Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Jan 2018
Review Meta AnalysisSystematic review with network meta-analysis: first- and second-line pharmacotherapy for moderate-severe ulcerative colitis.
There are limited data to inform positioning of agents for treating moderate-severe ulcerative colitis (UC). ⋯ Infliximab and vedolizumab are ranked highest as first-line agents, and tofacitinib is ranked highest as second-line agent, for induction of remission and mucosal healing in patients with moderate-severe UC, based on indirect comparisons. Head-to-head trials are warranted to inform clinical decision-making with greater confidence.
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Aliment. Pharmacol. Ther. · Jan 2018
ReviewReview article: the gut microbiome as a therapeutic target in the pathogenesis and treatment of chronic liver disease.
Mortality from chronic liver disease is rising exponentially. The liver is intimately linked to the gut via the portal vein, and exposure to gut microbiota and their metabolites translocating across the gut lumen may impact upon both the healthy and diseased liver. Modulation of gut microbiota could prove to be a potential therapeutic target. ⋯ Manipulation of the gut microbiota with diet, probiotics or faecal microbiota transplantation to promote the growth of "healthy" bacteria may ameliorate the dysbiosis and alter prognosis.
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Aliment. Pharmacol. Ther. · Jan 2018
Multicenter StudyShort-term risk of hepatocellular carcinoma after hepatitis C virus eradication following direct-acting anti-viral treatment.
With the development of direct-acting anti-virals (DAAs), almost all patients with chronic hepatitis C virus (HCV) infection can achieve sustained viral response (SVR). ⋯ For cirrhotic patients after elimination of HCV, serum EOT-AFP level and previous HCC characteristics would be useful markers for predicting de novo HCC or recurrence.
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Aliment. Pharmacol. Ther. · Jan 2018
Angiotensin receptor blocker use and gastro-oesophageal cancer survival: a population-based cohort study.
Angiotensin receptor blockers (ARBs; including candesartan, losartan, olmesartan and valsartan) are widely used to treat hypertension, heart failure and diabetic neuropathy. There is considerable pre-clinical evidence that ARBs can reduce cancer progression, particularly for gastric cancer. Despite this, epidemiological studies have yet to assess the impact of ARB use on gastro-oesophageal cancer survival. ⋯ In this large population-based gastro-oesophageal cancer cohort, we found moderately reduced cancer-specific mortality among ARB users. However, confirmation in further independent epidemiological studies with sufficient staging information is required.
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Aliment. Pharmacol. Ther. · Jan 2018
Risk factors for biopsy-proven advanced non-alcoholic fatty liver disease in the Veterans Health Administration.
With its increasing incidence, nonalcoholic fatty liver disease (NAFLD) is of particular concern in the Veterans Health Administration (VHA). ⋯ In the VHA, diabetes and severe obesity increased risk for advanced fibrosis in NAFLD. Of these patients, only a small proportion (~20%) had enrolled in diet/exercise programs or had bariatric surgery (~2%). These results suggest that providers should focus/tailor interventions to improve outcomes, particularly in those with diabetes and severe obesity.