Pub Date : 2025-10-05DOI: 10.1016/s2468-1253(25)00209-2
Yorick L van de Pavert, Janine B Kastelijn, Marc G Besselink, Dieke C Booij, Jurjen J Boonstra, Judith Boot, Marco J Bruno, Olivier R Busch, Freek Daams, Wouter J M Derksen, Paul Fockens, Bas Groot Koerkamp, Jeroen Hagendoorn, Jeanin E van Hooft, Akin Inderson, Willem J Lammers, Daan J Lips, J Sven D Mieog, I Quintus Molenaar, Alexander A F A Veenhof, Babs M Zonderhuis
<h3>Background</h3>In patients with malignant gastric outlet obstruction, endoscopic ultrasonography-guided gastroenterostomy might be superior to surgical gastroenterostomy, but randomised trials are scarce. We aimed to assess time to resumption of oral intake and the rate of persistent or recurrent obstructive symptoms requiring re-intervention following endoscopic ultrasonography-guided gastroenterostomy compared with surgical gastroenterostomy.<h3>Methods</h3>ENDURO was a multicentre, randomised controlled trial conducted at 12 Dutch academic and teaching hospitals. Hospitals with experience in at least 20 LAMS placements of any indication, at least ten endoscopic gastroenterostomies, and approved competence were eligible to perform endoscopic gastroenterostomy independently within the trial. Adults aged 18 years and older with symptomatic, malignant gastric outlet obstruction in a palliative setting were randomly assigned (1:1) to endoscopic or surgical gastroenterostomy. Randomisation was performed with an electronic data capture system using randomly generated permuted blocks of 2 and 4 and stratified by WHO performance status (0–1 and 2–3). The first coprimary outcome was time to resumption of solid oral intake (Gastric Outlet Obstruction Scoring System score ≥2). The second coprimary outcome was non-inferiority for persistent or recurrent obstructive symptoms requiring re-intervention. The predefined non-inferiority margin of the risk difference was 20%. All outcomes were analysed in all randomly assigned participants. This trial was registered in the International Clinical Trials Registry Platform, NL9592, and is completed.<h3>Findings</h3>Between Feb 18, 2022, and Feb 26, 2024, 250 patients were screened, 98 of whom were randomly assigned to endoscopic gastroenterostomy (n=48) or surgical gastroenterostomy (n=50). 43 (44%) patients were female and 55 (56%) were male. Endoscopic gastroenterostomy had a shorter time to solid oral intake than surgical gastroenterostomy (median 1 day [IQR 1–3] <em>vs</em> 3 days [1–6], hazard ratio 2·21 [95% CI 1·43–3·42]; p=0·0003). Endoscopic gastroenterostomy was non-inferior to surgical gastroenterostomy for persistent or recurrent obstructive symptoms requiring re-intervention (five [10%] <em>vs</em> six [12%], risk difference 1·6% [upper limit of 90% CI 8·9]). Overall adverse events were reported in 28 (58%) patients in the endoscopic gastroenterostomy group and 32 (64%) in the surgical gastroenterostomy group (relative risk 0·91 [95% CI 0·66–1·25]). One fatal event occurred in the endoscopic gastroenterostomy group and three fatal events occurred in the surgical gastroenterostomy group.<h3>Interpretation</h3>In patients with malignant gastric outlet obstruction, palliative treatment with endoscopic gastroenterostomy was superior to surgical gastroenterostomy for time to resumption of solid oral intake and was non-inferior for the rate of persistent or recurrent obstructive symptoms requiring re-inte
背景：对于恶性胃出口梗阻的患者，超声内镜引导下的胃肠造口术可能优于手术，但随机试验很少。我们的目的是评估超声内镜引导下的胃肠造口术与外科胃肠造口术后恢复口服摄入的时间和需要再次干预的持续或复发性阻塞性症状的比率。senduro是一项多中心、随机对照试验，在荷兰12所学术和教学医院进行。具有至少20例任何适应症的LAMS安置经验、至少10例内镜下胃肠造口术经验并获得批准的医院有资格在试验中独立进行内镜下胃肠造口术。年龄在18岁及以上的有症状的恶性胃出口梗阻的姑息性患者被随机（1:1）分配到内镜或手术胃肠造口术组。采用电子数据采集系统进行随机化，采用随机生成的2和4组，并按世卫组织绩效状况（0-1和2 - 3）分层。第一个主要终点是恢复固体口服摄入的时间（胃出口阻塞评分系统评分≥2）。第二个主要结局是非劣效性的持续或复发的阻塞性症状需要再次干预。预定义的风险差异非劣效性裕度为20%。对所有随机分配的参与者的所有结果进行分析。该试验已在国际临床试验注册平台NL9592注册，并已完成。在2022年2月18日至2024年2月26日期间，筛选了250例患者，其中98例随机分配到内镜下胃肠造口术（n=48）或手术胃肠造口术（n=50）。女性43例（44%），男性55例（56%）。内镜下胃肠造口术比外科胃肠造口术到固体口服的时间更短（中位1天[IQR 1 - 3] vs 3天[1 - 6]，风险比2.21 [95% CI 1.43 - 3.42]; p= 0.0003）。对于需要再次干预的持续性或复发性梗阻性症状，内镜下胃肠造口术不低于外科胃肠造口术（5例[10%]vs 6例[12%]，风险差异为1.6% [90% CI上限8.9]）。内镜胃肠造口组有28例（58%）患者报告了总体不良事件，手术胃肠造口组有32例（64%）患者报告了总体不良事件（相对危险度0.91 [95% CI 0.66 - 0.25]）。内镜下胃肠造口组发生1例死亡事件，手术组发生3例死亡事件。对于恶性胃出口梗阻患者，在恢复固体口服摄入的时间上，内镜下胃肠造口术的姑息性治疗优于外科胃肠造口术，并且在需要再次干预的持续或复发性梗阻症状的发生率上也不低于外科手术。基于这些结果，内镜下胃肠造口术应该是恶性胃出口梗阻患者的首选姑息治疗方法。资助荷兰癌症协会。
