Bowel
Diagnostic yield of colon capsule endoscopy (CCE) versus CT colonography in screening for colorectal polyps:
CCE was superior to CT colonography for detection of polyps ≥ 6 mm and non-inferior for identification of polyps ≥ 10 mm. However, neither of these tests is as effective as conventional colonoscopy.
Underwater vs. conventional endoscopic mucosal resection (EMR) of large sessile or flat colorectal polyps:
Underwater EMR was superior to conventional EMR regarding en bloc resection, R0 resection and procedure time for large colorectal lesions in a monocenter randomized trial. Moreover, recurrence rates for lesions between 30 mm and 40 mm in size were significantly lower following underwater EMR.
Histologic outcomes with vedolizumab vs. adalimumab in ulcerative colitis:
Analysis of the endoscopic end points of the VARSITY trial revealed that higher rates of histological remission, minimal histological disease activity and combined histologic plus endoscopic outcomes were observed with vedolizumab than with adalimumab therapy.
Liver
Proton-pump inhibitors in hereditary hemochromatosis:
Proton-pump inhibitors (PPIs) are currently linked to an unfavorable course of several conditions. In hereditary, HFE-associated hemochromatosis, however, PPI therapy can reduce the phlebotomy burden, presumably by inhibiting iron absorption.
Mortality risk in autoimmune hepatitis (AIH):
A current nationwide population-based cohort study from Sweden shows that AIH is associated with a 2-fold increased risk of death even today. However, mainly cirrhosis and portal hypertension at first diagnosis as well as overlap with cholestatic liver disease contribute to this unfavorable outcome.
Hepatitis C virus (HCV):
Protease inhibitor (PI)-based direct-acting antiviral (DAA) therapy is contraindicated in patients with advanced liver cirrhosis due to the risk of liver decompensation. A current cohort study suggests, however, that PIs are associated with an increased rate of transaminase elevation > 200 U/l, but not with severe liver dysfunction or liver decompensation. Further studies should therefore clarify whether patients with advanced cirrhosis can be safely treated with a PI-based DAA regimen. This would enable new therapeutic options for patients who failed on a non-PI-based therapy.
Oesophagus Stomach Duodenum
High vs. low dose swallowed topical steroids for maintenance therapy of eosinophilic esophagitis (EoE):
In a retrospective cohort study, histological relapse occurred frequently in EoE patients irrespective of steroid dosage. However, relapse developed later in patients on high dose topical steroids without an increase in side effects.
Surgery vs. chemoradiotherapy for stage I esophageal squamous cell carcinoma:
chemoradiotherapy was non-inferior to surgery with regard to overall survival in a prospective trial involving 368 patients and it may be used as alternative treatment option.
Adjustable intragastric balloon for treatment of obesity:
An adjustable intragastric balloon in combination with lifestyle modifications resulted in a sustained weight loss, which was achieved and maintained for 6 months following removal. Balloon volume adjustability permitted individualized therapy, maximizing weight loss and tolerance.
Pancreas
Cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulator use and risk of acute pancreatitis:
Use of CFTR modulators in CF patients was associated with a reduced risk of hospitalizations for acute pancreatitis in an observational cohort study.
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