Hepatology
Guidelines | Management of ascites in liver disease
31 May, 2023 | 14:08h | UTC
AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma
30 May, 2023 | 11:51h | UTC
Liver cystic echinococcosis: a parasitic review
25 May, 2023 | 11:19h | UTCLiver 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 | UTCSummary: 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
Among patients with severe alcohol-related #hepatitis receiving prednisolone, amoxicillin-clavulanate did not improve survival at 60-day follow-up compared with placebo. https://t.co/4XkVL2CTsP #DDW pic.twitter.com/9sh5vennkK
— JAMA (@JAMA_current) May 9, 2023
Review | Heart failure and liver disease: cardiohepatic interactions
15 May, 2023 | 13:06h | UTCHeart Failure and Liver Disease: Cardiohepatic Interactions – JACC: Heart Failure
Review | Nonalcoholic fatty liver disease from a primary care perspective
15 May, 2023 | 12:57h | UTCNonalcoholic 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 | UTCRelated:
AASLD Practice Guidance on Primary Sclerosing Cholangitis and Cholangiocarcinoma – Hepatology
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 | UTCDiagnosis 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 | UTCThe 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
RCT | High vs. low target mean arterial pressure in patients with cirrhosis and septic shock
3 May, 2023 | 15:01h | UTC
Review | New treatment paradigms in primary biliary cholangitis
26 Apr, 2023 | 13:49h | UTCNew 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
Commentary on Twitter
Liver #Tx in severe acute on chronic failure
➡️ #ICU care crucial in ACLF-3
➡️ improve referrals to LT centers & pre-LT workup
➡️ to decide to put pt on waitlist consider donor shortage/collective utility of LT
➡️ identifying transplantability window
🖇️ https://t.co/VZxDyZ1k74 pic.twitter.com/6YOcd5rzMu— Intensive Care Medicine (@yourICM) April 19, 2023
RCT | Bariatric–metabolic surgery is more effective than lifestyle intervention plus best medical care in non-alcoholic steatohepatitis
24 Apr, 2023 | 14:03h | UTCNews Release: Surgery most effective treatment of metabolic liver disease – King’s College London
Commentary on Twitter
New @TheLancet – Verrastro et al – Bariatric–metabolic surgery versus lifestyle intervention plus best medical care in non-alcoholic steatohepatitis (BRAVES): a multicentre, open-label, randomised trialhttps://t.co/pCWahvbReQ#NASH #NAFLD #fattyliver #livertwitter pic.twitter.com/xNMsAskJF9
— The Lancet Gastroenterology & Hepatology (@LancetGastroHep) April 21, 2023
Guideline | Management of psychiatric disorders in patients with hepatic and gastrointestinal diseases
19 Apr, 2023 | 13:07h | UTC
Guideline | Intrahepatic cholestasis of pregnancy
18 Apr, 2023 | 13:24h | UTCIntrahepatic cholestasis of pregnancy – BJOG
Guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU
17 Apr, 2023 | 13:19h | UTCGuidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations – Critical Care Medicine (free for a limited period)
Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations – Critical Care Medicine (free for a limited period)
Review | Anticoagulation in patients with liver cirrhosis: friend or foe?
11 Apr, 2023 | 14:17h | UTCAnticoagulation in Patients with Liver Cirrhosis: Friend or Foe? – Digestive Diseases and Sciences
Review | Assessing the risk of surgery in patients with cirrhosis
10 Apr, 2023 | 13:20h | UTCAssessing the risk of surgery in patients with cirrhosis – Hepatology Communications
Global epidemiology of cirrhosis — Etiology, trends and predictions
6 Apr, 2023 | 13:27h | UTC
Commentary on Twitter
New content online: Global epidemiology of cirrhosis — aetiology, trends and predictions https://t.co/EbgDWTjOyI pic.twitter.com/Cj7KFoWtLi
— Nature Reviews Gastroenterology & Hepatology (@NatRevGastroHep) March 28, 2023
RCT | Comparable efficacy of cefotaxime, ceftriaxone, and ciprofloxacin in treating spontaneous bacterial peritonitis
3 Apr, 2023 | 14:01h | UTCSummary: This multicenter, prospective, open-label, randomized controlled trial compared the efficacy of cefotaxime, ceftriaxone, and ciprofloxacin as initial treatments for spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites. The study included 261 patients aged 16 to 75, with liver cirrhosis, ascites, and a polymorphonuclear cell count of >250/mm3. Researchers performed follow-up paracentesis at 48 hours to evaluate the assigned antibiotics, and assessed resolution rates at 120 and 168 hours of treatment.
The primary endpoint, resolution rates at 120 hours, showed no statistically significant difference between the groups: 67.8% for cefotaxime, 77.0% for ceftriaxone, and 73.6% for ciprofloxacin. One-month mortality rates were also similar. The study concluded that these antibiotics are equally effective as initial treatments for SBP, particularly for community-acquired infections, when administered based on response-guided therapy.
Article: Response-Guided Therapy With Cefotaxime, Ceftriaxone, or Ciprofloxacin for Spontaneous Bacterial Peritonitis: A Randomized Trial: A Validation Study of 2021 AASLD Practice Guidance for SBP – American Journal of Gastroenterology (free for a limited period)
Overcoming size disparity in liver transplant access: prioritizing smaller donors for smaller candidates
3 Apr, 2023 | 13:41h | UTCAssociation of Body Surface Area With Access to Deceased Donor Liver Transplant and Novel Allocation Policies – JAMA Surgery (free for a limited period)
Invited Commentary: Addressing Size-Based Disparities in Liver Transplant – JAMA Surgery (free for a limited period)
Commentary on Twitter
In this study, liver waitlist candidates with the smallest body surface areas had a disadvantage due to size. Prioritizing allocation of smaller liver donors to smaller candidates may help overcome this disparity. https://t.co/p5F76Hgzm0
— JAMA Surgery (@JAMASurgery) March 30, 2023
RCT | Efficacy and safety of colesevelam for the treatment of bile acid diarrhea
30 Mar, 2023 | 14:06h | UTCEfficacy and safety of colesevelam for the treatment of bile acid diarrhoea: a double-blind, randomised, placebo-controlled, phase 4 clinical trial – The Lancet Gastroenterology & Hepatology (link to abstract – $ for full-text)
Commentary on Twitter
New research – Borup et al – Efficacy and safety of colesevelam for the treatment of bile acid diarrhoea: a double-blind, randomised, placebo controlled, phase 4 clinical trialhttps://t.co/m1r0heRgjX#gitwitter #BAD #diarrhoea pic.twitter.com/zk1TnZFS6b
— The Lancet Gastroenterology & Hepatology (@LancetGastroHep) February 7, 2023
Review | Recompensation in cirrhosis: current evidence and future directions
29 Mar, 2023 | 13:24h | UTCRecompensation in Cirrhosis: Current Evidence and Future Directions – Journal of Clinical and Experimental Hepatology (free for a limited period)
Cohort Study | Risk of liver fibrosis associated with long-term methotrexate therapy may be overestimated
29 Mar, 2023 | 13:02h | UTC