{"title":"Endoscopic versus surgical gastroenterostomy for palliation of malignant gastric outlet obstruction (ENDURO): a randomised controlled trial","authors":"Yorick L van de Pavert, Janine B Kastelijn, Marc G Besselink, Dieke C Booij, Jurjen J Boonstra, Judith Boot, Marco J Bruno, Olivier R Busch, Freek Daams, Wouter J M Derksen, Paul Fockens, Bas Groot Koerkamp, Jeroen Hagendoorn, Jeanin E van Hooft, Akin Inderson, Willem J Lammers, Daan J Lips, J Sven D Mieog, I Quintus Molenaar, Alexander A F A Veenhof, Babs M Zonderhuis","doi":"10.1016/s2468-1253(25)00209-2","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00209-2","url":null,"abstract":"<h3>Background</h3>In patients with malignant gastric outlet obstruction, endoscopic ultrasonography-guided gastroenterostomy might be superior to surgical gastroenterostomy, but randomised trials are scarce. We aimed to assess time to resumption of oral intake and the rate of persistent or recurrent obstructive symptoms requiring re-intervention following endoscopic ultrasonography-guided gastroenterostomy compared with surgical gastroenterostomy.<h3>Methods</h3>ENDURO was a multicentre, randomised controlled trial conducted at 12 Dutch academic and teaching hospitals. Hospitals with experience in at least 20 LAMS placements of any indication, at least ten endoscopic gastroenterostomies, and approved competence were eligible to perform endoscopic gastroenterostomy independently within the trial. Adults aged 18 years and older with symptomatic, malignant gastric outlet obstruction in a palliative setting were randomly assigned (1:1) to endoscopic or surgical gastroenterostomy. Randomisation was performed with an electronic data capture system using randomly generated permuted blocks of 2 and 4 and stratified by WHO performance status (0–1 and 2–3). The first coprimary outcome was time to resumption of solid oral intake (Gastric Outlet Obstruction Scoring System score ≥2). The second coprimary outcome was non-inferiority for persistent or recurrent obstructive symptoms requiring re-intervention. The predefined non-inferiority margin of the risk difference was 20%. All outcomes were analysed in all randomly assigned participants. This trial was registered in the International Clinical Trials Registry Platform, NL9592, and is completed.<h3>Findings</h3>Between Feb 18, 2022, and Feb 26, 2024, 250 patients were screened, 98 of whom were randomly assigned to endoscopic gastroenterostomy (n=48) or surgical gastroenterostomy (n=50). 43 (44%) patients were female and 55 (56%) were male. Endoscopic gastroenterostomy had a shorter time to solid oral intake than surgical gastroenterostomy (median 1 day [IQR 1–3] <em>vs</em> 3 days [1–6], hazard ratio 2·21 [95% CI 1·43–3·42]; p=0·0003). Endoscopic gastroenterostomy was non-inferior to surgical gastroenterostomy for persistent or recurrent obstructive symptoms requiring re-intervention (five [10%] <em>vs</em> six [12%], risk difference 1·6% [upper limit of 90% CI 8·9]). Overall adverse events were reported in 28 (58%) patients in the endoscopic gastroenterostomy group and 32 (64%) in the surgical gastroenterostomy group (relative risk 0·91 [95% CI 0·66–1·25]). One fatal event occurred in the endoscopic gastroenterostomy group and three fatal events occurred in the surgical gastroenterostomy group.<h3>Interpretation</h3>In patients with malignant gastric outlet obstruction, palliative treatment with endoscopic gastroenterostomy was superior to surgical gastroenterostomy for time to resumption of solid oral intake and was non-inferior for the rate of persistent or recurrent obstructive symptoms requiring re-inte","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"8 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226704","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 : 2025-09-30DOI: 10.1016/s2468-1253(25)00198-0
Kaichun Wu, Changqing Zheng, Qian Cao, Yijuan Ding, Xiang Gao, Jie Zhong, Cheng-Tang Chiu, Hu Zhang, Xin Wang, Bangmao Wang, Jie Liang, Xiaowei Liu, Yongjian Zhou, Baohong Xu, Tae-Oh Kim, Xizhong Shen, Dongfeng Chen, Weichang Chen, Yulan Liu, Jun Shen, Tien-Yu Huang
<h3>Background</h3>Etrasimod is an oral, once-daily sphingosine 1-phosphate (S1P) receptor modulator for the treatment of active ulcerative colitis. In the randomised, placebo-controlled, double-blind phase 3 ENLIGHT UC study, also known as the ES101002 study, we aimed to evaluate the efficacy and safety of etrasimod in patients with moderately to severely active ulcerative colitis in East Asia.<h3>Methods</h3>Using a central interactive web response system, in the 12-week induction period, adults (aged 18–75 years, inclusive) with moderately to severely active ulcerative colitis (modified Mayo score [MMS] 4–9 with an endoscopic subscore ≥2 and a rectal bleeding subscore ≥1) and an inadequate response, loss of response, or intolerance to at least one ulcerative colitis treatment were randomly assigned (2:1) to once-daily oral etrasimod 2 mg or placebo. Patients and study staff were masked to treatment assignment. Patients were enrolled from 52 hospitals across China, Taiwan, and Souh Korea. Randomisation was stratified by previous treatment status and baseline disease activity. Patients who had an MMS clinical response at induction period week 12 were re-randomly assigned (1:1) to once-daily oral etrasimod 2 mg or placebo for the 40-week maintenance period. Randomisation was stratified by induction period treatment, previous exposure to biologicals or JAK inhibitors, and concomitant use of oral corticosteroids at induction period baseline. The primary efficacy outcome was MMS clinical remission (stool frequency subscore=0 [or stool frequency subscore=1 with a ≥1 point decrease from induction period baseline], rectal bleeding