Author: Simonetto, Douglas ; Idalsoaga, Francisco ; Khan, Mohammad Qasim ; Malhi, Gurpreet ; Ramirez-Cadiz, Carolina ; Mehta, Heer ; Cabezas, Joaquín ; Kamath, Patrick S ; Sarin, Shiv K ; Bataller, Ramon ; Soriano, German ; Cuyas, Berta ; Maiwall, Rakhi ; Diaz, Luis Antonio ; Islam, Alvi Husni ; Havaj, Daniel Jan ; Shah, Vijay ; Al-Karaghouli, Mustafa ; Echavarria, Victor ; Arab, Juan Pablo ; Caldentey, Vicente ; Arrese, Marco ; Qian, Steve ; Ayares, Gustavo ; Mortuza, Rokhsana ; Higuera-De La Tijera, María Fátima ; Skladaný, Lubomir ; Guizzetti, Leonardo ; Arnold, Jorge ; Rincón, Diego ; Elfeki, Mohamed A ; Dunn, Winston ; Abraldes, Juan G ; Ventura Cots, Meritxell ; Poca, Maria ; Zhang, Wei ; Singal, Ashwani K

BackgroundSevere alcohol-associated hepatitis (sAH) is a life-threatening condition with high mortality, where corticosteroid use is the only treatment that has shown short-term benefits. Pentoxifylline, an anti-tumour necrosis factor-alpha agent, has been proposed for its potential to improve outcomes, especially in patients with acute kidney injury (AKI). We aimed to evaluate the impact of pentoxifylline on mortality in patients with sAH and AKI in a well-characterised global cohort.MethodsWe conducted a retrospective, registry-based study including patients meeting the National Institute on Alcohol Abuse and Alcoholism clinical criteria for sAH and AKI. Mortality was the primary endpoint, with liver transplantation as a competing risk. Statistical analysis included Cox regression and Kaplan-Meier survival estimates.ResultsWe included 525 patients from 20 centres across eight countries. The median age was 48 years, with 26.1% females, and 76.9% had a history of cirrhosis. Multivariable Cox regression models showed that pentoxifylline use was not associated with survival (HR 1.20, 95% CI 0.85 to 1.69, p=0.291). Factors associated with mortality included age (HR 1.23, 95% CI 1.10 to 1.36, p<0.001), Model for End-Stage Liver Disease score at admission (HR 1.06, 95% CI 1.04 to 1.08, p<0.001) and renal replacement therapy use (HR 1.39, 95% CI 1.05 to 1.84, p=0.019). The main causes of death were multiple organ failure (42%), infections (10%), oesophageal varices bleeding (7%) and renal failure (6%).ConclusionPentoxifylline showed no significant benefit on mortality in patients with sAH and AKI. Further studies are needed to refine treatment strategies for this high-risk group.

01 Feb 2025·Clinical Journal of Gastroenterology

The improvement of a refractory enterocutaneous fistula with colchicine in a patient with Crohn’s disease who had an MEFV gene mutation

Article

Author: Matusoka, Katsuyoshi ; Kurumi, Hiroki ; Yokoyama, Yoshihiro ; Akita, Kotaro ; Hayashi, Yuki ; Nakase, Hiroshi ; Kazama, Tomoe

Enterocutaneous fistulas (ECFs) occurring in the setting of Crohn's disease (CD) are difficult to cure with medical treatment alone and affects a patient's quality of life. A 39-year-old man was diagnosed with an ileocolitis-type CD in 2007. His inflammation was insufficiently controlled despite the administration of an anti-tumor necrosis factor-alpha antibody. Therefore, he underwent subtotal colectomy, terminal ileal resection, and ileostomy for multiple colon and anal stenoses in Dec 2015. The patient subsequently received ustekinumab; however, purulent discharge was observed from a postoperative scar around the umbilicus in July 2019. In July 2021, enteroscopy and magnetic resonance imaging (MRI) showed an ECF extending from the small intestine to the umbilicus. Upon referral to our hospital, laboratory data showed elevated C-reactive protein (CRP) and serum amyloid A (SAA). After receiving colchicine, his purulent discharge disappeared, and his CRP and SAA levels rapidly decreased. Enteroscopy and MRI performed 1 year and 5 months after the administration of colchicine revealed ECF closure. Genetic analysis revealed that the patient harbored an MEFV exon 1 (E84K) mutation.

01 Jun 2024·Clinical Journal of Gastroenterology

Severe ulcerative colitis induced by COVID-19 vaccination

Article

Author: Akizue, Naoki ; Ohta, Yuki ; Okimoto, Kenichiro ; Matsumura, Tomoaki ; Kato, Jun ; Ishikawa, Kentaro ; Taida, Takashi ; Kato, Naoya ; Saito, Keiko ; Matsusaka, Keisuke

AbstractA 37-year-old woman developed severe colitis with diffuse mucosal erythema and ulcerations throughout the entire colon after the 3rd vaccination of COVID-19. Stool culture was negative, and the pathological findings showed increased lymphoplasmacytic and neutrophilic infiltration in the colonic lamina propria, which were consistent with ulcerative colitis. After the treatment with anti-tumor necrosis factor-α agent, the ulceration markedly improved with development of severe colonic stenosis, which was successfully dilated with endoscopic balloon dilation. In case of COVID-19 vaccination, it should be noted that vaccination could be a trigger for the onset of UC.

100 Deals associated with Anti-tumour necrosis factor-alpha antibody(Materia Medica Holding Research And Production Company)

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EULAR2004	Phase 3	Rheumatoid Arthritis TNFalpha \| IL1 \| IL6	60	Artrofoon	(ymmdhtsisf) = uyxmebkfsd aidvcrczga (xkqclnfphm )	Positive	09 Jun 2004
				Diclofenac	(ymmdhtsisf) = lgovegqxfk aidvcrczga (xkqclnfphm )

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