Misoprostol for non-alcoholic steatohepatitis: a randomised control trial
BMJ Open Gastroenterology
by Siyal, M., Abbas, Z., Qadeer, M. A., Saeed, A., Ali, U., Khatoon, A.
1w ago
Introduction The management of non-alcoholic steatohepatitis (NASH) is an unmet clinical need. Misoprostol, a structural analogue of naturally occurring prostaglandin E1, has been reported to decrease proinflammatory cytokine production and may have a potential role in treating NASH. We aimed to evaluate the efficacy and safety of misoprostol in treating patients with NASH. Methods In this phase 2, double-blind, randomised, placebo-controlled trial, patients with NASH were randomly assigned in a 1:1 ratio to receive 200 µg of misoprostol or placebo thrice daily for 2 months. The primary endpoi ..read more
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Exploring factors influencing quality of life variability among individuals with coeliac disease: an online survey
BMJ Open Gastroenterology
by Elwenspoek, M., Banks, J., Desale, P. P., Watson, J., Whiting, P.
2w ago
Objective Patients with coeliac disease (CD) need to follow a strict gluten-free diet to manage symptoms and prevent complications. Restrictions imposed by the diet can be challenging and affect quality of life (QoL). We explored sources of variation in QoL among patients with CD. Design We conducted an online survey of coeliac patients in the UK, including a CD-specific QoL tool (CD-QOL V.1.0), questions on diet adherence and an optional comment box at the end. The survey was disseminated via social media and went live between January and March 2021. We performed multiple linear regression an ..read more
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Associations between prior healthcare use, time to diagnosis, and clinical outcomes in inflammatory bowel disease: a nationally representative population-based cohort study
BMJ Open Gastroenterology
by Jayasooriya, N., Saxena, S., Blackwell, J., Bottle, A., Creese, H., Petersen, I., Pollok, R. C. G., POP-IBD Collaboration
3w ago
Background Timely diagnosis and treatment of inflammatory bowel disease (IBD) may improve clinical outcomes. Objective Examine associations between time to diagnosis, patterns of prior healthcare use, and clinical outcomes in IBD. Design Using the Clinical Practice Research Datalink we identified incident cases of Crohn’s disease (CD) and ulcerative colitis (UC), diagnosed between January 2003 and May 2016, with a first primary care gastrointestinal consultation during the 3-year period prior to IBD diagnosis. We used multivariable Cox regression to examine the association of primary care cons ..read more
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Clinical, endoscopic and therapeutic features of bleeding Dieulafoys lesions: case series and literature review
BMJ Open Gastroenterology
by Aabdi, B., Kharrasse, G., Zazour, A., Koulali, H., Elmqaddem, O., Zahi, I.
3w ago
Objective Dieulafoy’s lesions (DLs) are a rare but potentially life-threatening source of gastrointestinal (GI) haemorrhage. They are responsible for roughly 1%–6.5% of all cases of acute non-variceal GI bleeding. Here, we describe retrospectively the clinical and endoscopic features, review the short-term and long-term outcomes of endoscopic management of bleeding DLs and we identify rate and risk factors, of recurrence and mortality in our endoscopic unit. Design Data were collected from patients presenting with GI haemorrhagic secondary to DLs between January 2018 and August 2023. Patients ..read more
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Impact of antitumour necrosis factor therapy on surgery in inflammatory bowel disease: a population-based study
BMJ Open Gastroenterology
by Hawthorne, A. B., Arms-Williams, B., Cannings-John, R., Pollok, R. C. G., Berry, A., Harborne, P., Trivedi, A.
3w ago
Objective It is unclear whether widespread use of biologics is reducing inflammatory bowel disease (IBD) surgical resection rates. We designed a population-based study evaluating the impact of early antitumour necrosis factor (TNF) on surgical resection rates up to 5 years from diagnosis. Design We evaluated all patients with IBD diagnosed in Cardiff, Wales 2005–2016. The primary measure was the impact of early (within 1 year of diagnosis) sustained (at least 3 months) anti-TNF compared with no therapy on surgical resection rates. Baseline factors were used to balance groups by propensity scor ..read more
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Population-level impact of the BMJ Rapid Recommendation for colorectal cancer screening: a microsimulation analysis
BMJ Open Gastroenterology
by van Duuren, L. A., Bulliard, J.-L., Mohr, E., van den Puttelaar, R., Plys, E., Brändle, K., Corley, D. A., Froehlich, F., Selby, K., Lansdorp-Vogelaar, I.