subscore=0, and endoscopic subscore ≤1 [excluding friability]), assessed in the induction and maintenance periods separately (at induction period week 12 and maintenance period week 40). The primary efficacy analyses used the full analysis set (FAS), which included all patients who were randomly assigned and received at least one dose of study treatment for the induction period, and all re-randomly assigned patients who showed clinical response at induction period week 12 and received at least one dose of study treatment for the maintenance period. The safety analyses for each treatment period used the safety analysis set (SAF), which included all patients who received any amount of study drug in the corresponding treatment period. ENLIGHT UC 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>NCT04176588</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 the study is complete.<h3>Findings</h3>606 patients were screened between Sept 25, 2019, a
{"title":"Etrasimod as induction and maintenance treatment for patients with moderately to severely active ulcerative colitis in East Asia (ENLIGHT UC): a randomised, double-blind, placebo-controlled, multicentre, phase 3 study","authors":"Kaichun Wu, Changqing Zheng, Qian Cao, Yijuan Ding, Xiang Gao, Jie Zhong, Cheng-Tang Chiu, Hu Zhang, Xin Wang, Bangmao Wang, Jie Liang, Xiaowei Liu, Yongjian Zhou, Baohong Xu, Tae-Oh Kim, Xizhong Shen, Dongfeng Chen, Weichang Chen, Yulan Liu, Jun Shen, Tien-Yu Huang","doi":"10.1016/s2468-1253(25)00198-0","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00198-0","url":null,"abstract":"<h3>Background</h3>Etrasimod is an oral, once-daily sphingosine 1-phosphate (S1P) receptor modulator for the treatment of active ulcerative colitis. In the randomised, placebo-controlled, double-blind phase 3 ENLIGHT UC study, also known as the ES101002 study, we aimed to evaluate the efficacy and safety of etrasimod in patients with moderately to severely active ulcerative colitis in East Asia.<h3>Methods</h3>Using a central interactive web response system, in the 12-week induction period, adults (aged 18–75 years, inclusive) with moderately to severely active ulcerative colitis (modified Mayo score [MMS] 4–9 with an endoscopic subscore ≥2 and a rectal bleeding subscore ≥1) and an inadequate response, loss of response, or intolerance to at least one ulcerative colitis treatment were randomly assigned (2:1) to once-daily oral etrasimod 2 mg or placebo. Patients and study staff were masked to treatment assignment. Patients were enrolled from 52 hospitals across China, Taiwan, and Souh Korea. Randomisation was stratified by previous treatment status and baseline disease activity. Patients who had an MMS clinical response at induction period week 12 were re-randomly assigned (1:1) to once-daily oral etrasimod 2 mg or placebo for the 40-week maintenance period. Randomisation was stratified by induction period treatment, previous exposure to biologicals or JAK inhibitors, and concomitant use of oral corticosteroids at induction period baseline. The primary efficacy outcome was MMS clinical remission (stool frequency subscore=0 [or stool frequency subscore=1 with a ≥1 point decrease from induction period baseline], rectal bleeding subscore=0, and endoscopic subscore ≤1 [excluding friability]), assessed in the induction and maintenance periods separately (at induction period week 12 and maintenance period week 40). The primary efficacy analyses used the full analysis set (FAS), which included all patients who were randomly assigned and received at least one dose of study treatment for the induction period, and all re-randomly assigned patients who showed clinical response at induction period week 12 and received at least one dose of study treatment for the maintenance period. The safety analyses for each treatment period used the safety analysis set (SAF), which included all patients who received any amount of study drug in the corresponding treatment period. ENLIGHT UC 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>NCT04176588</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 the study is complete.<h3>Findings</h3>606 patients were screened between Sept 25, 2019, a","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"23 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194958","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 : 2025-09-22DOI: 10.1016/s2468-1253(25)00190-6
Dina Kao, Karen Wong, Christine Lee, Theodor Steiner, Rose Franz, Chelsea McDougall, Marisela Silva, Thomas S B Schmidt, Jens Walter, Raimar Loebenberg, Tanya M Monaghan, Ryland T Giebelhaus, James J Harynuk, Huiping Xu, Maryna Yaskina, Karen V MacDonald, Deborah A Marshall, Thomas Louie
Background
Faecal microbiota transplantation (FMT) is highly effective in preventing recurrent Clostridioides difficile infection. However, it is not known whether live microbes are necessary in mediating FMT efficacy. This study aims to determine whether lyophilised sterile faecal filtrate (LSFF), free of live bacteria, is non-inferior to lyophilised donor stool (LFMT) in efficacy.
