Olmedo Moreno C, López Romero-Salazar F, Muñoz Gómez R
… +5 more, Maíz Jiménez M, Loinaz Segurola C, Cámara Jurado M, González Lama Y, Fernández Vázquez I
Martín-Cardona A, Ibáñez-Sanz G, Sudrià-Lopez E
… +13 more, Arau B, Carballal S, Garcia-Puig R, Carrasco A, Villar-Balboa I, Ibarra M, Ferrer C, Fonolleda M, Planella M, Salas A, Videla S, Loras C, Esteve M
Coeliac disease is a chronic immune-mediated enteropathy triggered by gluten intake, which affects the small intestine in genetically susceptible individuals (HLA-DQ2 and/or HLA-DQ8). This disease, which occurs in both c...Coeliac disease is a chronic immune-mediated enteropathy triggered by gluten intake, which affects the small intestine in genetically susceptible individuals (HLA-DQ2 and/or HLA-DQ8). This disease, which occurs in both children and adults, is among the most common genetically determined disorders in Western countries. It is characterized by the presence of very varied and often nonspecific clinical manifestations (primarily digestive symptoms and signs of intestinal malabsorption), as well as the presence of specific antibodies (tissue transglutaminase and endomysium) and enteropathy. Currently, the only treatment for coeliac disease is a strict gluten-free diet for life. The main objective of the NATURCEL (NATURal history, epidemiological, clinical, diagnostic and therapeutic aspects of CoELiac disease and noncoeliac enteropathies) registry is to collect selected variables on different aspects of the disease (epidemiological, clinical, genetic, immunological, etc.) for a subsequent shared analysis for scientific and translational purposes.
Modulation of sphingosine-1-phosphate receptors represents a relatively recent approach in the treatment of inflammatory bowel disease, although these modulators have been approved since 2010 for other inflammatory condi...Modulation of sphingosine-1-phosphate receptors represents a relatively recent approach in the treatment of inflammatory bowel disease, although these modulators have been approved since 2010 for other inflammatory conditions such as multiple sclerosis. Etrasimod is a sphingosine-1-phosphate receptor (S1PR) modulator that binds to S1PR1, S1PR4 and S1PR5 receptors, and its efficacy has been demonstrated in the treatment of moderately to severely active ulcerative colitis. It is a small molecule and synthetic drug administered orally, with a proper bioavailability and a fast elimination rate, predictable pharmacokinetics and lack of immunogenicity, which are convenient characteristics for both efficacy and safety. This article reviews the pharmacological characteristics of etrasimod and its safety profile.
Barreiro-de Acosta M, Mesonero F, Ferreiro-Iglesias R
… +8 more, García-López S, Aguas Peris M, Sierra Ausín M, Cano Sanz N, Valdivia Martínez A, Cábez A, Ramírez S, Ginard D
OBJECTIVE: Ulcerative proctitis (UP) usually presents a milder course, but some patients develop significant symptom burden, severe forms, or refractory UP (RUP). Our objective was to characterise RUP and generate recomm...OBJECTIVE: Ulcerative proctitis (UP) usually presents a milder course, but some patients develop significant symptom burden, severe forms, or refractory UP (RUP). Our objective was to characterise RUP and generate recommendations for daily practice. METHODS: A systematic review (SR) was conducted to analyze epidemiological, clinical, and pharmacological treatment aspects of RUP. The results were discussed in a nominal focus group meeting composed of seven gastroenterologists specialized in the management of inflammatory bowel disease, a nurse, and a patient. Several statements on the management of PU were proposed and voted to achieve agreement. RESULTS: The SR included 43 articles of low to moderate quality. Nearly 30% of patients presented RUP, and the impact of the disease on their quality of life was highly significant. Different gaps of knowledge related to the clinical characteristics and course of the disease, efficacy, safety, and selection of pharmacological treatments were identified. The experts proposed 13 practical statements that reached the established level of agreement. These address the diagnosis of UP and RUP, their therapeutic goals and treatment selection, monitoring, treatment response, and the role of the nurse. CONCLUSIONS: RUP is common and can have a significant impact on patients. More research is needed to characterize RUP and the long-term efficacy of available treatments. The proposed statements aim to address the knowledge gaps related to RUP.
Martinez-Ortega A, de Benito Sanz M, García Alonso FJ
… +10 more, Latras Cortés I, Aparicio Tormo JR, Sanchiz Soler V, Gornals JB, Subtil Iñigo JC, Martínez Moreno B, Sumalla-Garcia A, Sánchez Ocaña R, de la Serna-Higuera C, Perez-Miranda M
Otero Figar J, Muíño Dominguez D, Magide Yañez I
… +7 more, Álvarez Diez M, Mesonero de la Cruz B, Granda Villanueva E, Fernández Gil J, Ponte Romo M, Diaz Simal A, Franco Aguirre L
Gastric cancer is one of the leading causes of cancer mortality in Chile. To optimize early detection and surveillance of gastric premalignant conditions, the Chilean Association of Digestive Endoscopy (ACHED), together...Gastric cancer is one of the leading causes of cancer mortality in Chile. To optimize early detection and surveillance of gastric premalignant conditions, the Chilean Association of Digestive Endoscopy (ACHED), together with the Chilean Society of Gastroenterology, updated its 2014 clinical guideline. Using the AGREE II methodology, multidisciplinary working groups conducted systematic reviews in PubMed, Cochrane, and Scielo through December 2024. Recommendations were agreed upon via a Delphi panel (≥80% agreement) and graded according to GRADE, assessing evidence quality and recommendation strength. An expert panel of Chilean and international gastroenterology, endoscopy and pathology specialists reviewed the evidence and reached consensus to issue recommendations for opportunistic gastric cancer screening and surveillance using upper GI endoscopy in adults. These recommendations are feasible to implement in Chile and other Latin American countries with a high incidence of gastric cancer that have the necessary resources available. They complement any future efforts at population screening and aim to improve early detection and prognosis of gastric cancer in high-risk populations.
Cholestatic liver diseases comprise a heterogeneous group of disorders affecting both adult and pediatric population, characterized by alterations in bile formation, secretion, or flow, leading to the accumulation of bil...Cholestatic liver diseases comprise a heterogeneous group of disorders affecting both adult and pediatric population, characterized by alterations in bile formation, secretion, or flow, leading to the accumulation of bile acids and other toxic substances in the liver. In recent years, advances in new pharmacological therapies, the availability of next-generation genetic sequencing techniques, and the development of specific treatments for genetic cholestasis have transformed the diagnostic and therapeutic approach to these conditions. This document, jointly prepared by the "Asociación Española para el Estudio del Hígado" (AEEH) and the "Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica" (SEGHNP), presents a national evidence-based guideline for the diagnosis and management of hepatic cholestasis in Spain. It addresses recommendations for differential diagnosis, diagnostic algorithms, indications for genetic studies, treatment and follow-up criteria in diseases such as primary biliary cholangitis, primary sclerosing cholangitis, genetic cholestasis, intrahepatic cholestasis of pregnancy, and vanishing bile duct syndrome. In addition, recommendations are included for the management of extrahepatic complications, indications for liver transplantation, and special considerations in pregnancy and childhood. The guideline emphasizes the importance of a multidisciplinary approach, the use of non-invasive tools for risk stratification, and the incorporation of new targeted therapies, with the aim of improving the prognosis and quality of life of patients affected by cholestatic liver diseases.