Falk Gastro Info 5/2021

Video course abdominal ultrasound

Examination of abdominal vessels – Renal arteries

Author: Prof. Dr. Christoph F. Dietrich ©2019 Falk Foundation e.V., Freiburg. All rights reserved.

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Latest research in brief:

Bowel

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Rivière P et al, Clin Gastroenterol Hepatol. 2021;19(4):713–20.e1
Rates of postoperative recurrence of Crohn’s disease: Use of immunosuppressants and tumor necrosis factor antagonists to treat patients with an asymptomatic endoscopic postoperative recurrence of Crohn’s disease did not reduce long-term risk of clinical recurrence in patients with Rutgeerts score i2, but had a small effect in patients with scores of i3 or i4.

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Stournaras E et al, Gut. 2021;70(4):677–86
Efficacy of thiopurine monotherapy in patients with inflammatory bowel disease:): A retrospective analysis of a patient database comprising 11,928 patients revealed that thiopurine monotherapy is an effective long-term treatment for ulcerative colitis (response rate 52.7%) but significantly less effective in Crohn’s disease (response rate 34.2%).

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Khalili H et al, Gastroenterology. 2021;160(5):1599–607.e5
Risk factors for microscopic colitis: Results from a nationwide case-control study from Sweden indicate that gastrointestinal infections, particularly with Clostridioides difficile and norovirus, are associated with an increased risk of subsequent microscopic colitis.

Link to text Liver Biliary Tracts

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Semmler G et al, Hepatology. 2021;73(4):1275–89
NoHepatitis C virus (HCV):There are no well-established algorithms available to identify patients in need of continued monitoring after sustained virological response to HCV therapy. A current study demonstrates that liver stiffness measurement (LSM) and von Willebrand factor/platelet count ratio (VITRO) after therapy are strong and independent predictors of posttreatment hepatic decompensation in HCV-induced advanced chronic liver disease.

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Newsome PN et al, N Engl J Med. 2021;384(12):1113–24
AcuNon-alcoholic steatohepatitis (NASH): A recent and much discussed study shows that semaglutide leads to resolution of NASH without worsening of fibrosis in a higher proportion of patients than placebo. However, it did not show any superiority in terms of improvement of the stage of fibrosis as a further relevant clinical end point.

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Aqel B et al, J Hepatol. 2021;74(4):873–80
Liver transplantation (LT): Direct-acting antivirals (DAAs) allow hepatitis C virus (HCV) elimination with little side effects in almost all patients. Therefore, transplants from HCV-seropositive donors can now be considered for LT. A recent prospective cohort study demonstrates that LT from HCV-seropositive donors into HCV-seronegative recipients resulted in excellent short-term outcomes. Antiviral therapy after LT was effective and well tolerated.

Link to text Oesophagus Stomach Duodenum

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Kelly RJ et al, N Engl J Med. 2021;384(13):1191–203
Adjuvant nivolumab in patients with resected esophageal or gastroesophageal junction cancer: Disease-free survival in patients who received adjuvant nivolumab following neoadjuvant chemoradiotherapy and resection was significantly longer than in patients who received placebo.

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Laursen SB et al, Gut. 2021;70(4):707–16
Risk scores for mortality in acute upper and lower gastrointestinal bleeding: : In contrast to previous scores, the ABC score which comprises age, blood tests and comorbidities, has a good performance for predicting mortality in upper and lower gastrointestinal bleeding, thereby allowing early identification and targeted management of patients at high risk of death.

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Adamson D et al, Lancet Gastroenterol Hepatol. 2021;6(4):292–303
Palliative radiotherapy after esophageal cancer stenting: In a randomized phase III trial, patients with advanced esophageal cancer requiring insertion of self-expandable metal stents for the primary management of dysphagia did not gain additional benefit from concurrent palliative radiotherapy, which should not be routinely offered. For a minority of patients at high risk of tumor bleeding, concurrent palliative radiotherapy might reduce bleeding risk and the need for associated interventions.

Link to text Pancreas

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Mahapatra SJ et al, Am J Gastroenterol. 2021;116(3):600–8
Clinical course of chronic pancreatitis (CP) during pregnancy: Younger patients with CP had later and fewer pregnancies compared with patients with late onset CP after pregnancy. However, there was no increased risk of adverse maternal and fetal outcomes and the clinical course of CP during pregnancy was rather benign.

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Online Live Event

Abdominal Imaging in Gastroenterology and Hepatology

Date:
June 2, 2021

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Current Falk literature:

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