In reflux-related heartburn unresponsive to PPIs, surgery increased treatment success vs active medical treatment
An ACP Journal Club commentary noted that physicians should not change their practice based on the results of the trial, which are in contrast to the literature and expert opinion, until they are confirmed by studies assessing objective primary end points.
27 Mar 2020
While fecal microbiota transplantation was effective in patients with moderate to severe irritable bowel syndrome in a randomized trial, long-term risks of the therapy remain uncertain, an ACP Journal Club commentary noted.
22 May 2020
In high-risk patients with acute upper GI bleeding, urgent vs. early endoscopy did not differ for 30-day mortality
While a randomized trial found no better outcomes with endoscopy within six hours of gastroenterology consult, “middle-of-the-night” endoscopy should still be considered for certain higher-risk patients who were excluded from the trial, an ACP Journal Club commentary noted.
28 Aug 2020
After surgery for stage II or III colorectal cancer, more vs less frequent follow-up did not differ for 5-year mortality
The findings help clarify the ideal process for surveillance of clinical recurrence of colorectal cancer, an ACP Journal Club commentary said.
26 Oct 2018
H. pylori treatment reduced risk for gastric cancer in patients with a family history of gastric cancer
While results of the trial support a test-and-treat screening approach for Helicobacter pylori in patients with a first-degree relative with gastric cancer, more research is needed before considering universal screening in this population, an ACP Journal Club commentary noted.
26 Jun 2020
In CVD, continuing vs interrupting clopidogrel before colonoscopy did not differ for delayed postpolypectomy bleeding
The results of this randomized trial do not support current guidelines, which recommend withholding antiplatelet drugs to reduce risk for postpolypectomy bleeding, an ACP Journal Club commentary said.
26 Jul 2019
H. pylori eradication therapy may reduce gastric cancer risk; rifabutin-based therapy effective in industry-sponsored trial
A meta-analysis suggested that, in addition to preventing progression, early Helicobacter pylori eradication therapy reduces gastric cancer risk, and a novel rifabutin-based therapy may offer physicians another option for initiating eradication treatment, an ACP Journal Club commentary on both studies said.
25 Sep 2020
In US veterans, PPIs were linked to increased all-cause and some cause-specific mortality compared with H2-blockers
The observational study cannot establish causation, and the only way to prove that proton-pump inhibitors (PPIs) cause the various adverse outcomes attributed to them is to compare them with placebo or no treatment in a randomized trial, according to an ACP Journal Club commentary.
27 Sep 2019
Pantoprazole did not reduce risk for a composite of upper gastrointestinal events in stable arterial disease
Given the limitations of this large industry-funded trial, the only definitive conclusion one can draw is that patients on aspirin and rivaroxaban with low risk for bleeding may get a very small benefit from long-term proton-pump inhibitor therapy, an ACP Journal Club commentary said.
25 Oct 2019
In compensated cirrhosis with portal hypertension, beta-blockers reduced a composite of decompensation or death
The trial results cannot be generalized to all patients with cirrhosis, and future trials should look at whether similar effects could be achieved simply by limiting salt intake, an ACP Journal Club commentary said.
23 Aug 2019