A randomized controlled study shows that heat-inactivated Bifidobacterium bifidum MIMBb75 substantially alleviates IBS and its symptoms. These beneficial effects are mediated independently of cell viability
Results of an Italian registry including 79 IBD patients suggest that active IBD, age and comorbidities are associated with negative COVID-19 outcomes including pneumonia and mortality while medical therapies are not.
Management of patients with inflammatory bowel diseases and immune-mediated secondary loss of response to anti-TNF
Randomized trial reveals that combination therapy of a second anti-TNF and azathioprine is superior to anti-TNF monotherapy with regard to maintenance of response as well as pharmacokinetic response rates.
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.
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.
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
A large randomized trial including approx. 12.000 patients revealed that high-dose tranexamic acid over 24 hours does not reduce death from gastrointestinal bleeding while rates of venous thromboembolic events are slightly increased.
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.
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.
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.