Methods
This multicentre, randomised, double-blinded, non-inferiority trial was done at four academic centres in Canada. Eligible patients were adults aged 18 years or older with recurrent C difficile infection (at least two recurrences). Eligible patients were randomly assigned (1:1 using a prespecified computer-generated randomisation list with permutation blocks of 2 and 4, stratified by age >65 years or <65 years) to receive oral LSFF or LFMT. Each treatment dose consisted of 15 capsules that appeared identical. Participants and investigators were masked to treatment allocation. The primary outcome was the proportion of participants without recurrent C difficile infection (absence of more than three Bristol type 6 or 7 bowel movements per 24 h persisting more than 2 consecutive days) at 8 weeks. Analysis was done in the per protocol population, in which participants with unknown outcome status at 8 weeks due to death or loss to follow-up were excluded. Non-inferiority was established if the lower bound of the one-sided 95% CI for the difference in proportions of participants without recurrent C difficile between the LSFF and LFMT groups was above the non-inferiority margin of –10%. This trial was registered at ClinicalTrials.gov, NCT03806803, and is complete.
Findings
Between March 27, 2019, and Nov 6, 2023, we assessed 409 patients for eligibility. 271 were excluded and the remaining 138 were enrolled and randomly assigned to receive LSFF (n=72) or LFMT (n=66). Participants' mean age was 61·2 years (SD 18·6); 91 (66%) of 138 patients were women and 47 (34%) were male. 127 participants (92%) were White. 130 (94%) of 138 participants completed the trial. At the planned interim analysis, 47 (65%) of 72 participants in the LSFF group and 57 (88%) of 65 participants in the LFMT group did not have C difficile recurrence at 8 weeks (difference –23%, one-sided 95% CI –33·8% to infinity; p=0·96). Given the pre-specified non-inferiority margin of –10%, non-inferiority of LSFF to LFMT could not be established and the study was terminated at the recommendation of
{"title":"Effects of lyophilised faecal filtrate compared with lyophilised donor stool on Clostridioides difficile recurrence: a multicentre, randomised, double-blinded, non-inferiority trial","authors":"Dina Kao, Karen Wong, Christine Lee, Theodor Steiner, Rose Franz, Chelsea McDougall, Marisela Silva, Thomas S B Schmidt, Jens Walter, Raimar Loebenberg, Tanya M Monaghan, Ryland T Giebelhaus, James J Harynuk, Huiping Xu, Maryna Yaskina, Karen V MacDonald, Deborah A Marshall, Thomas Louie","doi":"10.1016/s2468-1253(25)00190-6","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00190-6","url":null,"abstract":"<h3>Background</h3>Faecal microbiota transplantation (FMT) is highly effective in preventing recurrent <em>Clostridioides difficile</em> infection. However, it is not known whether live microbes are necessary in mediating FMT efficacy. This study aims to determine whether lyophilised sterile faecal filtrate (LSFF), free of live bacteria, is non-inferior to lyophilised donor stool (LFMT) in efficacy.<h3>Methods</h3>This multicentre, randomised, double-blinded, non-inferiority trial was done at four academic centres in Canada. Eligible patients were adults aged 18 years or older with recurrent <em>C difficile</em> infection (at least two recurrences). Eligible patients were randomly assigned (1:1 using a prespecified computer-generated randomisation list with permutation blocks of 2 and 4, stratified by age >65 years or <65 years) to receive oral LSFF or LFMT. Each treatment dose consisted of 15 capsules that appeared identical. Participants and investigators were masked to treatment allocation. The primary outcome was the proportion of participants without recurrent <em>C difficile</em> infection (absence of more than three Bristol type 6 or 7 bowel movements per 24 h persisting more than 2 consecutive days) at 8 weeks. Analysis was done in the per protocol population, in which participants with unknown outcome status at 8 weeks due to death or loss to follow-up were excluded. Non-inferiority was established if the lower bound of the one-sided 95% CI for the difference in proportions of participants without recurrent <em>C difficile</em> between the LSFF and LFMT groups was above the non-inferiority margin of –10%. This trial was registered at <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>NCT03806803</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 complete.<h3>Findings</h3>Between March 27, 2019, and Nov 6, 2023, we assessed 409 patients for eligibility. 271 were excluded and the remaining 138 were enrolled and randomly assigned to receive LSFF (n=72) or LFMT (n=66). Participants' mean age was 61·2 years (SD 18·6); 91 (66%) of 138 patients were women and 47 (34%) were male. 127 participants (92%) were White. 130 (94%) of 138 participants completed the trial. At the planned interim analysis, 47 (65%) of 72 participants in the LSFF group and 57 (88%) of 65 participants in the LFMT group did not have <em>C difficile</em> recurrence at 8 weeks (difference –23%, one-sided 95% CI –33·8% to infinity; p=0·96). Given the pre-specified non-inferiority margin of –10%, non-inferiority of LSFF to LFMT could not be established and the study was terminated at the recommendation of ","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"21 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116484","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 : 2025-09-22DOI: 10.1016/s2468-1253(25)00195-5
