Pub Date : 2025-01-07DOI: 10.1016/s2468-1253(24)00397-2
Raja Atreya, Markus F Neurath
No Abstract
没有抽象的
{"title":"No easy way out: blocking lymphocyte egress by the S1P1 receptor 1 modulator tamuzimod in ulcerative colitis","authors":"Raja Atreya, Markus F Neurath","doi":"10.1016/s2468-1253(24)00397-2","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00397-2","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"8 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936065","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 : 2025-01-06DOI: 10.1016/s2468-1253(24)00319-4
Ohad Atia, Zivia Shavit-Brunschwig, Raffi Lev-Tzion, Ronen Stein, Efrat Broide, Darja Urlep, Jeffrey Hyams, Batia Weiss, Marina Aloi, Amit Assa, Konstantinos Gerasimidis, Ben Nichols, Richard K Russell, Dan Turner
<h3>Background</h3>Infliximab and adalimumab are the only biologics thus far approved for paediatric patients with inflammatory bowel disease (IBD), so other biologics, such as vedolizumab, are prescribed off-label. Despite its frequent use, prospective data for vedolizumab treatment in children are available only for short-term induction outcomes. We aimed to evaluate the long-term efficacy and safety of maintenance therapy with vedolizumab in paediatric patients with IBD.<h3>Methods</h3>In this multicentre, prospective, cohort study (VEDOKIDS), children younger than 18 years with Crohn's disease, ulcerative colitis, or IBD unclassified (analysed with the ulcerative colitis group) who had initiated intravenous vedolizumab were enrolled from 17 centres in six countries (Israel, the USA, Italy, Ireland, Denmark, and Slovenia). Patients initiating vedolizumab to prevent postoperative recurrence were excluded. Vedolizumab dose or schedule were not standardised, and concomitant treatment with any other medication was permitted. Patients were prospectively followed up for 54 weeks, with repeated biosampling. The primary outcome was complete remission at week 54, defined as clinical remission (weighted Paediatric Crohn's Disease Activity Index [wPCDAI] of <12·5 points in Crohn's disease and Paediatric Ulcerative Colitis Activity Index [PUCAI] of <10 in ulcerative colitis) without the need for surgery, exclusive enteral nutrition for children with Crohn's disease, or steroids (steroid-free and exclusive enteral nutrition-free clinical remission) plus CRP concentration lower than 1·5 times the upper limit of normal (ULN) of 0·5 mg/dL. In cases of missing data on CRP, ESR was used instead (concentrations <1·5 times the ULN, which was 25 mm/h). Data were analysed by intention to treat. This study is 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>NCT02862132</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>.<h3>Findings</h3>Between May 19, 2016, and April 1, 2022, we enrolled 142 patients. Five children who had received only one or two infusions of their three-infusion induction before switching drugs due to COVID-19 pandemic-related reasons were excluded, leaving 137 children (64 [47%] with Crohn's disease, 64 [47%] with ulcerative colitis, and nine [7%] with IBD unclassified; 63 [46%] male and 74 [54%] female; age range of 0·7–17·6 years) in the intention-to-treat population. The median wPCDAI score in children with Crohn's disease decreased from 35 (IQR 18 to 49) at baseline to 13 (0 to 25; median of differences –14 [95% CI –33 to 0]) at week 54, and the median PUCA
{"title":"Maintenance treatment with vedolizumab in paediatric inflammatory bowel disease (VEDOKIDS): 54-week outcomes of a multicentre, prospective, cohort study","authors":"Ohad Atia, Zivia Shavit-Brunschwig, Raffi Lev-Tzion, Ronen Stein, Efrat Broide, Darja Urlep, Jeffrey Hyams, Batia Weiss, Marina Aloi, Amit Assa, Konstantinos Gerasimidis, Ben Nichols, Richard K Russell, Dan Turner","doi":"10.1016/s2468-1253(24)00319-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00319-4","url":null,"abstract":"<h3>Background</h3>Infliximab and adalimumab are the only biologics thus far approved for paediatric patients with inflammatory bowel disease (IBD), so other biologics, such as vedolizumab, are prescribed off-label. Despite its frequent use, prospective data for vedolizumab treatment in children are available only for short-term induction outcomes. We aimed to evaluate the long-term efficacy and safety of maintenance therapy with vedolizumab in paediatric patients with IBD.