November top 10: Guideline updates, ACG, GI Outlook
Healio Gastroenterology presents the following report on the top 10 peer-tested articles from November 2021.
Stories include meeting news coverage from ACG and GI Outlook as well as research in GERD, defecatory dysfunction, colorectal cancer screening and more.
Top stories follow.
ACG updates guidelines for GERD diagnosis, management
The ACG updated guidelines for GERD to include pharmacologic, lifestyle, surgical and endoscopic management. The changes were published in the American Journal of Gastroenterology.
“The ethos of the new GERD guidelines is to synthesize the highest quality, yet still practical, recommendations for the diagnosis and management of patients with GERD,” Philip O. Katz, MD, MACG, professor of medicine at Weill Cornell Medicine in New York City, told Healio Gastroenterology. “They have been developed for the clinician to enhance their opportunity to provide the best possible evidence-based patient care, using the full menu of diagnostic tests and therapeutic interventions for these often-complex patients. We hope you find them useful in your everyday practice.” Read more.
Squatting improves rectal evacuation among younger women with defecatory dysfunction
Squatting assist stools improved rectal evacuation in defecatory dysfunction among women who were younger with normal stool consistency and lower resting anal sphincter pressure, according to research presented at ACG.
“The squatting assist stool (SAS) has become popularized in the last decade. In theory it works by straightening the anorectal angle to improve mechanics of evacuation,” Lauren Ulsh, MD, a second-year resident at Stanford University Medical Center, said. “We hypothesized that squatting can help some individuals with defecatory dysfunction overcome anorectal dyssynergia.” Read more.
Blood-based CRC screening test identifies asymptomatic, low-grade tumors
LAS VEGAS — Multimodal circulating tumor DNA blood-based colorectal cancer screening tests may have clinically meaningful performance among patients in an average risk screening population, according to a presentation.
“Blood-based colorectal cancer screening holds potential to improve compliance with CRC screening recommendations given the ability to seamlessly integrate a blood-based test into standard of care clinical pathways,” Hee Cheol Kim, MD, of the Samsung Medical Center and Sungkyunkwan University School of Medicine in Seoul, South Korea, said during the ACG Annual Scientific Meeting presentation. “However, to contribute significantly to the CRC screening landscape, the blood-based screening test must detect CRC across multiple clinical parameters in order to prove clinically meaningful.” Read more.
FDA grants fast track designation to oral testosterone prodrug for treatment of NASH
The FDA granted fast track designation to LPCN 1144 as a treatment for non-cirrhotic nonalcoholic steatohepatitis, according to a release from Lipocine.
“The granting of fast track designation represents an important recognition by the FDA of LPCN 1144’s potential to address a significant unmet need in the treatment of NASH,” Mahesh Patel, PhD, chairman, president and CEO of Lipocine, said in the release. “We believe the fast track designation will enable us to work closely with the FDA on our development program for NASH, including the design of the phase 3 program.” Read more.
VIDEO: Samir A. Shah focuses on ‘bold progression’ for ACG
LAS VEGAS — In a video exclusive with Healio Gastroenterology, Samir A. Shah, MD, FACG, clinical professor of medicine at Brown University’s Alpert Medical School, shared his focus as the newly appointed president of the ACG.
“Bold, beacon and boom: I want the ACG to be bold and move ahead in multiple ways. ... The ACG will continue to be a beacon for our members and our patients to make it easier to deliver top quality care everywhere,” Shah said. “We need to make sure we have enough representation amongst women and amongst underrepresented minorities so that they can advance and — boom — things will progress.” Read more.
VIDEO: Trulance yields rapid, durable response in chronic idiopathic constipation
LAS VEGAS — In this video exclusive, Eric Shah, MD, MBA, of Dartmouth-Hitchcock Health in Lebanon, New Hampshire, discussed the use of Trulance in patients with chronic idiopathic constipation.
The research was presented at the ACG Annual Scientific Meeting. Read more.
Q&A: Experts aim to ‘inspire’ earlier CRC screening across all racial groups
While colorectal adenocarcinoma incidence rates are increasing in white individuals aged 40 to 49 years, they are stabilizing in Black individuals of the same age, according to results published in JAMA Network Open.
Therefore, the absolute incidence rates are becoming equivalent between the two population groups and for the rectal subsite, incidence rates are now 39.3% lower in the Black population compared with the white population. Read more.
Increased diversity in leadership requires self-promotion, participating in allyship
Increased diversity in leadership casts a wider perspective for solving problems and bolstering health equity in patient care, according to a speaker at GI Outlook.
Progress in building diversity in leadership has improved over the years, but disparity still remains, Amrita Sethi, MD, MASGE, of Columbia University Medical Center, said during a presentation. Focus on the data reveals that although women account for about 50% of medical school graduates, retention rates dwindle as they progress in their careers. Specifically, only 37% and less than 20% of GI fellows and advanced endoscopy fellows, respectively, are women. These numbers dip even lower when looking at women in senior career levels (< 25%) and women in top leadership levels (< 8% of division chiefs), Sethi reported. Read more.
VIDEO: Terlipressin safe, effective for esophageal bleeding, liver cirrhosis
LAS VEGAS — In this video exclusive, Kevin Moore, MD, discussed a study assessing real-world outcomes in patients with esophageal variceal hemorrhage and liver cirrhosis treated with terlipressin.
The results were presented at the ACG Annual Scientific Meeting. Read more.
Initial choice of biologic may affect persistence of therapy in IBD
Among patients with inflammatory bowel disease who received at least two biologic therapies, discontinuation of treatment appeared to vary based on initial treatment choice, according to data presented at the ACG Annual Scientific Meeting.
“Decisions about choice of biologic for treatment of moderate to severe Crohn’s disease and ulcerative colitis are complex, owing to limited data on the comparative effectiveness of treatments,” Noa Krugliak Cleveland, MD, gastroenterology and advanced IBD fellow at the University of Chicago Medicine, said during a virtual poster presentation. “However, choice of initial biologic therapy is important because it may influence subsequent lines of therapy and clinical outcomes of patients.” Read more.
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