Maria J G T Vehreschild
No Abstract
没有抽象的
{"title":"Filtered hopes and full-spectrum realities","authors":"Maria J G T Vehreschild","doi":"10.1016/s2468-1253(25)00195-5","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00195-5","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"39 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116485","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 : 2025-09-18DOI: 10.1016/s2468-1253(25)00193-1
Sumeet K Asrani, Jessica Mellinger, Stacy Sterling, Michael R Lucey, Katharine A Bradley, Neeraj Bhala, Jeremy Bray, Po-Hung Chen, Andrea DiMartini, Anne Fernandez, Murtuza Ghadiali, Lamia Y Haque, Mandana Khalili, Brian Lee, Lewei Allison Lin, Anjana A Pillai, Derek D Satre, Shreya Sengupta, Marina Serper, Doug Simonetto, Vijay H Shah
The prevalence of alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) is rising. The National Institute on Alcohol Abuse and Alcoholism organised a multistakeholder workshop focused on reducing the burden of ALD. Decreasing ALD morbidity and mortality requires a multipronged approach, including increased population-based screening for AUD, early recognition of ALD, and multidisciplinary treatment. Recommended screening tools for alcohol use include the alcohol use disorders identification test for consumption (AUDIT-C). In patients with elevated AUDIT-C scores (AUDIT-C score of ≥3 points in women, ≥4 points in men), screening for fibrosis is recommended using non-invasive blood-based tests, such as the Fibrosis-4 index. Sequential testing using blood-based and imaging-based non-invasive liver disease assessment is preferred to blood-based tests alone to increase the positive predictive value of referral pathways. Screening, brief intervention, and referral to treatment are effective for reducing unhealthy alcohol use among adults who are not alcohol dependent. Integrated care models that incorporate mental health treatment into general medical settings are crucial for AUD and ALD. Emerging care models, such as multidisciplinary ALD clinics and substance use navigators, can improve patient engagement and outcomes. Markers of success include a reduction in per capita alcohol consumption, declines in morbidity and mortality related to AUD and ALD, and a decrease in health-care costs.
{"title":"Reducing alcohol-associated liver disease burden in the general population","authors":"Sumeet K Asrani, Jessica Mellinger, Stacy Sterling, Michael R Lucey, Katharine A Bradley, Neeraj Bhala, Jeremy Bray, Po-Hung Chen, Andrea DiMartini, Anne Fernandez, Murtuza Ghadiali, Lamia Y Haque, Mandana Khalili, Brian Lee, Lewei Allison Lin, Anjana A Pillai, Derek D Satre, Shreya Sengupta, Marina Serper, Doug Simonetto, Vijay H Shah","doi":"10.1016/s2468-1253(25)00193-1","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00193-1","url":null,"abstract":"The prevalence of alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) is rising. The National Institute on Alcohol Abuse and Alcoholism organised a multistakeholder workshop focused on reducing the burden of ALD. Decreasing ALD morbidity and mortality requires a multipronged approach, including increased population-based screening for AUD, early recognition of ALD, and multidisciplinary treatment. Recommended screening tools for alcohol use include the alcohol use disorders identification test for consumption (AUDIT-C). In patients with elevated AUDIT-C scores (AUDIT-C score of ≥3 points in women, ≥4 points in men), screening for fibrosis is recommended using non-invasive blood-based tests, such as the Fibrosis-4 index. Sequential testing using blood-based and imaging-based non-invasive liver disease assessment is preferred to blood-based tests alone to increase the positive predictive value of referral pathways. Screening, brief intervention, and referral to treatment are effective for reducing unhealthy alcohol use among adults who are not alcohol dependent. Integrated care models that incorporate mental health treatment into general medical settings are crucial for AUD and ALD. Emerging care models, such as multidisciplinary ALD clinics and substance use navigators, can improve patient engagement and outcomes. Markers of success include a reduction in per capita alcohol consumption, declines in morbidity and mortality related to AUD and ALD, and a decrease in health-care costs.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"67 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083711","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 : 2025-09-16DOI: 10.1016/s2468-1253(25)00297-3
Torp N, Bech KT, Schnefeld HL, et al Phosphatidylethanol and self-reported alcohol intake to subclassify individuals at risk of steatotic liver disease: an analysis of data from a prospective cohort study. Lancet Gastroenterol Hepatol 2025; published online Sept 10. https://doi.org/10.1016/S2468-1253(25)00187-6—The title of this Article has been corrected. This correction has been made as of Sept 16, 2025.
