Falk Gastro Info 6/2024

Lujan R et al, Gastroenterology. 2024;166(5):815–25.e22

Early initiation of biologics and disease outcomes in inflammatory bowel diseases: Very early initiation of biologics was associated with a modest risk reduction of surgery and steroid dependency in Crohn’s disease in a nationwide Israelian study. In ulcerative colitis, early initiation of biologics was not associated with reduced risk of colectomy or steroid dependency.

Coronado GD et al, Gut. 2024;73(4):622–8

Blood-based colorectal cancer screening: Among adults who had declined prior colorectal cancer screening, the offer of a blood-based screening test boosted screening rates by 17,5% over usual care in a randomized trial.

Gish RG et al, Hepatology. 2024;79(5):1129–40

Meta-analysis highlights the serious course of hepatitis B/D co-infection: A current meta-analysis compares the complication rate in HBsAg and HDV antibody positive patients who are either positive or negative for HDV RNA. HDV-RNA-positive patients have a significantly higher risk of progression to compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC), more frequently require liver transplantation and have a higher overall liver-related mortality. These data highlight the importance of screening HBV patients for HDV co-infection.

Younossi ZM et al, J Hepatol. 2024;80(5):694–701

Clinical profiles and mortality rates in metabolic dysfunction-associated steatotic liver disease (MASLD) and non-alcoholic fatty liver disease (NAFLD) are similar: A recent study with 2 large cohorts indicates that the evidence generated under the NAFLD definition can be used for MASLD. Individuals with MASLD appear to be slightly older and have a slightly higher risk of mortality than individuals with NAFLD. This is likely due to cardiometabolic risk factors in the small proportion of patients for whom the definitions of MASLD and NAFLD do not overlap.

Schönauer R et al, Gastroenterology. 2024;166(5):902–14

Female sex, gene variants and liver volume progression are risk factors for a complicated course of autosomal dominant polycystic liver disease: Autosomal dominant polycystic liver disease is relatively rare and can be asymptomatic or course complications that may require liver transplantation. Until now, the clinical course can hardly be predicted. A recent international study demonstrates that female sex, germline alterations in the PRKCSH gene and rapid progression of total liver volume on imaging is associated with the greatest risk of hospitalization related to polycystic liver disease.

Black EL et al, Gut. 2024;73(5):729–40

Malignant potential of gastric metaplasia (GM) of the esophagus and its relevance to Barrett’s esophagus surveillance: A British cohort study revealed that short-segment GM is a clinically and genetically distinct entity as compared to short-segment intestinal metaplasia (IM) and has a significantly lower malignant potential. It is therefore questionable whether patients with short-segment GM warrant inclusion in surveillance programs for Barrett’s esophagus.

Hernández-Rocha C et al, J Crohns Colitis. 2024;18(4):615–27

Clinical predictors of early and late endoscopic recurrence following ileocolonic resection in Crohn’s disease: This prospective cohort study revealed several risk factors for early endoscopic recurrence including male gender, smoking and non-white ethnicity, while therapy with TNF antibodies was protective. Mild inflammation at the first colonoscopy was predictive of subsequent recurrence at later stages.