Falk Gastro Info 4/2024

Decraecker L et al, Gut. 2024;73(3):459–69

Histamine 1 receptor antagonist ebastine to treat irritable bowel syndrome: Ebastine was superior to placebo with regard to global symptom severity as well as abdominal pain in patients with irritable bowel syndrome without constipation.

Hirschfield GM et al, N Engl J Med. 2024;390(9):783–94

Seladelpar for treatment of primary biliary cholangitis (PBC) in patients who had inadequate response to or unacceptable side effects with ursodeoxycholic acid (UDCA): A current phase 3 trial demonstrates a decent response in terms of biochemical response (62% vs. 20% with placebo), normalization of alkaline phosphatase (25% vs. 0%) and decrease in itching. 94% of patients continued to receive UDCA during the study.

Kowdley KV et al, N Engl J Med. 2024;390(9):795–805

Elafibranor for treatment of primary biliary cholangitis (PBC) in patients who had inadequate response to or unacceptable side effects with ursodeoxycholic acid (UDCA): A current phase 3 study shows a decent response in terms of biochemical response (51% vs. 4% with placebo) and normalization of alkaline phosphatase (15% vs. 0%). The decrease in itching was numerically greater than with placebo, but this did not reach statistical significance. In addition, gastrointestinal side effects occurred more frequently with elafibranor.

Israelsen M et al, Lancet Gastroenterol Hepatol. 2024;9(3):218–28

New nomenclature of steatotic liver disease – Prospective cohort study indicates prognostic relevance of subgroups: The analysis of a prospective cohort study demonstrates that the risks of decompensation and mortality increase from metabolic dysfunction-associated steatotic liver disease (MASLD) to metabolic dysfunction and alcohol-related steatotic liver disease (MetALD) and further to alcohol-related liver disease (ALD).

Wood RA et al, N Engl J Med. 2024;390(10):889–99

Anti-IgE antibody omalizumab for the treatment of multiple food allergies: In children as young as 1 year old as well as in adults with multiple food allergies, omalizumab treatment for 16 weeks was superior to placebo in increasing the reaction threshold for peanut and other common food antigens.

Noor NM et al, Lancet Gastroenterol Hepatol. 2024 [ahead of print]

Biomarker-stratified comparison of top-down versus step-up therapeutic strategies for Crohn’s disease: Top-down combination therapy with infliximab plus immunomodulator achieved substantially better outcomes at 1 year than accelerated step-up treatment in the PROFILE trial, while the biomarker did not show clinical utility.