Falk Gastro Info 2/2024

Haskey N et al, J Crohns Colitis. 2023;17(10):1569–78

Mediterranean diet for ulcerative colitis: Mediterranean diet patterns induce gut microbiome alterations associated with the maintenance of clinical remission and reduced fecal calprotectin in patients with quiescent ulcerative colitis in a pilot trial involving 28 patients.

Ford AC et al, Lancet. 2023;402(10414):1773–85

Low dose amitriptyline to treat irritable bowel syndrome (IBS): Titrated low-dose amitriptyline was superior to placebo as second-line treatment for IBS in primary care across multiple outcomes in a large trial enrolling 463 participants.

Corpechot C et al, Hepatology. 2024;79(1):39–48

Prognostic benefit of an optimal versus adequate therapeutic response in primary biliary cholangitis (PBC): Currently, a decrease in alkaline phosphatase to less than 1.5 times the upper limit of normal is considered as an adequate therapeutic response. However, a current, large international cohort study demonstrates that patients with advanced fibrosis and/or relatively young age in particular benefit significantly from complete normalization of alkaline phosphatase. For these patients, additional therapeutic efforts should thus be considered.

Åberg F et al, J Hepatol. 2024;80(1):99–108

Tacrolimus is superior to cyclosporine for immunosuppression after liver transplantation for primary sclerosing cholangitis (PSC): An evaluation of the large international registries indicates that tacrolimus is associated with better patient and transplant survival rates than cyclosporine in liver transplant patients with primary sclerosing cholangitis (PSC). Tacrolimus should therefore be the standard calcineurin inhibitor in these patients.

Murray SM et al, J Hepatol. 2024;80(1):109–23

COVID-19 vaccine response in liver disease: A recent international cohort study demonstrates that patients with liver diseases generally develop strong antibody and T cell responses after 3 COVID-19 vaccinations and have a mild course of COVID-19. Only liver transplant recipients have persistently low antibody titers, appear to be most susceptible to severe COVID-19 and should thus be strongly advised to participate in booster vaccinations.

Holmberg D et al, BMJ. 2023;382:e076017

Non-erosive gastroesophageal reflux disease (NERD) and incidence of esophageal adenocarcinoma: Patients with NERD seem to have similar incidence of esophageal adenocarcinoma as the general population in a large Scandinavian population-based cohort study.

Dellon ES et al, Gut. 2023;72(10):1828–37

Limited efficacy of the IL-5 antibody mepolizumab to treat eosinophilic esophagitis (EoE): Mepolizumab did not achieve the primary end point of improving dysphagia symptoms compared with placebo. While eosinophil counts and endoscopic severity improved with mepolizumab at 3 months, longer treatment did not yield additional improvement.

Wan Y et al, BMJ. 2023;382:e073939

Carbohydrate intake and long-term weight changes: Results from large prospective cohort studies including 136.432 patients highlight the potential importance of carbohydrate quality and source for long term weight management. Limiting added sugar, sugar sweetened beverages, refined grains and starchy vegetables in favor of whole grains, fruits and non-starchy vegetables may support efforts to control weight.