Real-World Effectiveness and Safety of Upadacitinib in Crohn's disease: A Multi-Centre Study.

Background: We aimed to describe the real-world effectiveness and safety of upadacitinib (UPA), an oral Janus kinase 1 inhibitor (JAKi) in patients with Crohn's disease (CD).

Methods: A retrospective analysis was conducted across nine centers in the United States, focusing on adults with CD treated with UPA 45 mg as induction therapy for active luminal disease. The co-primary endpoints were clinical remission at 12 weeks (Harvey Bradshaw Index ≤ 4 or absence of symptoms on physician's global assessment) and endoscopic remission at 6 months (SEMA-CD score of 0-1 or absence of ulcers).

Trend of Representation of Women in Gastroenterology, Hepatology, and Endoscopy Conferences in Asia.

Objectives: Despite progress in promoting gender equality, gender bias remains a significant obstacle for women and hinders their academic advancement. We aim to survey and critically analyze women's representation in conferences and changes over time in various regions of Asian countries.

Methods: An international survey was conducted with representatives from East Asia (Hong Kong, China, and Japan), South Asia (India and Pakistan), and Southeast Asia (Vietnam and Thailand).

Single-Cell and Spatial Multi-omics Reveal Interferon Signaling in the Pathogenesis of Perianal Fistulizing Crohn's Disease.

Background & Aims: Perianal fistulizing Crohn's disease (PCD) is a common and debilitating complication with elusive pathophysiology. We examined mucosal cells from patients with PCD and related conditions using a multi-omics approach.

Methods: We recruited patients with PCD (n = 24), CD without perianal disease (NPCD, n = 10), and idiopathic perianal fistulas (IPF, n = 29).

Consensus definition of a radiologically healed fistula on magnetic resonance imaging in perianal Crohn's disease: an international Delphi study.

Introduction: Perianal fistulising Crohn's disease (pfCD) is a distinct and debilitating phenotype seen in around one-third of patients with CD. Clinical trials in pfCD are increasingly using magnetic resonance imaging (MRI) criteria as a primary endpoint, but there is heterogeneity in the radiological definition of a healed perianal fistula that currently limits our ability to perform meaningful meta-analyses of studies. Our aim is to standardise outcomes through the generation of an international consensus definition of a radiologically healed fistula.

Gender disparities in gastroenterology and hepatology conferences: The journey towards equality.

Background: This study scrutinizes gender representation in invited faculty and conference committee leadership at key gastroenterology and hepatology conferences in Pakistan over five years, exploring the impact of the "glass ceiling" and "sticky floor" phenomena on gender diversity within academic medicine.

Methods: This cross-sectional study was conducted between January and March of 2023. The three major national societies of gastroenterology and hepatology in Pakistan that had been established for more than 10 years and the scientific programs of their annual conferences, which were publicly accessible, were included and coded as Society 1, Society 2 and Society 3 to maintain anonymity.

Perianal fistulizing Crohn's disease: Current perspectives on diagnosis, monitoring and management with a focus on emerging therapies.

Crohn's disease (CD), a chronic inflammatory bowel disorder, manifests in various phenotypes, with fistulizing perianal CD (CD-PAF) being one of its most severe phenotypes. Characterized by fistula formation and abscesses, CD-PAF impacts 17% to 34% of all CD cases and with a significantly deleterious impact on patient's quality of life, while increasing the risk for anorectal cancers. The pathogenesis involves a complex interplay of genetic, immunological and environmental factors, with cytokines such as tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) playing pivotal roles.

Benefits and Challenges of Treat-to-Target in Inflammatory Bowel Disease.

There is notable disparity between symptomatology and disease activity in a significant proportion of patients with inflammatory bowel disease (IBD), and escalation of treatment based on symptoms alone can fail to significantly alter the course of disease. The STRIDE-II position statement, published in 2021 by the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) initiative of the International Organisation for the Study of IBD (IOIBD) provides the most current recommendations for a treat-to-target (T2T) approach in IBD. Despite the benefits offered by a T2T approach in IBD, there are numerous drawbacks and current limitations to its widespread implementation in real-world clinical practice.

Role of Confocal Laser Endomicroscopy in Early Detection of Upper Gastrointestinal Malignancy in High Risk Patients.

Background: Upper gastrointestinal malignancies are a major global health burden. Early diagnosis of upper gastrointestinal premalignant and malignant lesions is crucial for improving prognosis and reducing morbidity and mortality. The purpose of this study was to investigate the diagnostic accuracy of confocal laser endomicroscopy (CLE) in detecting upper gastrointestinal premalignant and early malignant lesions in high-risk patients, as well as diagnosing patients with inconclusive white light endoscopy (WLE) and histopathology results.

Redefining non-alcoholic fatty liver disease to metabolic associated fatty liver disease: Is this plausible?

Recently, a single letter change has taken the world by storm. A group of experts have developed a consensus to upgrade the term non-alcoholic fatty liver disease (NAFLD) to metabolic associated fatty liver disease (MAFLD), suggesting that MAFLD would more accurately reflect not only the disease pathogenesis but would also help in patient stratification for management with NAFLD. However, the difference of opinion exists, which has made the NAFLD MAFLD debate the current talk of the town.