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Gastroenterology
Top Medical News
The tricyclic antidepressant amitriptyline, when used at low dose in the second-line treatment setting and titrated according to symptom response and side-effects, is safe and provides relief from symptoms of irritable bowel syndrome (IBS), as shown in the phase III ATLANTIS* trial.
People who consume a lot of ultra-processed food (UPF) have a greater risk of developing nonalcoholic fatty liver disease (NAFLD), liver fibrosis, and cirrhosis, as well as severe liver disease and adverse levels of several clinical biomarkers, reveals a study.
Primary tumour resection (PTR) in combination with chemotherapy (C) appears beneficial to a specific subgroup of patients with unresectable colorectal mucinous adenocarcinoma with liver metastasis (UCR-MAC-LM) compared with PTR or C alone, suggests a study.
Both vedolizumab and ustekinumab are safe to use in pregnant women with inflammatory bowel disease (IBD), as reported in a study.
Adding sotorasib to panitumumab significantly improves progression-free survival (PFS) in patients with chemorefractory KRAS G12C-mutated metastatic colorectal cancer (mCRC) compared with investigator’s choice of standard of care treatment, according to the CodeBreaK 300 trial presented at ESMO Asia 2023.
The risk of osteoporotic fracture seems greater in patients with autoimmune hepatitis (AIH), reveals a recent study. In addition, those with cirrhosis and long-term use of glucocorticoids appear to be at much greater risk.
It is safe to use long-term growth hormone (GH) therapy in patients with decompensated cirrhosis (DC), suggests a study, noting improvements in malnutrition and even quality of life (QoL). However, 12-month survival does not seem to improve.
Special Reports
Dual blockade of KRASG12C and EGFR may overcome treatment resistance in KRASG12C-mutated colorectal cancer (CRC). At the European Society for Medical Oncology Congress 2023 (ESMO 2023), Dr Filippo Pietrantonio of the Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, presented primary results of the phase III CodeBreaK 300 trial, which demonstrated significantly prolonged progression-free survival (PFS) with sotorasib in combination with panitumumab vs standard care with trifluridine plus tipiracil (T/T) or regorafenib in patients with chemorefractory metastatic CRC (mCRC) harbouring a KRASG12C mutation. Discussant Professor Miriam Koopman of Department of Medical Oncology, Utrecht University, Utrecht, Netherlands, shared her insights into the trial.
At the United European Gastroenterology Week (UEGW) 2023 held in Copenhagen, Denmark, researchers presented latest findings on tofacitinib in ulcerative colitis (UC). Topics covered included identification of factors associated with tofacitinib treatment response and maintenance of response, histological outcomes following treatment, and long-term safety data from the global tofacitinib UC clinical programme.
Intestinal ultrasound (IUS) is increasingly acknowledged as a valid point-of-care tool that objectively assesses inflammatory bowel disease (IBD) activity. At the International Digestive Disease Forum (IDDF) 2023, Professor Christian Maaser of the Municipal Hospital of Lüneburg, Lüneburg, Germany, discussed the emerging role of IUS in IBD management. He also shared practical tips in using IUS, including how and when to use it as well as what to look for while performing IUS.
A 77-year-old male presented with an incidental finding of lymphocytosis (absolute lymphocyte count [ALc], 9 x 109/L) in November 2018.
Major bleeding secondary to intake of direct oral anticoagulants (DOACs) and hyperkalaemia are two potentially fatal conditions encountered in the Accident and Emergency (A&E) department. At an industry-sponsored meeting organized by the Hong Kong College of Emergency Medicine, Professor Adam J Singer of the Stony Brook University Hospital in Stony Brook, New York, US, shared updates on management of these conditions, focusing on the role of andexanet alfa in reversing the effects of factor Xa (FXa) inhibitors, and discussed the emergence of sodium zirconium cyclosilicate (SZC) as the preferred potassium binder to treat life-threatening hyperkalaemia.
A 75-year-old male with shortness of breath and mild chronic cough was admitted to hospital in September 2022. He had multiple comorbidities, including diabetes, fatty liver, hypertensive nephropathy, postinfectious pulmonary fibrosis, and haemolytic anaemia (managed with azathioprine). Upon admission, the patient was not experiencing anorexia or weight loss, and his Eastern Cooperative Oncology Group performance status (ECOG PS) was 0. (Table 1)
In the phase III TOPAZ-1 trial, adding the immune checkpoint inhibitor (ICI), durvalumab, to standard-of-care (SoC) chemotherapy with gemcitabine plus cisplatin (GemCis) resulted in improved survival and response rates in patients with advanced biliary tract cancer (BTC). In an interview with MIMS Oncology, Dr Thomas Yau, Specialist in Medical Oncology in Hong Kong, who is one of the investigators of TOPAZ-1, discussed the trial’s key findings and how adding first-line immunotherapy may improve the limited survival gained from upfront chemotherapy alone in patients with advanced BTC.
Conference Reports
Adding sotorasib to panitumumab significantly improves progression-free survival (PFS) in patients with chemorefractory KRAS G12C-mutated metastatic colorectal cancer (mCRC) compared with investigator’s choice of standard of care treatment, according to the CodeBreaK 300 trial presented at ESMO Asia 2023.
Higher red meat intake is linked to a higher risk of ulcerative colitis (UC) flare, according to an expert who presented findings from a recent study at AIBD 2023.
Treatment with upadacitinib (UPA) delivers clinical benefits to patients with prior Crohn’s disease (CD)-related surgeries, according to a study presented at AIBD 2023. Moreover, a maintenance dose of 30 mg once a day (QD) demonstrates greater efficacy.
Risankizumab outdoes ustekinumab in achieving endoscopic remission at week 24 in patients with moderate-to-severe Crohn’s disease (CD), as well as in other clinical, endoscopic, and quality of life (QoL) outcomes, as shown by the results of the phase IIIB SEQUENCE trial presented at AIBD 2023.
A study presented at AIBD 2023 provides strong evidence that histological remission may be achievable in patients with ulcerative colitis (UC).
Exposure to ozanimod during early pregnancy does not appear to pose risks of adverse pregnancy outcomes and foetal health despite recommendations to avoid getting pregnant while receiving ozanimod and for 3 months after treatment discontinuation, according to a study.
Individuals who have undergone an appendectomy may be at heightened risk of Crohn’s disease, according to the results of a systematic review and meta-analysis.
