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Hepatology

Liver Transplantation 2023 | Status report, current and future challenges

29 Jun, 2023 | 13:50h | UTC

Liver Transplantation 2023: Status Report, Current and Future Challenges – Clinical Gastroenterology and Hepatology

 

RCT | Bulevirtide reduces HDV RNA and ALT levels in chronic hepatitis D patients

28 Jun, 2023 | 13:20h | UTC

Summary: This randomized phase 3 trial evaluated the efficacy of bulevirtide, an inhibitor of HDV entry into hepatocytes, in patients with chronic hepatitis D. Patients were randomized to receive either 2 mg or 10 mg of bulevirtide daily for 144 weeks, or no treatment for 48 weeks followed by 10 mg bulevirtide daily for 96 weeks. The study involved 150 patients, 49 in the 2-mg group, 50 in the 10-mg group, and 51 in the control group.

After 48 weeks of treatment, 45% and 48% of patients in the 2-mg and 10-mg groups respectively achieved the primary end point of undetectable HDV RNA level or a decrease of at least 2 log10 IU per milliliter from baseline, and normalization of ALT level. Only 2% in the control group reached the primary endpoint. ALT levels normalized in 51% and 56% of patients in the 2-mg and 10-mg groups respectively, a significant difference from the 12% normalization in the control group. Notably, loss of HBsAg did not occur by week 48 in the bulevirtide groups. No serious adverse events related to the treatment were reported, though side effects including headache, pruritus, and fatigue were more common in the bulevirtide groups.

These results demonstrate the effectiveness of bulevirtide in reducing HDV RNA and ALT levels in patients with chronic hepatitis D. However, the absence of HBsAg loss in bulevirtide groups raises questions about its long-term implications.

Article: A Phase 3, Randomized Trial of Bulevirtide in Chronic Hepatitis D – New England Journal of Medicine (link to abstract – $ for full-text)

 

Commentary on Twitter

 

EASL Clinical Practice Guidelines on acute-on-chronic liver failure

27 Jun, 2023 | 14:00h | UTC

EASL Clinical Practice Guidelines on acute-on-chronic liver failure – Journal of Hepatology

 

Commentary on Twitter

 

Review | Update in the treatment of the complications of cirrhosis

21 Jun, 2023 | 13:20h | UTC

Update in the Treatment of the Complications of Cirrhosis – Clinical Gastroenterology and Hepatology

 

Podcast | Inpatient cirrhosis management

20 Jun, 2023 | 12:30h | UTC

# 398:Live! From SHM: Inpatient Cirrhosis Management – The Curbsiders

 

Cohort Study | Alcohol consumption and risks of more than 200 diseases in Chinese men

16 Jun, 2023 | 13:55h | UTC

Alcohol consumption and risks of more than 200 diseases in Chinese men – Nature Medicine

News Release: Alcohol consumption increases the risks of over 60 diseases – University of Oxford

 

M-A | Comparing non-invasive tests, histology for predicting non-alcoholic fatty liver outcomes

15 Jun, 2023 | 14:50h | UTC

Performance of non-invasive tests and histology for the prediction of clinical outcomes in patients with non-alcoholic fatty liver disease: an individual participant data meta-analysis – The Lancet Gastroenterology & Hepatology

 

M-A | Significant non-alcoholic fatty liver disease prevalence in South Asia, many non-obese affected

6 Jun, 2023 | 14:00h | UTC

Prevalence and associated factors for non-alcoholic fatty liver disease among adults in the South Asian Region: a meta-analysis – The Lancet Regional Health – Southeast Asia

 

AASLD-IDSA Guideline | Updated 2023 recommendations for the testing, management, and treatment of Hepatitis C virus infection

1 Jun, 2023 | 12:21h | UTC

Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection – Clinical Infectious Diseases

 

Guidelines | Management of ascites in liver disease

31 May, 2023 | 14:08h | UTC

Asia–Pacific association for study of liver guidelines on management of ascites in liver disease – Hepatology International

 

AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma

30 May, 2023 | 11:51h | UTC

AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma – Hepatology

 

Liver cystic echinococcosis: a parasitic review

25 May, 2023 | 11:19h | UTC

Liver cystic echinococcosis: a parasitic review – Therapeutic Advances in Infectious Disease

 

RCT | Prophylactic antibiotics show no statistically significant survival improvement in severe alcohol-related hepatitis

15 May, 2023 | 13:21h | UTC

Summary: This multicenter, randomized, double-blind clinical trial aimed to determine the efficacy of amoxicillin-clavulanate combined with prednisolone compared to placebo combined with prednisolone on mortality in patients hospitalized with severe alcohol-related hepatitis. The study involved 284 patients from 25 centers in France and Belgium with biopsy-proven severe alcohol-related hepatitis, who were followed up for 180 days.