Torp N, Bech KT, Schnefeld HL，等。磷脂酰乙醇和自我报告的酒精摄入量对脂肪变性肝病风险个体的亚分类：一项前瞻性队列研究的数据分析。Lancet Gastroenterol Hepatol 2025；9月10日在线发布。https://doi.org/10.1016/S2468-1253(25)00187-6 -本文的标题已被更正。此更正已于2025年9月16日进行。
{"title":"Correction to Lancet Gastroenterol Hepatol 2025; published online Sept 10. https://doi.org/10.1016/S2468-1253(25)00187-6","authors":"","doi":"10.1016/s2468-1253(25)00297-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00297-3","url":null,"abstract":"<em>Torp N, Bech KT, Schnefeld HL, et al Phosphatidylethanol and self-reported alcohol intake to subclassify individuals at risk of steatotic liver disease: an analysis of data from a prospective cohort study.</em> Lancet Gastroenterol Hepatol <em>2025; published online Sept 10. https://doi.org/10.1016/S2468-1253(25)00187-6—</em>The title of this Article has been corrected. This correction has been made as of Sept 16, 2025.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"78 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145072249","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 : 2025-09-12DOI: 10.1016/s2468-1253(25)00188-8
Ciro Celsa, Grazia Pennisi, Adele Tulone, Giacinta Ciancimino, Marco Vaccaro, Fabiana Pecorella, Gabriele Di Maria, Marco Enea, Federico Midiri, Alessandro Mantovani, Giovanni Targher, Aleksander Krag, Mary E Rinella, Calogero Cammà, Salvatore Petta
<h3>Background</h3>Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction and alcohol-associated steatotic liver disease (MetALD) are two separate entities within the spectrum of steatotic liver disease. We aimed to compare the risks of hepatic and extrahepatic outcomes between individuals with MASLD and MetALD in a comprehensive meta-analysis.<h3>Methods</h3>In this systematic review and meta-analysis, we systematically searched PubMed, Scopus, and the Cochrane Central Register of Controlled Trials for observational cohort studies published up to March 1, 2025, and written in English. We included studies comparing clinical outcomes between adults (>18 years) with MASLD and MetALD, if the studies incorporated appropriate statistical adjustments for known risk factors and potential confounding factors. We excluded studies that did not differentiate between MASLD and MetALD, case reports, case series, commentaries, cross-sectional or case-control studies. We evaluated each study to assess its eligibility and extracted the data. The primary outcome was liver-related events; secondary outcomes included hepatocellular carcinoma, liver-related mortality, cardiovascular events, extrahepatic cancers, and all-cause mortality. We used random-effect models to calculate pooled hazard ratios (HRs) with 95% CIs. The study was registered with PROSPERO (CRD420251003928).<h3>Findings</h3>Of 5579 records identified, we included 24 cohort studies involving 11 575 558 individuals in the analysis. 9 801 312 individuals had MASLD (mean age 57·0 years [SD 4·55], ~62% male, and ~38% female) and 1 774 246 had MetALD (mean age 48·6 years [SD 4·91], ~82% male, and ~18% female). Individuals with MetALD had significantly higher risks of liver-related events (HR 1·62, 95% CI 1·16–2·25; p=0·0086), hepatocellular carcinoma (1·33, 1·00–1·77; p=0·048), and extrahepatic cancers (1·03, 1·01–1·06; p<0·0001) compared with those with MASLD. The rates of cardiovascular events (HR 0·96, 95% CI 0·85–1·09; p=0·48), extrahepatic cancer-related mortality (1·44, 0·97–2·15; p=0·065), and all-cause mortality (1·08, 0·97–1·19; p=0·14) did not differ between the two liver conditions. Substantial heterogeneity was observed across most analyses (<em>I</em><sup>2</sup>=76–93%), with only extrahepatic cancer incidence showing low heterogeneity (<em>I</em><sup>2</sup>=0%). Egger's regression tests suggested that publication bias was unlikely for all outcomes except extrahepatic cancer-related mortality.<h3>Interpretation</h3>MetALD might be associated with a higher risk of liver-related events, hepatocellular carcinoma, and extrahepatic cancers than MASLD, whereas all-cause mortality, extrahepatic cancer-related mortality, and cardiovascular events seem similar between the two conditions. These findings emphasise the need for distinct clinical strategies for these related yet different entities within the steatotic liver disease spectrum and highlight the imp
{"title":"Risk of hepatic and extrahepatic outcomes associated with metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction and alcohol-associated steatotic liver disease: a systematic review and meta-analysis","authors":"Ciro Celsa, Grazia Pennisi, Adele Tulone, Giacinta Ciancimino, Marco Vaccaro, Fabiana Pecorella, Gabriele Di Maria, Marco Enea, Federico Midiri, Alessandro Mantovani, Giovanni Targher, Aleksander Krag, Mary E Rinella, Calogero Cammà, Salvatore Petta","doi":"10.1016/s2468-1253(25)00188-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00188-8","url":null,"abstract":"<h3>Background</h3>Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction and alcohol-associated steatotic liver disease (MetALD) are two separate entities within the spectrum of steatotic liver disease. We aimed to compare the risks of hepatic and extrahepatic outcomes between individuals with MASLD and MetALD in a comprehensive meta-analysis.<h3>Methods</h3>In this systematic review and meta-analysis, we systematically searched PubMed, Scopus, and the Cochrane Central Register of Controlled Trials for observational cohort studies published up to March 1, 2025, and written in English. We included studies comparing clinical outcomes between adults (>18 years) with MASLD and MetALD, if the studies incorporated appropriate statistical adjustments for known risk factors and potential confounding factors. We excluded studies that did not differentiate between MASLD and MetALD, case reports, case series, commentaries, cross-sectional or case-control studies. We evaluated each study to assess its eligibility and extracted the data. The primary outcome was liver-related events; secondary outcomes included hepatocellular carcinoma, liver-related mortality, cardiovascular events, extrahepatic cancers, and all-cause mortality. We used random-effect models to calculate pooled hazard ratios (HRs) with 95% CIs. The study was registered with PROSPERO (CRD420251003928).