Thiopurines Reduce Colorectal Cancer Risk in Patients with IBD

But, does this benefit outweigh the risks of these drugs?

Telaprevir Markedly Improves HCV Genotype 1 Cure Rates

Final results of phase III trials show that telaprevir plus standard therapy with peginterferon alfa-2a and ribavirin was more effective than standard therapy alone.

Recently, telaprevir-based triple therapy (i.e., in combination with peginterferon alfa-2a and ribavirin) was approved for the treatment of chronic hepatitis C virus (HCV) infection. The final results of the international phase III trials for both treatment-naive and treatment-experienced patients with HCV genotype 1 infection are now available.

GlideScope Matches Flexible Fiber-Optic Scope for Intubation in Obese Patients

In this small study, time to intubation, number of attempts, success rate, and incidence of complications were comparable.

Which Scoring System Best Predicts Outcomes of Upper Gastrointestinal Bleeding?

Glasgow-Blatchford and Rockall scores were similarly effective, but comparing systems is less important than using some method to identify which patients need early and vigorous therapy.

Multiple studies have evaluated various scoring systems to predict the outcome of patients with nonvariceal upper gastrointestinal bleeding (UGIB). Recent comparisons between Rockall scores — including both pre-endoscopy scores and postendoscopy (complete) scores — and the Glasgow-Blatchford score (GBS), which does not require endoscopy, have suggested that these three scores all have predictive value.

To further compare the ability of these scores to predict outcomes, investigators prospectively collected data from patients who presented with UGIB at four hospitals in the U.K. Some data were collected retrospectively from one hospital. Therapy was provided according to existing guidelines but varied somewhat when different protocols were used at some hospitals.

Efficacy of rabeprazole in treating ulcers was high with either aspirin or clopidogrel.

Aspirin and clopidogrel are antiplatelet drugs used to prevent thrombotic vascular events. However, both are associated with increased risk for bleeding from peptic ulcer disease (PUD). Aspirin induces peptic ulcers, and both drugs prevent their healing — aspirin through inhibiting mucosal prostaglandin generation and clopidogrel by decreasing platelet-related growth factors. Proton-pump inhibitor (PPI) treatment is effective for healing aspirin-associated PUD, but for patients requiring continued antiplatelet therapy, it is unclear whether the outcomes are different in patients taking clopidogrel versus aspirin.

Vegetarians Have Lower Risk for Symptomatic Diverticular Disease

Results support earlier findings on the protective effects of dietary fiber intake and vegetarianism on diverticular disease.

Thalidomide Effective for Refractory Bleeding from Gastrointestinal Vascular Malformations

In a small, randomized, controlled trial, thalidomide significantly reduced bleeding episodes, blood transfusions, and hospitalizations.

Every experienced gastroenterologist has encountered patients who have refractory bleeding from gastrointestinal vascular malformations and are dependent on iron replacement or blood transfusion. Now, in an open-label, randomized trial, researchers in China investigated the efficacy and safety of administering thalidomide in 55 patients with bleeding that was unresponsive or unsuited to treatment by means such as endoscopy, colonoscopy, and double-balloon enteroscopy. Twenty-eight of the participants were transfusion dependent before randomization; 3 with gastric antral vascular ectasia (GAVE) had failed to respond to argon plasma coagulation treatment. Exclusion criteria included portal hypertension, severe comorbidities, peripheral neuropathy, or a history of thromboembolic disease; treatment with steroids, nonsteroidal anti-inflammatory agents, or antiplatelet drugs; or current cancer chemotherapy.

Telaprevir Therapy for 24 Weeks Appropriate for Many with HCV Infection

Response-guided treatment with telaprevir, peginterferon alfa-2a, and ribavirin for 24 weeks was noninferior to the standard 48-week course in patients with hepatitis C virus infection.

Ferric Carboxymaltose Better for Intravenous Iron Replacement in IBD

A novel regimen was superior to standard iron sucrose at increasing hemoglobin levels in patients with inflammatory bowel disease and iron deficiency — at less overall cost.

Intravenous iron is commonly used to correct iron deficiency anemia in patients with inflammatory bowel disease (IBD). Prior studies have demonstrated its greater efficacy, tolerability, and quality-of-life improvement compared with oral iron therapy. Now, investigators have tested the efficacy and safety of an alternative intravenous regimen — ferric carboxymaltose (FCM) — against standard intravenous iron sucrose (IS) therapy.

Results of a large population-based study support the hypothesis that estrogen promotes duodenal bicarbonate secretion, which lowers the risk for ulcers.

Studies have shown that women are less likely than men to develop duodenal ulcers (DUs). Other studies have suggested that estrogen stimulates duodenal bicarbonate secretion, which could be a biological mechanism for the lower incidence of DUs among women. To investigate this possible link, researchers in China conducted an epidemiologic study involving 64,385 patients who underwent endoscopy for dyspepsia.