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GI Pearls Episode 6 – First two weeks of July 2017 Gastroenterology Literature Review

Show Notes for 2017 First two weeks of July 006
  1. Treatment with Biologic Agents has not Reduced Surgeries among Patients with Crohn’s Disease with Short Bowel Syndrome – CGH
  2. Risk of colorectal cancer in chronic liver diseases: a systematic review and meta-analysis – GIE
  3. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection among Metabolically Healthy Obese Adults – JAMA Internal Medicine
  4. Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis – GIE
  5. Mobile phone in the stomach:call the emergency endoscopist! – GIE
  6. Impact of gum chewing on the quality of bowel preparation for colonoscopy: an endoscopist-blinded, randomized controlled trial – GIE
  7. Hepatitis B reactivation in Hepatitis B and C coinfected Patients treated with Antiviral Agents: A systematic Review and Meta-analysis. – Hepatology
  8. Gastostomies Preserve But Do Not Increease Quality of Life for Patients and Caregivers – CGH
  9. “Errare Humanum Est, Perseverare Autem Diabolicum” – Gastro
  10. Association of Changes in Diet Quality with Total and Cause-Specific Mortality – NEJM
  11. Association Between Proton Pump Inhibitor Use and Cognitive Function in Women – Gastro
  12. Increased Rate of Adenoma Detection Associates with Reduced Risk of Colorectal Cancer and Death – Gastro
  13. Risk Factors for 30-day Hospital Readmission for Diverticular Hemorrhage. – J of Clinical Gastro
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2017 · CGH · Podcast

GI Pearls Episode 2 – First two weeks of May 2017

Show Notes for 2017 May 1- 15 002

 This one is a bit noisy. Not the Best Microphone. Sorry. 

List of articles cited

  1. Tofacitinib as Induction and Maintenance Therapy for Ulcerative Colitis NEJM
  2. Thiazolidinediones and Advanced Liver Fibrosis in Nonalcoholic Steatohepatitis  – Jama Internal Medicine
  3. Tenapanor Treatment of Patients With Constipation-Predominant Irritable Bowel Syndrome: A Phase 2, Randomized, Placebo-Controlled Efficacy and Safety Trial  The AmJ of Gastro
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2015 · Article · Uncategorized

AJM300 – Oral Therapy for Ulcerative Colitis

I am surprised that there are so few new oral drugs coming out for IBD. I guess Infusions are all the rage due to potential profits.  AJM300 has been around for a while, and I remember seeing an abstract for it at DDW last year.

This Article – in Gastroenterology, which has been online for a while, finally came out in print edition.

AJM300 is an alpha4 integrin antagonist. In their paper describing a double-blind, placebo-controlled phase 2a study, AJM300 was shown to be well tolerated and more effective than placebo including both clinical response, remission and mucosal healing.

For those of you like me, who do not remember what Phase 2a is – Pilot clinical trials to evaluate efficacy ( and safety) in selected populations of patients with the disease or condition to be treated, diagnosed, or prevented. Objectives may focus on dose-response, type of patient, frequency of dosing, or numerous other characteristics of safety and efficacy.  (2B being a larger study showing efficacy, the so-called “Pivotal trial”).

Another interesting statement in the article made me aware of the number of cases of PML as a result of Natalizumab treatment – 2.1 cases per 1000 (total of 212 cases out of 99,751 patients treated). Two take aways for me – I had no idea that many patients were treated with Ntalizumab!!!I had no idea that there was a registry, but that makes sense.

Once again, remember,  JCV negative patients never get PML.

Lastly, efficacy in this group: I will only mention mucosal healing which is most important for these pilot studies:  58.8% – AJM300 versus 29.4% in placebo group. – another reminder that a third of patients with UC will just get better.

 

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