Revista Gastroenterología

August – September 2020



Primary sclerosing cholangitis (PSC)

A current phase 2 trial demonstrates that obeticholic acid (5–10 mg once daily) reduced serum alkaline phosphatase. Mild-to-moderate dose-related pruritus was the most common adverse event. Further trials should evaluate the clinical benefit such as liver transplantation-free survival.

Primary biliary cholangitis (PBC)

A current database analysis of the Global PBC Study Group demonstrates that the absolute clinical efficacy of ursodeoxycholic acid (UDCA) with respect to liver transplantation or death varied with baseline prognostic characteristics (presence of cirrhosis, level of alkaline phosphatase), but was high throughout. Indeed, the number needed to treat to prevent liver transplantation or death within 5 years ranged from 4 to 26. These findings strongly emphasize the incentive to promptly initiate UDCA treatment in all patients with PBC and may improve patient compliance.

Hepatitis B virus (HBV):

In a phase 2 randomized trial, addition of nucleic acid polymers (REP 2129 or REP 2165, respectively) to tenofovir and pegylated interferon-α2a induced functional cure (HBsAg negative, HBV-DNA negative, normal alanine aminotransferase levels) and HBsAg to anti-HBs seroconversion in 14 of 40 (35%) HBeAg-negative patients. Addition of nucleic acid polymers did not affect tolerability of tenofovir and pegylated interferon-α2a.

Oesophagus Stomach Duodenum

Diet and aging

Results of a basic science study indicate that a Mediterranean diet intervention for 1 year alters the gut microbiota in older people and improves the abundance of bacterial taxa associated with reduced frailty and better cognitive functions. These findings suggest that healthy diet has the potential to promote healthier ageing.

Neurological symptoms in patients with celiac disease

Analysis of data from a UK biobank indicate that patients with celiac disease have significantly more cognitive deficits and indications of worsened mental health as compared to healthy controls. These alterations are associated with white matter changes as determined by magnetic resonance imaging.


Preoperative chemoradiotherapy for pancreatic cancer

A phase III trial of preoperative chemoradiotherapy versus immediate surgery did not show a significant overall survival benefit. Although, chemoradiotherapy was associated with better outcomes of secondary end points including R0 resection rate, disease-free survival and tumor invasion, additional evidence is required to improve the care of patients with pancreatic cancer.




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