Falk Gastro Info 6/2022

Vedolizumab for perianal fistulizing Crohn’s disease: Sustained improvements in fistulizing disease were seen in a small phase 4 trial (ENTERPRISE). An additional dose at week 10 does not appear to alter treatment outcomes.

Computer-aided polyp detection (CADe) and colonoscopy experience: In less experienced examiners, CADe assistance during colonoscopy increased adenoma detection rates. Experience in endoscopy appears to play a minor role as determining factor.

Systematic review underlines the risk of hepatitis B virus (HBV) reactivation during therapies for hepatocellular carcinoma (HCC): HBsAg-positive patients with HCC are at high or intermediate risk of HBV reactivation depending on the type of HCC therapy. Nucleos(t)ide analogue prophylaxis reduces the risk of HBV reactivation, practically eliminates the risk of hepatitis flare, and should be administered regardless of HCC treatment.

Modelling study demonstrates little change in global hepatitis C virus (HCV) prevalence between 2015 and 2020: At the beginning of 2020 (and thus before the onset of the COVID-19 pandemic), there were an estimated 56.8 million viremic HCV infections globally. Although this number represents a decrease of 6.8 million from 2015, the forecasts suggest that we are not currently on track to achieve global elimination targets by 2030.

Double-blind randomized controlled trial on L-ornithine L-aspartate (LOLA) in acute treatment of severe hepatic encephalopathy (HE): Data on the use of intravenous LOLA in the treatment of overt HE (OHE) is limited. A current double-blind randomized controlled trial demonstrates that the combination of LOLA with lactulose and rifaximin is more effective than only lactulose and rifaximin in improving grades of hepatic encephalopathy, recovery time from encephalopathy, with lower 28-day mortality.

Epidemiology of celiac disease: A nationwide population-based cohort study from Sweden revealed that the incidence of celiac disease increased until 2002/2003 in females and until 2006 in males. Since then, incidence has declined despite increasing numbers of duodenal/jejunal biopsies. The lifetime risk to develop celiac disease was 1:44 in females and 1:72 in males.

Time-restricted eating in weight loss: In a randomized trial among patients with obesity, a regimen with time-restricted eating and calorie restriction was not more beneficial with regard to reduction in body weight than calorie restriction alone.