Dr. Falk Video report
Who get’s EoE? – Part I: Individual & epidemiological risk factors
The most important facts summarized:
– Which reasons might play a role for an individual patient to get eosinophilic esophagitis (EoE)?
o Allergic triggers from food and the environment
o Allergic comorbidities like asthma, hay fever or eczema
o The exact reasons are not yet finally determined
– Can we learn something about EoE from epidemiological data?
o Risk factors can be allergic diseases, certain climate zones (cold and arid), vegetation and aeroallergens
o In rural areas the risk can be higher due to pesticides or farming practices
o The impact of a lack of infection with H. pylori is controversial
o Other factors discussed are caesarean section birth delivery, breast feeding, use of antibiotics especially in early childhood as well as proton-pump inhibitors
Dr. Falk Video-Report – interview with Prof. Evan Dellon, Chapel Hill (USA), which took place during ueg week 2019 in Barcelona (Spain) within the scope of the Satellite Symposium „EoE – Recent Developments in Diagnosis & Treatment“. In part I of the interview „Who get’s EoE?“ Prof. Dellon describes individual and epidemiological risk factors for the development of the disease.
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Latest research in brief:
Bowel
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Chey WD et al, Am J Gastroenterol. 2020;115(2):281–93
Novel therapeutic approach to treat patients with irritable bowel syndrome with constipation (IBS-C): Tenapanor, a first-in-class small molecule inhibitor of the intestinal sodium/hydrogen exchanger NHE3, improved IBS-C symptoms and was generally well tolerated in a phase III trial.
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Waljee AK et al, Lancet Gastroenterol Hepatol. 2020;5(3):276–84
Anti-TNF therapy in patients with previous cancer diagnosis: Results of a population based study indicate that therapy with TNF antibodies in patients with chronic inflammatory diseases and previous cancer diagnosis does not influence the risk of recurrent or primary cancer development. Also timing of TNF inhibitor therapy does not affect cancer risk.
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D’Haens G et al, Gastroenterology. 2020;158(3):515–26.e10
Non-invasive markers to monitor endoscopic Crohn’s disease activity: The endoscopic healing index (EHI) based on serum concentrations of 13 proteins identified patients in endoscopic remission and patients with resolution of endoscopic disease activity with good accuracy. However, the score is affected by disease duration, comparable to analysis of fecal calprotectin and superior to measurement of serum C-reactive protein.
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Liver Biliary Tracts
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Hajarizadeh B et al, J Hepatol. 2020;72(4):643–57
Reinfection after successful treatment of hepatitis C: A current meta-analysis demonstrates a relatively high reinfection rate in patients with recent drug use, while patients receiving opioid agonist therapy without recent drug use display very low reinfection rates.
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Kanwal F et al, Hepatology. 2020;71(3):808–19
Non-alcoholic fatty liver disease (NAFLD): A retrospective cohort study indicates that each additional metabolic trait increases the risk of cirrhosis and hepatocellular carcinoma (HCC). Diabetes confers the highest risk of progression to HCC. These results may help to prioritize patients for secondary prevention programs.
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Maiwall R et al, Hepatology. 2020;71(3):1009–22
Transition of acute kidney injury (AKI) to chronic kidney disease (CKD): One-third of cirrhotic patients develop CKD. MELD (Model for End-stage Liver Disease) score, serum cystatin C levels, and number of AKI episodes predict development of CKD.
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Oesophagus Stomach Duodenum
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Hirano I et al, Gastroenterology. 2020;158(1):111–22.e10
Efficacy of dupilumab, a monoclonal anti-IL-4 receptor antibody, in adult patients with eosinophilic esophagitis (EoE): Results of a placebo controlled phase II trial indicate that dupilumab reduces dysphagia, histologic features of EoE, and abnormal endoscopic features compared with placebo.
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Ducrotte P et al, Gastroenterology. 2020;158(3):506–14.e2/em>
Gastric electrical stimulation (GES) in patients with refractory vomiting: Results of a randomized trial suggest that GES reduces the frequency of refractory vomiting in patients with and without diabetes, although it did not accelerate gastric emptying or increase quality of life.
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Huang RJ et al, Gastrointest Endosc. 2020;91(1):70–7.e1
Gastric intestinal metaplasia (GIM): Results of an American retrospective study indicate that the point prevalence of GIM is high (11.7%) and that GIM particularly affects non-white and Hispanic Americans. In patients with GIM, increasing age and male gender were predominant risk factors for progression to dysplasia or gastric cancer.
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Pancreas
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Lakhtakia S et al, Gastrointest Endosc. 2020;91(2):361–9.e3
Endoscopic therapy for benign biliary strictures secondary to chronic pancreatitis: Five years after a single placement of a single fully covered self-expandable metal stent, approx. 60% of patients remained asymptomatic and stent-free with a reasonable safety profile in an open-label multinational prospective study.
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Current Falk literature:
Aftercare Following Liver Transplantation
Pharmacological Therapy – Complications – Lifestyle
Recommended Practices for Cooperation Between the
Primary Care Provider and the Transplant Center
Authors: K. Herzer, G. Gerken
(28 pages)
U13e