<h3>Methods</h3>In this multicentre, prospective, cohort study (VEDOKIDS), children younger than 18 years with Crohn's disease, ulcerative colitis, or IBD unclassified (analysed with the ulcerative colitis group) who had initiated intravenous vedolizumab were enrolled from 17 centres in six countries (Israel, the USA, Italy, Ireland, Denmark, and Slovenia). Patients initiating vedolizumab to prevent postoperative recurrence were excluded. Vedolizumab dose or schedule were not standardised, and concomitant treatment with any other medication was permitted. Patients were prospectively followed up for 54 weeks, with repeated biosampling. The primary outcome was complete remission at week 54, defined as clinical remission (weighted Paediatric Crohn's Disease Activity Index [wPCDAI] of <12·5 points in Crohn's disease and Paediatric Ulcerative Colitis Activity Index [PUCAI] of <10 in ulcerative colitis) without the need for surgery, exclusive enteral nutrition for children with Crohn's disease, or steroids (steroid-free and exclusive enteral nutrition-free clinical remission) plus CRP concentration lower than 1·5 times the upper limit of normal (ULN) of 0·5 mg/dL. In cases of missing data on CRP, ESR was used instead (concentrations <1·5 times the ULN, which was 25 mm/h). Data were analysed by intention to treat. This study is 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>NCT02862132</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>.<h3>Findings</h3>Between May 19, 2016, and April 1, 2022, we enrolled 142 patients. Five children who had received only one or two infusions of their three-infusion induction before switching drugs due to COVID-19 pandemic-related reasons were excluded, leaving 137 children (64 [47%] with Crohn's disease, 64 [47%] with ulcerative colitis, and nine [7%] with IBD unclassified; 63 [46%] male and 74 [54%] female; age range of 0·7–17·6 years) in the intention-to-treat population. The median wPCDAI score in children with Crohn's disease decreased from 35 (IQR 18 to 49) at baseline to 13 (0 to 25; median of differences –14 [95% CI –33 to 0]) at week 54, and the median PUCA","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"6 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935147","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 : 2025-01-06DOI: 10.1016/s2468-1253(24)00381-9
Elizabeth A Spencer
No Abstract
没有抽象的
{"title":"Long-term VEDOKIDS results: implications for practice and research","authors":"Elizabeth A Spencer","doi":"10.1016/s2468-1253(24)00381-9","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00381-9","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"28 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935148","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 : 2024-12-19DOI: 10.1016/s2468-1253(24)00429-1
James L Alexander, Nick Powell, Freddy Caldera, Nick Kennedy, Shahida Din
No Abstract
没有抽象的
{"title":"Widening access to recombinant zoster vaccination in IBD","authors":"James L Alexander, Nick Powell, Freddy Caldera, Nick Kennedy, Shahida Din","doi":"10.1016/s2468-1253(24)00429-1","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00429-1","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"65 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857697","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 : 2024-12-17DOI: 10.1016/s2468-1253(24)00389-3
Catherine Freeland, Jack Wallace, Su Wang, Prince Okinedo, Kenneth Kabagambe, Theobald Owusu-Ansah, Dee Lee, Charles Ampong Adjei, Thomas Tu, Chari Cohen
No Abstract
无摘要
{"title":"The urgent need to end hepatitis B stigma and discrimination","authors":"Catherine Freeland, Jack Wallace, Su Wang, Prince Okinedo, Kenneth Kabagambe, Theobald Owusu-Ansah, Dee Lee, Charles Ampong Adjei, Thomas Tu, Chari Cohen","doi":"10.1016/s2468-1253(24)00389-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00389-3","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"64 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841076","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 : 2024-12-16DOI: 10.1016/s2468-1253(24)00320-0