1M ago
Objective In 2019, a BMJ Rapid Recommendation advised against colorectal cancer (CRC) screening for adults with a predicted 15-year CRC risk below 3%. Using Switzerland as a case study, we estimated the population-level impact of this recommendation. Design We predicted the CRC risk of all respondents to the population-based Swiss Health Survey. We derived the distribution of risk-based screening start age, assuming predicted risk was calculated every 5 years between ages 25 and 70 and screening started when this risk exceeded 3%. Next, the MISCAN-Colon microsimulation model evaluated biennial ..read more
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Effects of prednisolone tapering on effectiveness of infliximab in patients with ulcerative colitis: data from a retrospective cohort
BMJ Open Gastroenterology
by Ovesen, P. D., Attauabi, M., Ilvemark, J. F. K. F., Wewer, M. D., Warren, D. J., Burisch, J., Klaasen, R. A., Bolstad, N., Steenholdt, C., Seidelin, J. B.
1M ago
Background and objective The influence of concomitant prednisolone on clinical outcomes and safety in infliximab-treated ulcerative colitis (UC) patients is unknown. Design, setting, participants and outcome measures A retrospective cohort study was performed, including 147 UC patients treated with infliximab at a tertiary inflammatory bowel disease (IBD) centre. Primary outcome was corticosteroid-free clinical remission (CFCR) at week 14 and week 52. Patients were grouped according to prednisolone tapering regimens: standard (≤5 mg/week), fast (>5 mg/week), direct discontinuation or no pre ..read more
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What is the role of out of programme clinical fellowships in the era of Shape of Training? A single-centre cohort study
BMJ Open Gastroenterology
by Raju, S. A., Bowker-Howell, F. J., Aziz, I., Thoufeeq, M., Lobo, A. J., Gleeson, D. C., Al-Joudeh, A., McAlindon, M. E., Hopper, A. D., Kumar, S., Sidhu, R., Sanders, D. S.
1M ago
Background The updated Shape of Training curriculum has shortened the duration of specialty training. We present the potential role of out of programme clinical fellowships. Method An electronic online survey was sent to all current fellows to understand their experiences, training opportunities and motivations. Data were collected on fellows’ endoscopic experiences and publications using PubMed for all previous doctors who have completed the Sheffield Fellowship Programme. Results Since 2004, 39 doctors have completed the Sheffield Fellowship. Endoscopic experience: current fellows completed ..read more
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Safety and tolerability of OP-724 in patients with haemophilia and liver cirrhosis due to HIV/HCV coinfection: an investigator-initiated, open-label, non-randomised, single-centre, phase I study
BMJ Open Gastroenterology
by Kimura, K., Tanuma, J., Kimura, M., Imamura, J., Yanase, M., Ieiri, I., Kurosaki, M., Watanabe, T., Endo, T., Yotsuyanagi, H., Gatanaga, H.
1M ago
Objective Patients with haemophilia and HIV who acquire hepatitis C virus (HCV) after receiving contaminated blood products can experience accelerated progression of liver fibrosis and a poor prognosis, making liver disease a prominent cause of mortality among these patients. In the current study, we aimed to evaluate the safety and tolerability of the potential antifibrotic agent OP-724—a CREB-binding protein/β-catenin inhibitor—in this patient subset. Design In this single-centre, open-label, non-randomised, phase I trial, we sequentially enrolled patients with cirrhosis following HIV/HCV co ..read more
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Increased rate of pancreatitis in gender diverse and transgender patients on hormone therapy: a case series study
BMJ Open Gastroenterology
by Podboy, A., Casey, C., Buerlein, R. C. D., Strand, D. S., Shami, V. M., Wang, A. Y.
2M ago
Background There is limited data on the incidence of gastrointestinal-specific pathology in gender non-conforming (GNC) populations. Methods Retrospective analysis of pancreatitis incidence rates in transgender and GNC persons exposed and not exposed to gender-affirming hormone therapy (GAHT). Results 7 of the 1333 patients on hormone therapy had an incidence of pancreatitis. 0 of the 615 patients with no history of GAHT use developed pancreatitis. Representing a 6.96 (95% CI 2.76 to 848.78) for the development of pancreatitis in patients with exposure to GAHT therapy. Conclusion Clinicians wo ..read more
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