<h3>Findings</h3>Of 5579 records identified, we included 24 cohort studies involving 11 575 558 individuals in the analysis. 9 801 312 individuals had MASLD (mean age 57·0 years [SD 4·55], ~62% male, and ~38% female) and 1 774 246 had MetALD (mean age 48·6 years [SD 4·91], ~82% male, and ~18% female). Individuals with MetALD had significantly higher risks of liver-related events (HR 1·62, 95% CI 1·16–2·25; p=0·0086), hepatocellular carcinoma (1·33, 1·00–1·77; p=0·048), and extrahepatic cancers (1·03, 1·01–1·06; p<0·0001) compared with those with MASLD. The rates of cardiovascular events (HR 0·96, 95% CI 0·85–1·09; p=0·48), extrahepatic cancer-related mortality (1·44, 0·97–2·15; p=0·065), and all-cause mortality (1·08, 0·97–1·19; p=0·14) did not differ between the two liver conditions. Substantial heterogeneity was observed across most analyses (<em>I</em><sup>2</sup>=76–93%), with only extrahepatic cancer incidence showing low heterogeneity (<em>I</em><sup>2</sup>=0%). Egger's regression tests suggested that publication bias was unlikely for all outcomes except extrahepatic cancer-related mortality.<h3>Interpretation</h3>MetALD might be associated with a higher risk of liver-related events, hepatocellular carcinoma, and extrahepatic cancers than MASLD, whereas all-cause mortality, extrahepatic cancer-related mortality, and cardiovascular events seem similar between the two conditions. These findings emphasise the need for distinct clinical strategies for these related yet different entities within the steatotic liver disease spectrum and highlight the imp","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"124 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043285","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 : 2025-09-11DOI: 10.1016/s2468-1253(25)00294-8
Budzyń K, Romańczyk M, Kitala D, et al. Endoscopist deskilling risk after exposure to artificial intelligence in colonoscopy: a multicentre, observational study. Lancet Gastroenterol Hepatol 2025; 10: 896–903—A covariate (indication for colonoscopy) had been mistakenly omitted from the multivariable analysis presented in supplementary table 6 in the appendix of this Article. The appendix has been updated with the corrected analysis; the only affected findings are for the variables “After AI introduction (using AI in colonoscopy)” and “Age >60 years”. These changes do not affect the interpretation of the data. This correction has been made as of Sept 11, 2025.
budzyzyk, Romańczyk M, Kitala D，等。内镜医师在结肠镜检查中暴露于人工智能后降低风险：一项多中心观察性研究。Lancet Gastroenterol Hepatol 2025；[10:896 - 903]本文附录补充表6中的多变量分析错误地遗漏了一个协变量（结肠镜适应症）。附录中已更新了修正后的分析；唯一受影响的结果是变量“引入人工智能后（在结肠镜检查中使用人工智能）”和“年龄>；60岁”。这些变化不影响对数据的解释。此更正已于2025年9月11日进行。
{"title":"Correction to Lancet Gastroenterol Hepatol 2025; 10: 896–903","authors":"","doi":"10.1016/s2468-1253(25)00294-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00294-8","url":null,"abstract":"<em>Budzyń K, Romańczyk M, Kitala D, et al. Endoscopist deskilling risk after exposure to artificial intelligence in colonoscopy: a multicentre, observational study.</em> Lancet Gastroenterol Hepatol <em>2025;</em> 10: <em>896–903</em>—A covariate (indication for colonoscopy) had been mistakenly omitted from the multivariable analysis presented in supplementary table 6 in the appendix of this Article. The appendix has been updated with the corrected analysis; the only affected findings are for the variables “After AI introduction (using AI in colonoscopy)” and “Age >60 years”. These changes do not affect the interpretation of the data. This correction has been made as of Sept 11, 2025.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"35 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043096","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 : 2025-09-10DOI: 10.1016/s2468-1253(25)00187-6
Nikolaj Torp, Katrine Tholstrup Bech, Helle Lindholm Schnefeld, Stine Johansen, Camilla Dalby Hansen, Georg Semmler, Javier Vega Benjumea, Katrine Prier Lindvig, Katrine Holtz Thorhauge, Ellen Lyngbeck Jensen, Ellen Elise Petersen, Johanne Kragh Hansen, Ida Falk Villesen, Peter Andersen, Marianne Lerbæk Bergmann, Aleksander Krag, Mads Israelsen, Maja Thiele
<h3>Background</h3>Phosphatidylethanol is a direct biomarker of alcohol consumption within the past 1–4 weeks, making it a potential tool in the subclassification of patients with steatotic liver disease. However, the clinical utility of phosphatidylethanol among individuals at risk of steatotic liver disease remains to be established. We aimed to investigate the correlation between phosphatidylethanol and self-reported alcohol intake among individuals at risk of steatotic liver disease due to excessive alcohol consumption or metabolic dysfunction.