Anne Catrine Daugaard Mikkelsen, Kristoffer Kjærgaard, Anthony H V Schapira, Rajeshwar P Mookerjee, Karen Louise Thomsen
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects around 30% of the global population. Studies suggest that MASLD is associated with compromised brain health and cognitive dysfunction, initiating a growing interest in exploring the liver–brain axis mechanistically within MASLD pathophysiology. With the prevalence of MASLD increasing at an alarming rate, leaving a large proportion of people potentially at risk, cognitive dysfunction in MASLD is a health challenge that requires careful consideration and awareness. This Review summarises the current literature on cognitive function in people with MASLD and discusses plausible causes for its impairment. It is likely that a multifaceted spectrum of factors works collectively to affect cognition in patients with MASLD. We describe the role of inflammation, vascular disease, and brain ageing and neurodegeneration as possible key players. This Review also highlights the need for future studies to identify the optimal test for diagnosing cognitive dysfunction in patients with MASLD, to examine the correlation between MASLD progression and the severity of cognitive dysfunction, and to evaluate whether new MASLD-targeted therapies also improve brain dysfunction.
{"title":"The liver–brain axis in metabolic dysfunction-associated steatotic liver disease","authors":"Anne Catrine Daugaard Mikkelsen, Kristoffer Kjærgaard, Anthony H V Schapira, Rajeshwar P Mookerjee, Karen Louise Thomsen","doi":"10.1016/s2468-1253(24)00320-0","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00320-0","url":null,"abstract":"Metabolic dysfunction-associated steatotic liver disease (MASLD) affects around 30% of the global population. Studies suggest that MASLD is associated with compromised brain health and cognitive dysfunction, initiating a growing interest in exploring the liver–brain axis mechanistically within MASLD pathophysiology. With the prevalence of MASLD increasing at an alarming rate, leaving a large proportion of people potentially at risk, cognitive dysfunction in MASLD is a health challenge that requires careful consideration and awareness. This Review summarises the current literature on cognitive function in people with MASLD and discusses plausible causes for its impairment. It is likely that a multifaceted spectrum of factors works collectively to affect cognition in patients with MASLD. We describe the role of inflammation, vascular disease, and brain ageing and neurodegeneration as possible key players. This Review also highlights the need for future studies to identify the optimal test for diagnosing cognitive dysfunction in patients with MASLD, to examine the correlation between MASLD progression and the severity of cognitive dysfunction, and to evaluate whether new MASLD-targeted therapies also improve brain dysfunction.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"8 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142832845","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 : 2024-12-13DOI: 10.1016/s2468-1253(24)00384-4
Julie Jemutai, Louise Downs, Motswedi Anderson, Chari Cohen, Janet Seeley, Binta Sultan, Joy Ko, Stuart Flanagan, Collins Iwuji, Rachel Halford, Oriel Fernandes, Peter Vickerman, Asgeir Johannessen, Philippa C Matthews
No Abstract
没有抽象的
{"title":"Elimination of hepatitis B requires recognition of catastrophic costs for patients and their families","authors":"Julie Jemutai, Louise Downs, Motswedi Anderson, Chari Cohen, Janet Seeley, Binta Sultan, Joy Ko, Stuart Flanagan, Collins Iwuji, Rachel Halford, Oriel Fernandes, Peter Vickerman, Asgeir Johannessen, Philippa C Matthews","doi":"10.1016/s2468-1253(24)00384-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00384-4","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"20 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820675","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 : 2024-12-12DOI: 10.1016/s2468-1253(24)00313-3
