Falk Gastro Info 12/2024

Choy MC et al, Lancet Gastroenterol Hepatol. 2024;9(11):981–96

Intensified infliximab therapy for steroid-refractory acute severe ulcerative colitis (ASUC): Intensified and/or accelerated dosing of infliximab are frequently used in ASUC patients to improve clinical outcomes. However, intensified or accelerated infliximab therapy was not associated with differences in clinical response, remission or colectomy as compared with standard dosing in this randomized multicenter trial of patients with steroid-refractory ASUC.

Sands BE et al, N Engl J Med. 2024;391(12):1119–29

Efficacy of the monoclonal anti-TL1A antibody tulisokibart for ulcerative colitis: Tumor necrosis factor-like protein 1A (TL1A) is a pro-inflammatory cytokine of the TNF superfamily and mediates various pro-inflammatory functions and fibrosis in intestinal inflammation. Inhibition of TL1A by tulisokibart was superior to placebo in inducing clinical remission in patients with moderately to severely active ulcerative colitis in this phase 2 trial (ARTEMIS-UC).

Campani C et al, Gut. 2024;73(11):1870–82

Circulating tumour DNA as a useful marker to determine tumour activity in individuals with hepatocellular carcinoma: In this study, tumour mutations in circulating DNA were analyzed longitudinally and compared to mutations in tumour material from the same individuals. Tumour-specific mutations in the circulation reflected those in the tumor tissue and changes in the mutational burden correlated with the treatment responses and tumour stage.

Fan R et al, Gut. 2024;73(10):1725–36

Repeated measurements of quantitative HBsAg can be helpful in predicting the probability of HBsAg loss: In this study with 6792 individuals infected chronically with hepatitis B virus from China who were treated with nucleos(t)ide analogues, a score based on twice-yearly measurements of quantitative HBsAg was developed that was able to predict HBsAg loss. Overall, however, the rate of HBsAg loss after 5 years was only 2.4%.

Alkabbani W et al, BMJ. 2024;387:e080340

Glucagon-like peptide-1 (GLP-1) receptor agonists before upper gastrointestinal (GI) endoscopy are not associated with increased risk of aspiration: GLP-1 receptor agonists delay gastric emptying which may interfere with endoscopic procedures of the upper GI tract. However, the risk of aspiration during upper GI endoscopy was not increased in this comparative cohort study of diabetic patients treated with GLP-1 agonists as compared to control medication (SGLT-2 inhibitors). Intake of GLP-1 receptor agonists was rather associated with a 2-fold increased risk of discontinuation of the procedure, which was possibly due to delayed gastric emptying.