<h3>Methods</h3>We used data from a single-centre, prospective study that was conducted at Odense University Hospital (Odense, Denmark), designed to investigate use of non-invasive markers for screening for fibrosis. We analysed data for at-risk participants aged 30–75 years from the general population with a history of ongoing or previous excessive alcohol use (alcohol group) or metabolic dysfunction without excessive alcohol use (metabolic group). Participants self-reported past 1-week and 3-month average alcohol intake, and completed the Alcohol Use Disorders Identification-Consumption (AUDIT-C) questionnaire. The presence of hepatic steatosis (controlled attenuation parameter ≥248 dB/m), cardiometabolic risk factors and past 3-month alcohol intake were used to classify participants as having metabolic dysfunction-associated steatotic liver disease (MASLD; <20 g [females] or <30 g [males] per day), metabolic and alcohol-related liver disease (MetALD; 20–49 g or 30–59 g per day), or alcohol-related liver disease (ALD; ≥50 g or ≥60 g per day). Phosphatidylethanol was quantified with liquid chromatography-mass spectrometry according to standard procedures. We assessed correlations and concordance between phosphatidylethanol and self-reported alcohol intake. Underestimation of alcohol intake was defined as a low self-reported intake (<20 g [females] or <30 g [males] per day) but phosphatidylethanol of at least 80 ng/mL or a moderate–high self-reported intake (20–49 g or 30–59 g per day) but phosphatidylethanol 200 ng/mL or higher. We also developed a decision tree to guide clinical use of phosphatidylethanol testing on the basis of self-reported intake and AUDIT-C.<h3>Findings</h3>1482 individuals in the alcohol group and 1442 in the metabolic group recruited between Oct 9, 2017, and Dec 9, 2022, were included in this analysis. Median phosphatidylethanol concentration was 172 ng/mL (IQR 45–434) in the alcohol group and 11 ng/mL (5–37) in the metabolic group. Phosphatidylethanol correlated with past 1-week self-reported intake (<em>r</em><sub>S</sub>=0·638 [95% CI 0·600–0·676] in the alcohol group <em>vs r</em><sub>S</sub>=0·655 [0·623–0·688] in the metabolic group), and the average preceding 3-months self-reported intake (<em>r</em><sub>S</sub>=0·628 [95% CI 0·586–0·669] <em>vs r</em><sub>S</sub>=0·725 [0·697–0·753]). 586 (39·5%) of 1482 participants in the alcohol group and 160 (11·1%) of 14
{"title":"Phosphatidylethanol and self-reported alcohol intake to subclassify in individuals at risk of steatotic liver disease: an analysis of data from a prospective cohort study","authors":"Nikolaj Torp, Katrine Tholstrup Bech, Helle Lindholm Schnefeld, Stine Johansen, Camilla Dalby Hansen, Georg Semmler, Javier Vega Benjumea, Katrine Prier Lindvig, Katrine Holtz Thorhauge, Ellen Lyngbeck Jensen, Ellen Elise Petersen, Johanne Kragh Hansen, Ida Falk Villesen, Peter Andersen, Marianne Lerbæk Bergmann, Aleksander Krag, Mads Israelsen, Maja Thiele","doi":"10.1016/s2468-1253(25)00187-6","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00187-6","url":null,"abstract":"<h3>Background</h3>Phosphatidylethanol is a direct biomarker of alcohol consumption within the past 1–4 weeks, making it a potential tool in the subclassification of patients with steatotic liver disease. However, the clinical utility of phosphatidylethanol among individuals at risk of steatotic liver disease remains to be established. We aimed to investigate the correlation between phosphatidylethanol and self-reported alcohol intake among individuals at risk of steatotic liver disease due to excessive alcohol consumption or metabolic dysfunction.<h3>Methods</h3>We used data from a single-centre, prospective study that was conducted at Odense University Hospital (Odense, Denmark), designed to investigate use of non-invasive markers for screening for fibrosis. We analysed data for at-risk participants aged 30–75 years from the general population with a history of ongoing or previous excessive alcohol use (alcohol group) or metabolic dysfunction without excessive alcohol use (metabolic group). Participants self-reported past 1-week and 3-month average alcohol intake, and completed the Alcohol Use Disorders Identification-Consumption (AUDIT-C) questionnaire. The presence of hepatic steatosis (controlled attenuation parameter ≥248 dB/m), cardiometabolic risk factors and past 3-month alcohol intake were used to classify participants as having metabolic dysfunction-associated steatotic liver disease (MASLD; <20 g [females] or <30 g [males] per day), metabolic and alcohol-related liver disease (MetALD; 20–49 g or 30–59 g per day), or alcohol-related liver disease (ALD; ≥50 g or ≥60 g per day). Phosphatidylethanol was quantified with liquid chromatography-mass spectrometry according to standard procedures. We assessed correlations and concordance between phosphatidylethanol and self-reported alcohol intake. Underestimation of alcohol intake was defined as a low self-reported intake (<20 g [females] or <30 g [males] per day) but phosphatidylethanol of at least 80 ng/mL or a moderate–high self-reported intake (20–49 g or 30–59 g per day) but phosphatidylethanol 200 ng/mL or higher. We also developed a decision tree to guide clinical use of phosphatidylethanol testing on the basis of self-reported intake and AUDIT-C.<h3>Findings</h3>1482 individuals in the alcohol group and 1442 in the metabolic group recruited between Oct 9, 2017, and Dec 9, 2022, were included in this analysis. Median phosphatidylethanol concentration was 172 ng/mL (IQR 45–434) in the alcohol group and 11 ng/mL (5–37) in the metabolic group. Phosphatidylethanol correlated with past 1-week self-reported intake (<em>r</em><sub>S</sub>=0·638 [95% CI 0·600–0·676] in the alcohol group <em>vs r</em><sub>S</sub>=0·655 [0·623–0·688] in the metabolic group), and the average preceding 3-months self-reported intake (<em>r</em><sub>S</sub>=0·628 [95% CI 0·586–0·669] <em>vs r</em><sub>S</sub>=0·725 [0·697–0·753]). 586 (39·5%) of 1482 participants in the alcohol group and 160 (11·1%) of 14","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"83 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043098","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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