Andrea Lindfors, Rickard Strandberg, Hannes Hagström
<h3>Background</h3>International guidelines suggest screening for advanced fibrosis due to metabolic dysfunction-associated steatotic liver disease in people with type 2 diabetes, but how to implement these guidelines in clinical care remains unclear. We hypothesise that examination with VCTE could be implemented simultaneously with retina scanning with a high acceptance rate in people with type 2 diabetes.<h3>Methods</h3>In this cross-sectional study, we offered VCTE to people with type 2 diabetes referred to routine retina scanning in a large retina scanning facility in Stockholm, Sweden. We excluded people with type 1 diabetes, currently pregnant, with known liver disease, reporting high alcohol consumption, who did not speak Swedish, or younger than 18 years. Between Nov 6, 2020, and June 20, 2023, we conducted surveys with included participants and collected data from medical records on diabetes retinopathy, sex, and VCTE measurements. Increased liver stiffness was defined as at least 8·0 kPa, and possible advanced fibrosis as more than 12·0 kPa. Presence of metabolic dysfunction-associated steatotic liver disease was defined as a controlled attenuation parameter (CAP) value of 280 dB/m or higher. Participants with a liver stiffness measurement of at least 8·0 kPa or those with unreliable measurements were subsequently referred for a secondary evaluation at a liver specialist, including a follow-up liver stiffness measurement with VCTE. The primary outcome was the proportion of eligible people approached for screening who accepted. Secondary outcomes were the prevalence of elevated liver stiffness (≥8·0 kPa or >12·0 kPa), presence of metabolic dysfunction-associated steatotic liver disease, and the proportion of elevated liver stiffness readings at the first VCTE examination that were not elevated in the secondary evaluation with a liver specialist. Secondary outcomes were assessed in all participants who accepted screening, except false positives, which were assessed only in participants who had a second examination.<h3>Findings</h3>1301 participants were eligible to undergo assessment with VCTE, which was accepted by 1005 (77·2%). 973 (96·8%) participants had complete measurements, of whom 504 (51·8%) had CAP values of 280 dB/m or higher, indicating metabolic dysfunction-associated steatotic liver disease. Of 977 participants with reliable liver stiffness measurements, 154 (15·8%) had values of at least 8·0 kPa, suggestive of liver fibrosis, and 49 (5·0%) had values higher than 12·0 kPa, indicating possible advanced fibrosis. However, upon reassessment with a second VCTE after referral, 56 (45·2%) of 124 individuals had values less than 8·0 kPa. 74 (7·4%) of 1005 participants had a final liver stiffness of at least 8·0 kPa; 29 (2·9%) had values greater than 12·0 kPa.<h3>Interpretation</h3>Simultaneous examination with VCTE alongside retina scanning had a high acceptance rate among people with type 2 diabetes and could be a strategy for
{"title":"Screening for advanced liver fibrosis due to metabolic dysfunction-associated steatotic liver disease alongside retina scanning in people with type 2 diabetes: a cross-sectional study","authors":"Andrea Lindfors, Rickard Strandberg, Hannes Hagström","doi":"10.1016/s2468-1253(24)00313-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00313-3","url":null,"abstract":"<h3>Background</h3>International guidelines suggest screening for advanced fibrosis due to metabolic dysfunction-associated steatotic liver disease in people with type 2 diabetes, but how to implement these guidelines in clinical care remains unclear. We hypothesise that examination with VCTE could be implemented simultaneously with retina scanning with a high acceptance rate in people with type 2 diabetes.