The primary outcome was all-cause mortality at 60 days, while secondary outcomes included mortality at 90 and 180 days, infection rates, hepatorenal syndrome, and changes in Model for End-stage Liver Disease (MELD) and Lille scores. The results showed no statistically significant difference in 60-day mortality between the two groups, with 17.3% in the amoxicillin-clavulanate group and 21.3% in the placebo group. However, infection rates at 60 days were significantly lower in the amoxicillin-clavulanate group compared to the placebo group.

It is worth noting that the study may have been underpowered, as the absolute risk difference of 4% did not achieve statistical significance. In conclusion, the combination of amoxicillin-clavulanate and prednisolone did not show a statistically significant improvement in 2-month survival in patients hospitalized with severe alcohol-related hepatitis compared to prednisolone alone. These findings do not support the use of prophylactic antibiotics to improve survival in this patient population, but the potential underpowered nature of the study should be considered.

Article: Effect of Prophylactic Antibiotics on Mortality in Severe Alcohol-Related Hepatitis: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

 

Commentary on Twitter

 

Review | Heart failure and liver disease: cardiohepatic interactions

15 May, 2023 | 13:06h | UTC

Heart Failure and Liver Disease: Cardiohepatic Interactions – JACC: Heart Failure

 

Review | Nonalcoholic fatty liver disease from a primary care perspective

15 May, 2023 | 12:57h | UTC

Nonalcoholic fatty liver disease from a primary care perspective – Diabetes, Obesity and Metabolism

 

Recent advances in the management of primary sclerosing cholangitis

11 May, 2023 | 11:45h | UTC

Recent Advances in the Management of Primary Sclerosing Cholangitis – Clinical Gastroenterology and Hepatology

Related:

AASLD Practice Guidance on Primary Sclerosing Cholangitis and Cholangiocarcinoma – Hepatology

APASL clinical practice guidance: the diagnosis and management of patients with primary biliary cholangitis – Hepatology International

A consensus integrated care pathway for patients with primary biliary cholangitis.

Biliary Endoscopy in the Management of Primary Sclerosing Cholangitis and its Complications

 

Review | Diagnosis and management of cirrhosis and its complications

10 May, 2023 | 16:06h | UTC

Diagnosis and Management of Cirrhosis and Its Complications: A Review – JAMA (free for a limited period)

Author Interview: Management of Cirrhosis in 2023

 

Review | The global burden of liver disease

5 May, 2023 | 15:23h | UTC

The Global Burden of Liver Disease – Clinical Gastroenterology and Hepatology

 

Review | Carvedilol as the new non-selective beta-blocker of choice in patients with cirrhosis and portal hypertension

4 May, 2023 | 13:36h | UTC

Carvedilol as the new non-selective beta-blocker of choice in patients with cirrhosis and portal hypertension – Liver International

 

RCT | High vs. low target mean arterial pressure in patients with cirrhosis and septic shock

3 May, 2023 | 15:01h | UTC

A randomized-controlled trial (TARGET-C) of high vs. low target mean arterial pressure in patients with cirrhosis and septic shock – Journal of Hepatology

 

Review | New treatment paradigms in primary biliary cholangitis

26 Apr, 2023 | 13:49h | UTC

New Treatment Paradigms in Primary Biliary Cholangitis – Clinical Gastroenterology and Hepatology

 

Perspective | Liver transplantation for patients with severe acute on chronic liver failure: it is time to change paradigms

25 Apr, 2023 | 14:37h | UTC

Liver transplantation for patients with severe acute on chronic liver failure: it is time to change paradigms – Intensive Care Medicine

 

Commentary on Twitter

 

RCT | Bariatric–metabolic surgery is more effective than lifestyle intervention plus best medical care in non-alcoholic steatohepatitis

24 Apr, 2023 | 14:03h | UTC

Bariatric–metabolic surgery versus lifestyle intervention plus best medical care in non-alcoholic steatohepatitis (BRAVES): a multicentre, open-label, randomised trial – The Lancet

News Release: Surgery most effective treatment of metabolic liver disease – King’s College London

 

Commentary on Twitter

 

Guideline | Management of psychiatric disorders in patients with hepatic and gastrointestinal diseases

19 Apr, 2023 | 13:07h | UTC

Management of Psychiatric Disorders in Patients with Hepatic and Gastrointestinal Diseases – Indian Journal of Psychiatry

 

Guideline | Intrahepatic cholestasis of pregnancy

18 Apr, 2023 | 13:24h | UTC

Intrahepatic cholestasis of pregnancy – BJOG

 

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