Falk Gastro Info 4/2023

Early management of acute severe ulcerative colitis in the biologics era: A cohort study indicates that emergency colectomy rates have halved in the past 25 years to 8–15% worldwide. Patients not responding to corticosteroids may be readily identified on admission using a simple score consisting of serum C-reactive protein, albumin and an endoscopic activity score.

Rapid and sustained symptom relief in patients with ulcerative colitis treated with filgotinib: Post-hoc analysis of data from the SELECTION trial indicates that filgotinib therapy results in rapid and sustained improvements of symptoms related to ulcerative colitis within days.

Association of inflammatory bowel disease (IBD) and metabolic-associated fatty liver disease (MAFLD): A large recent case-control study demonstrates a significantly increased risk of MAFLD and liver fibrosis in IBD patients. This was independent of classic metabolic risk factors such as body mass index or type 2 diabetes.

Retreatment with immune checkpoint inhibitors after severe immune-related hepatitis: A current prospective study indicates that retreatment with immune checkpoint inhibitors is a feasible option after severe immune-related hepatitis, even with the same immune checkpoint inhibitors. There was no recurrence of liver injury in up to 65% of retreated patients.

Risk factors for hepatocellular carcinoma (HCC) in contemporary cohorts of patients with cirrhosis: In 2 contemporary, prospective multiethnic U.S. cohorts of patients with cirrhosis, HCC incidence was lower than previously reported. HCC risk was variable across etiologies, with higher risk in patients with hepatitis C-associated cirrhosis (even after cure of hepatitis C) and lower risk in those with cirrhosis due to non-alcoholic fatty liver disease. Smoking and obesity increased HCC risk.

Second-line eradication of Helicobacter pylori: In this randomized controlled trial, levofloxacin-based and bismuth-based quadruple therapies were equally effective to mediate eradication of Helicobacter pylori. The transient increase in the antibiotic resistome and perturbation of intestinal microbiota were largely restored to pretreatment states from 2 months to 1 year after eradication therapy.