<h3>Methods</h3>In this cross-sectional study, we offered VCTE to people with type 2 diabetes referred to routine retina scanning in a large retina scanning facility in Stockholm, Sweden. We excluded people with type 1 diabetes, currently pregnant, with known liver disease, reporting high alcohol consumption, who did not speak Swedish, or younger than 18 years. Between Nov 6, 2020, and June 20, 2023, we conducted surveys with included participants and collected data from medical records on diabetes retinopathy, sex, and VCTE measurements. Increased liver stiffness was defined as at least 8·0 kPa, and possible advanced fibrosis as more than 12·0 kPa. Presence of metabolic dysfunction-associated steatotic liver disease was defined as a controlled attenuation parameter (CAP) value of 280 dB/m or higher. Participants with a liver stiffness measurement of at least 8·0 kPa or those with unreliable measurements were subsequently referred for a secondary evaluation at a liver specialist, including a follow-up liver stiffness measurement with VCTE. The primary outcome was the proportion of eligible people approached for screening who accepted. Secondary outcomes were the prevalence of elevated liver stiffness (≥8·0 kPa or >12·0 kPa), presence of metabolic dysfunction-associated steatotic liver disease, and the proportion of elevated liver stiffness readings at the first VCTE examination that were not elevated in the secondary evaluation with a liver specialist. Secondary outcomes were assessed in all participants who accepted screening, except false positives, which were assessed only in participants who had a second examination.<h3>Findings</h3>1301 participants were eligible to undergo assessment with VCTE, which was accepted by 1005 (77·2%). 973 (96·8%) participants had complete measurements, of whom 504 (51·8%) had CAP values of 280 dB/m or higher, indicating metabolic dysfunction-associated steatotic liver disease. Of 977 participants with reliable liver stiffness measurements, 154 (15·8%) had values of at least 8·0 kPa, suggestive of liver fibrosis, and 49 (5·0%) had values higher than 12·0 kPa, indicating possible advanced fibrosis. However, upon reassessment with a second VCTE after referral, 56 (45·2%) of 124 individuals had values less than 8·0 kPa. 74 (7·4%) of 1005 participants had a final liver stiffness of at least 8·0 kPa; 29 (2·9%) had values greater than 12·0 kPa.<h3>Interpretation</h3>Simultaneous examination with VCTE alongside retina scanning had a high acceptance rate among people with type 2 diabetes and could be a strategy for ","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"10 26 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816266","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)00403-5
Holly Baker
<h2>Section snippets</h2><section><section><h2>Mirikizumab for Crohn's disease</h2>Mirikizumab, a monoclonal antibody targeting IL-23p19, shows promise for patients with moderately-to-severely active Crohn's disease, according to the <span><span>VIVID-1 phase 3 trial</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>. Marc Ferrante and colleagues randomly assigned patients who had a previous inadequate response, loss of response, or intolerance to one or more therapies to receive either mirikizumab (n=579), ustekinumab (n=287), or placebo (n=199). The coprimary composite endpoints (mirikizumab <em>vs</em> placebo) were the proportion of patients</section></section><section><section><h2>Endoscopic sphincterotomy for post-ERCP pancreatitis</h2>Endoscopic sphincterotomy does not reduce the risk of pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) in patients undergoing biliary drainage for distal malignant biliary obstruction, according to the <span><span>SPHINX trial</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>. Anke M Onnekink and colleagues randomly assigned patients to receive either endoscopic sphincterotomy (n=156) or no sphincterotomy (control group; n=141) before ERCP with fully covered self-expandable metal stent placement. The primary endpoint of</section></section><section><section><h2><span><span>FMT in Crohn's disease</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></h2>Faecal microbiota transplantation (FMT) was not efficacious at inducing remission in patients with Crohn's disease, according to a results from a new study. Dina Kao and colleagues randomly assigned patients with mild-to-moderate Crohn's disease to receive either FMT, delivered initially via colonoscopy followed by weekly capsules, or placebo for 7 weeks. The trial was halted early due to futility—at week 8, none (0%) of 15 patients in the FMT group had achieved the primary endpoint of combined</section></section><section><section><h2>Switch maintenance therapy for gastric cancer</h2>Paclitaxel plus ramucirumab as switch maintenance could be a promising treatment strategy for patients with advanced gastric cancer, according to the <span><span>ARMANI phase 3 trial</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>. Giovanni Randon and colleagues randomly assigned patients with advanced gastric or gastro-oe
