95% CI –14·8 to –2·8]; adjusted risk ratio [aRR] 0·47 [95% CI 0·27 to 0·82]). Severe complications to 30 days occurred in 37 (17%) patients allocated to hypovolaemic phlebotomy and 36 (16%) allocated to usual care (aRR 1·06 [95% CI 0·70–1·61]). Overall complications to 30 days occurred in 135 (61%) of 223 patients allocated to hypovolaemic phlebotomy and 116 (52%) of 223 patients allocated to usual care (1·08 [0·92–1·25]). There was no postoperative mortality to 90 days.<h3>Interpretation</h3>In p","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"234 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142797382","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 : 2024-12-05DOI: 10.1016/s2468-1253(24)00311-x
Serena Porcari, Benjamin H Mullish, Francesco Asnicar, Siew C Ng, Liping Zhao, Richard Hansen, Paul W O'Toole, Jeroen Raes, Georgina Hold, Lorenza Putignani, Christian Lodberg Hvas, Georg Zeller, Omry Koren, Hein Tun, Mireia Valles-Colomer, Maria Carmen Collado, Monika Fischer, Jessica Allegretti, Tariq Iqbal, Benoit Chassaing, Gianluca Ianiro
There is growing interest in the potential exploitation of the gut microbiome as a diagnostic tool in medicine, but evidence supporting its clinical usefulness is scarce. An increasing number of commercial providers offer direct-to-consumer microbiome diagnostic tests without any consensus on their regulation or any proven value in clinical practice, which could result in considerable waste of individual and health-care resources and potential drawbacks in the clinical management of patients. We convened an international multidisciplinary expert panel to standardise best practices of microbiome testing for clinical implementation, including recommendations on general principles and minimum requirements for their provision, indications, pre-testing protocols, method of analyses, reporting of results, and potential clinical value. We also evaluated current knowledge gaps and future directions in this field. We aimed to establish a framework to regulate the provision of microbiome testing and minimise the use of inappropriate tests and pave the way for the evidence-based development and use of human microbiome diagnostics in clinical medicine.
{"title":"International consensus statement on microbiome testing in clinical practice","authors":"Serena Porcari, Benjamin H Mullish, Francesco Asnicar, Siew C Ng, Liping Zhao, Richard Hansen, Paul W O'Toole, Jeroen Raes, Georgina Hold, Lorenza Putignani, Christian Lodberg Hvas, Georg Zeller, Omry Koren, Hein Tun, Mireia Valles-Colomer, Maria Carmen Collado, Monika Fischer, Jessica Allegretti, Tariq Iqbal, Benoit Chassaing, Gianluca Ianiro","doi":"10.1016/s2468-1253(24)00311-x","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00311-x","url":null,"abstract":"There is growing interest in the potential exploitation of the gut microbiome as a diagnostic tool in medicine, but evidence supporting its clinical usefulness is scarce. An increasing number of commercial providers offer direct-to-consumer microbiome diagnostic tests without any consensus on their regulation or any proven value in clinical practice, which could result in considerable waste of individual and health-care resources and potential drawbacks in the clinical management of patients. We convened an international multidisciplinary expert panel to standardise best practices of microbiome testing for clinical implementation, including recommendations on general principles and minimum requirements for their provision, indications, pre-testing protocols, method of analyses, reporting of results, and potential clinical value. We also evaluated current knowledge gaps and future directions in this field. We aimed to establish a framework to regulate the provision of microbiome testing and minimise the use of inappropriate tests and pave the way for the evidence-based development and use of human microbiome diagnostics in clinical medicine.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"3 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782378","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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