Search results for "From ACP Journal Club"
Diagnostic performance of 5 FITs varied for detection of advanced colorectal neoplasia
The differences among the fecal immunochemical tests (FITs) in the cross-sectional study show that choice of FIT clearly matters and that FITs should not be considered interchangeable in screening programs for colorectal cancer, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2024/12/20/8.htm
20 Dec 2024
In active ulcerative colitis, risankizumab induced and maintained remission
An industry-funded study provided evidence that risankizumab can be considered a first-line or rescue therapy for moderate to severe ulcerative colitis, but with many medication options, cost may be a consideration, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2024/11/22/10.htm
22 Nov 2024
In patients receiving invasive ventilation, PPIs reduce upper GI bleeding but did not affect mortality at 90 d
An ACP Journal Club commentary said the results of the REVISE trial support the routine use of first-line proton-pump inhibitors (PPIs) for stress ulcer prophylaxis in high-risk, critically ill, ventilated patients but noted that the definition of “high risk” is uncertain.
https://gastroenterology.acponline.org/archives/2024/10/25/9.htm
25 Oct 2024
A next-generation mt-sDNA test had 94% sensitivity for colorectal cancer and 91% specificity for advanced neoplasia
An ACP Journal Club commentary questioned whether multitarget stool DNA (mt-sDNA) is better than fecal immunochemical testing (FIT) or outperformed FIT because of a lower threshold for colonoscopy referral, recommending that the tests be compared at the same referral rate.
https://gastroenterology.acponline.org/archives/2024/09/27/8.htm
27 Sep 2024
In NASH with liver fibrosis, resmetirom improved NASH resolution and reduced fibrosis at 1 y
This was an interim analysis of an industry trial, and final results are needed to determine whether patients with nonalcoholic (or metabolic dysfunction-associated) steatohepatitis (NASH) show clinically meaningful benefits, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2024/06/28/11.htm
28 Jun 2024
In primary care, second-line IBS therapy with amitriptyline vs. placebo reduced symptoms at 6 mo
An ACP Journal Club commentary said the high-quality randomized trial provides pragmatic guidance on amitriptyline dosing in patients with irritable bowel syndrome (IBS), as well as additional support for the drug as an option in primary care after first-line therapies fail.
https://gastroenterology.acponline.org/archives/2024/02/23/7.htm
23 Feb 2024
In persons aged ≥45 y, the mt-sRNA test had 94% sensitivity for colorectal cancer and 46% for advanced adenomas
The results of the industry-funded study support the use of the multitarget stool RNA (mt-sRNA) test for screening, but better adherence will be needed, and it is unclear whether the new test offers any advantages over current stool DNA testing, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2024/02/23/6.htm
23 Feb 2024
In symptomatic adults undergoing high-resolution manometry, long-term opioid use was linked to esophageal dysmotility
The results of a recent meta-analysis highlight the need for clinicians to widen their perspective on the risks of opioids to include both upper and lower GI motility disorders, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2023/12/22/8.htm
22 Dec 2023
In moderate-to-severe Crohn disease, upadacitinib increased clinical remission at 12 and 52 wk
The benefits of upadacitinib need to be weighed against individual patients' risk profiles, but the drug is an important step forward in treating Crohn disease, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2023/09/22/9.htm
22 Sep 2023
In moderately to severely active UC, etrasimod increased remission at 12 and 52 wk but increased adverse events
Given their overall safety and convenience, etrasimod and other oral sphingosine-1-phosphate receptor modulators can be considered as first-line therapy in clinically appropriate patients with ulcerative colitis (UC) who do not respond to 5-aminosalicylic acid medications, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2023/07/28/7.htm
28 Jul 2023
In H pylori infection, vonoprazan plus high-dose amoxicillin was noninferior to B-quadruple therapy for eradication
While the dual therapy provides another promising option for Helicobacter pylori eradication, replicating the findings in more diverse patient populations would provide additional reassurance about widespread use, an ACP Journal Club commentary noted.
https://gastroenterology.acponline.org/archives/2023/05/26/8.htm
26 May 2023
In persons with constipation or IBS-C, kiwifruit vs. psyllium increased spontaneous bowel movements
Findings of the randomized trial bolster recommendations of diet manipulation and lifestyle modifications for chronic constipation syndromes, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2023/05/26/7.htm
26 May 2023
In older patients receiving aspirin, H pylori eradication reduced hospitalization or death due to peptic ulcer bleeding at 2.5 y
Several limitations of the trial may affect the extent to which the results will change current practice of Helicobacter pylori eradication in patients receiving aspirin, especially older patients, an ACP Journal Club commentary noted.
https://gastroenterology.acponline.org/archives/2023/04/21/6.htm
21 Apr 2023
In adults receiving mechanical ventilation, selective decontamination of the digestive tract reduces hospital mortality
While findings of the meta-analysis did not show evidence of increased incidence of antimicrobial-resistant organisms, the review included data from regions that have very low levels of antimicrobial resistance, an ACP Journal Club commentary noted.
https://gastroenterology.acponline.org/archives/2023/03/24/11.htm
24 Mar 2023
In adults using oral anticoagulants, PPI use may be associated with lower risk for upper GI bleeding
An ACP Journal Club commentary on the meta-analysis stressed the importance of assessing patients' underlying risk for GI bleeding and using overall clinical risk to guide shared decision making in those at higher risk or with lower baseline bleeding tolerance.
https://gastroenterology.acponline.org/archives/2022/11/18/9.htm
18 Nov 2022
Recommendations for pharmacologic management of IBS with diarrhea, constipation
New guidelines suggest that there are several effective drugs available for irritable bowel syndrome (IBS), but a more detailed analysis indicates that the best treatments increase the rate of response by only 15% versus placebo, an ACP Journal Club commentary said.
https://gastroenterology.acponline.org/archives/2022/11/18/8.htm
18 Nov 2022
In active UC, upadacitinib induced and maintained remission
JAK inhibitors, such as upadacitinib, represent an advance in the management of patients with ulcerative colitis (UC); however, it remains unclear whether the balance of efficacy versus risk favors one drug over the others, according to an ACP Journal Club commentary.
https://gastroenterology.acponline.org/archives/2022/10/28/11.htm
28 Oct 2022
In active Crohn disease, risankizumab increased clinical remission and endoscopic response at 12 wk
While the FDA has now approved risankizumab for adults with moderate to severe Crohn disease, understanding of the drug's role in relation to other biologic therapies is limited by broad exclusion criteria in randomized controlled trials, an ACP Journal Club commentary noted.
https://gastroenterology.acponline.org/archives/2022/10/28/10.htm
28 Oct 2022
In IBS, a smartphone application for self-managing a FODMAP-lowering diet vs. otilonium bromide reduced symptoms at 8 wk
Delivery of a fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)-lowering dietary intervention via an app may help educate patients about diet and augment the clinician-patient relationship, an ACP Journal Club commentary noted.
https://gastroenterology.acponline.org/archives/2022/08/26/9.htm
26 Aug 2022
In drug-refractory IBS, group CBT with interoceptive exposure improved symptoms and quality of life at 13 wk
Given the results of this small, randomized trial, a head-to-head comparison of multidisciplinary care versus group cognitive behavioral therapy (CBT) delivered over the internet for patients with irritable bowel syndrome (IBS) is now warranted, an ACP Journal Club commentary noted.
https://gastroenterology.acponline.org/archives/2022/08/26/10.htm
26 Aug 2022