Alimentary pharmacology & therapeutics
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Aliment. Pharmacol. Ther. · Feb 2018
Meta Analysis Comparative StudySystematic review with network meta-analysis: comparative assessment of tofacitinib and biological therapies for moderate-to-severe ulcerative colitis.
Biological therapies have improved the care of patients with ulcerative colitis (UC). Tofacitinib, an oral small-molecule Janus kinase inhibitor, is potentially a new treatment option. ⋯ Tofacitinib and biologics are efficacious and safe for UC. Further high-quality research is warranted to establish the best therapeutic option.
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Aliment. Pharmacol. Ther. · Feb 2018
Observational StudyInterferon-free therapy of chronic hepatitis C with direct-acting antivirals does not change the short-term risk for de novo hepatocellular carcinoma in patients with liver cirrhosis.
Hepatitis C virus (HCV) clearance with IFN-based therapies reduces the incidence of hepatocellular carcinoma (HCC). There has been some debate if IFN-free therapy with direct-acting antivirals alters the risk for HCC. ⋯ IFN-free direct-acting antiviral therapy of chronic hepatitis C does not alter the short-term risk for HCC in patients with liver cirrhosis. A reduced HCC incidence may become evident after more than 1.5 years of follow-up.
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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.