Research News

Research priority setting in Barrett's oesophagus and gastro-oesophageal reflux disease

Wednesday, 18 October 2017 11:04

The vast potential burden of gastro-oesophageal reflux disease and Barrett's oesophagus on patients and health-care resources stimulates a need to define and focus research efforts. This priority setting exercise aimed to produce a list of the top ten uncertainties in the field that reflect the priorities of patients and health-care providers. These priorities covered a range of issues, including a need for improved patient risk stratification, alternative diagnostic and surveillance tests, safety of long-term drug treatment, and questions regarding the durability and role of different endoscopic therapies for dysplastic Barrett's oesophagus. To read the full article, visit The Lancet.

C-CREST trials published: HCV antivirals

Wednesday, 18 October 2017 09:43

The final result of two randomised, phase 2, open-label trials examining the safety and efficacy of an 8-week regimen of direct-acting antiviral agents in participants infected with hepatitis C virus (HCV) genotypes 1, 2 or 3 has been published (Part A). The safety and efficacy of this fixed-dose combination regimen of grazoprevir, ruzasvir and uprifosbuvir, with or without ribavirin, in patients with HCV genotype 1, 2 or 3 was then evaluated for different treatment durations (8, 12 or 16 weeks) in a broader population (Part B). The findings of the trials suggest this regimen has the potential to provide a simplified treatment for HCV that is effective and well tolerated in most individuals infected with HCV, as well as a shorter duration of treatment in many individuals. For the full articles visit Part A and Part B.

Surgery in ileocaecal Crohn's disease

Wednesday, 18 October 2017 08:50

Despite the continuous increase in incidence of Crohn's disease, the use of surgery for the disease seems to have declined over the past six decades. This is most likely because of the increased availability of more effective drugs. The proper use of surgery has been suggested multiple times to be better than long-term medical treatment in some patients and the results of a much awaited multicentre, randomised controlled trial have now been published by Ponsioen et al, see the BSG website. This trial compares infliximab, the current medical standard of treatment, with a surgical approach in patients with Crohn's disease in whom initial treatment has failed. The decisions about treatment for ileocaecal Crohn's disease still remain difficult for practicing clinicians. If a surgical approach is chosen, good clinical practice will probably lead to optimised outcomes. To see the full article visit The Lancet.

Surgery v biological agents for terminal ileitis in Crohn's disease

Monday, 16 October 2017 14:25

Surgery can offer excellent short-term and long-term results in the treatment of patients with ileocaecal Crohn's disease who have not yet responded to conventional therapy. Ponsioen et al. carried out a randomised, controlled, open-label, multicentre trial comparing laproscopic ileocaecal resection with infliximab to assess how they affect health-related quality of life. It was shown that although laparoscopic ileocaecal resection did not improve quality of life scores to a significantly greater extent than infliximab treatment, it is also not associated with more serious adverse events. Long-term follow-up data indicated that more than a third of patients who started on infliximab required an ileocaecal resection within a few years, whereas only one in four patients who initially had resection needed anti-TNF therapy later. This study demonstrates that laparoscopic resection in patients with limited, non-stricturing, ileocaecal Crohn's disease, in whom conventional therapy has failed, could be considered a reasonable alternative to infliximab therapy.

To view the full article, visit The Lancet.

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