mirikizumab是一种靶向IL-23p19的单克隆抗体，根据VIVID-1 iii期临床试验显示，mirikizumab有望用于中度至重度活动性克罗恩病患者。Marc Ferrante及其同事随机分配先前对一种或多种治疗反应不足、反应丧失或不耐受的患者接受mirikizumab （n=579）、ustekinumab （n=287）或安慰剂（n=199）。根据SPHINX试验，主要复合终点（mirikizumab与安慰剂）是内镜下括约肌切开术治疗ERCP后胰腺炎的患者比例。内镜下括约肌切开术不能降低因远端恶性胆道梗阻而行胆道引流的患者内镜下逆行胆道造影术（ERCP）后胰腺炎的风险。Anke M Onnekink及其同事随机分配患者接受内窥镜括约肌切开术（n=156）或不接受括约肌切开术(对照组；n=141)在ERCP前置入全覆盖自膨胀金属支架。根据一项新研究的结果，粪便微生物群移植（FMT）在诱导克罗恩病患者缓解方面无效。Dina Kao及其同事随机分配轻度至中度克罗恩病患者接受FMT治疗，最初通过结肠镜检查，随后每周服用胶囊，或安慰剂治疗7周。该试验因无效而提前停止——在第8周时，FMT组的15名患者中没有（0%）达到联合切换维持治疗胃癌的主要终点紫杉醇加ramucirumab，根据ARMANI 3期试验，切换维持治疗可能是晚期胃癌患者的一种有希望的治疗策略。Giovanni Randon及其同事随机分配在一线化疗（FOLFOX或CAPOX） 3个月后疾病控制的晚期胃癌或胃食管结癌患者切换到紫杉醇加ramucirumab(切换维持组；新的研究表明，卡维地洛加辛伐他汀可能对肝硬化和严重门脉高压患者有益。Edilmar Alvarado-Tapias及其同事将对传统非选择性β受体阻滞剂反应不足的肝硬化和高危静脉曲张患者随机分配到卡维地洛加辛伐他汀组（n=41）或卡维地洛加安慰剂组（n=41）。肝静脉压梯度（HVPG）降低2.97±2.5 mm Hg
{"title":"Research in Brief","authors":"Holly Baker","doi":"10.1016/s2468-1253(24)00403-5","DOIUrl":"https://doi.org/10.1016/s2468-1253(24)00403-5","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Mirikizumab for Crohn's disease</h2>Mirikizumab, a monoclonal antibody targeting IL-23p19, shows promise for patients with moderately-to-severely active Crohn's disease, according to the <span><span>VIVID-1 phase 3 trial</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>. Marc Ferrante and colleagues randomly assigned patients who had a previous inadequate response, loss of response, or intolerance to one or more therapies to receive either mirikizumab (n=579), ustekinumab (n=287), or placebo (n=199). The coprimary composite endpoints (mirikizumab <em>vs</em> placebo) were the proportion of patients</section></section><section><section><h2>Endoscopic sphincterotomy for post-ERCP pancreatitis</h2>Endoscopic sphincterotomy does not reduce the risk of pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) in patients undergoing biliary drainage for distal malignant biliary obstruction, according to the <span><span>SPHINX trial</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>. Anke M Onnekink and colleagues randomly assigned patients to receive either endoscopic sphincterotomy (n=156) or no sphincterotomy (control group; n=141) before ERCP with fully covered self-expandable metal stent placement. The primary endpoint of</section></section><section><section><h2><span><span>FMT in Crohn's disease</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></h2>Faecal microbiota transplantation (FMT) was not efficacious at inducing remission in patients with Crohn's disease, according to a results from a new study. Dina Kao and colleagues randomly assigned patients with mild-to-moderate Crohn's disease to receive either FMT, delivered initially via colonoscopy followed by weekly capsules, or placebo for 7 weeks. The trial was halted early due to futility—at week 8, none (0%) of 15 patients in the FMT group had achieved the primary endpoint of combined</section></section><section><section><h2>Switch maintenance therapy for gastric cancer</h2>Paclitaxel plus ramucirumab as switch maintenance could be a promising treatment strategy for patients with advanced gastric cancer, according to the <span><span>ARMANI phase 3 trial</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>. Giovanni Randon and colleagues randomly assigned patients with advanced gastric or gastro-oe","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"15 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809533","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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