Recent Studies And Trials In Gastroenterology And Hepatology

Which of the following is the first oral medication for the treatment of moderate to severe active Crohn's disease to be licensed by the US FDA?

Upadacitinib, an inhibitor of JAK 1.

Where is it indicated?

Patients with CD who are moderately to highly active and resistant to TNF alpha-blockers should use it. 

How much is the dose?

For 12 weeks, the dosage will be 45 mg OD. There will be a maintenance dose of 15 mg OD. Try 30 mg OD if the case is severe or refractory. 

AASLD

Revealed that following a primary liver transplant, low-dose aspirin offers protection against acute cellular allograft rejection.  Aspirin is used to stop HAT (Hepatic Artery Thrombosis) before it starts.  The anti-inflammatory qualities of aspirin may aid in preventing cellular ejection. 

Examined the impact of low-dose aspirin on arterial patency rates in primary adult liver transplantation. 

The study encompassed three years, from 2013 to 2015, and involved 17 high-volume liver transplant centers.  Patients received low-dose aspirin (61%).  The aspirin group's 1-year rejection-free survival rate was 89%, while the non-aspirin group's was 82%.  The aspirin group's 1-year primary arterial patency rates were 99%, whereas the non-aspirin group's rates were 96%.  After LT in the first year of liver transplantation., low-dose aspirin use was linked to a decreased risk of ACR and HAT.

Also Read: Management of Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease) 

FDA

 Approves initial treatment for the chronic immunological illness eosinophilic esophagitis; Suggested Diet: the elementary diet, often known as SFED;  PPI: first-line pharmaceutical drugs 

Second-line topical corticosteroids. Dupilumab is the first FDA-approved treatment for eosinophilic esophagitis. Its mechanism of action is an IL4 R blocker. It is indicated for patients who weigh more than 40 kg and who are older than 12 years old. The biopsy's count has significantly decreased, and the remission rate is high.

AGA / JTF 2022 Recommendations 

1. PPIs: Greater Than No Rx
2. Topical glucocorticoids: Without prescription
3. Systemic steroids versus topical steroids
4. No prescription diets over:
5. Empiric SFED over: No prescription
6. Based on allergy tests Get rid of the diet instead of foods taken out: 

One might begin the process of eliminating food by using cow milk. Consider topical steroids if 1FED is not working for them. A six-food elimination diet and a single-food elimination diet are comparable. 

Hope you found this blog helpful for your NEET SS Gastroenterology and Hepatobiliary preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.