Top 7 in June: Hepatitis outbreak, FDA approval, chronic constipation

Healio presents the top peer-tested articles from June, which include updates on the acute hepatitis outbreak in children, FDA approval of Skyrizi for Crohn’s disease, investigational care of patients with chronic constipation and more.

Acute hepatitis outbreak swells to nearly 900 cases; global data shows ‘mixed picture’

An outbreak of acute, severe hepatitis of unknown etiology in children has grown to 894 cases across 33 countries, according to data presented during a media briefing at the International Liver Congress.

“As of June 20, we now have 894 probable cases reported in 33 countries in five WHO regions,” Philippa Easterbrook, MD, senior scientist at the Global HIV, Hepatitis and STI Programs at WHO headquarters in Geneva, told attendees. “Since the last WHO public communication on May 27, this represents 244 additional cases over a space of about a month. However, it’s important to remember that this includes both new cases as well as retrospectively identified cases.” Read more.

FDA approves Skyrizi for moderately to severely active Crohn's disease

The FDA has approved AbbVie’s Skyrizi for the treatment of adults with moderately to severely active Crohn’s disease, according to a company press release.

Previously approved in the United States for the treatment of adult patients with moderately to severely active plaque psoriasis and psoriatic arthritis, Skyrizi (risankizumab-rzaa, AbbVie) is the first interleukin-23 inhibitor to enter the Crohn’s disease market. Read more.

Rectal expulsion device may predict outcomes in patients with chronic constipation

An investigational, point-of-care rectal expulsion device may help determine whether patients with chronic constipation will improve with pelvic floor physical therapy, according to data presented at Digestive Disease Week 2022.

“[Rectal expulsion device (RED)] was specifically designed to simplify and pull the tertiary care paradigm of anorectal function testing downstream to any general gastroenterologists’ medical office for patients with chronic constipation,” Eric D. Shah, MD, MBA, assistant professor at Dartmouth College Geisel School of Medicine and Dartmouth-Hitchcock Medical Center in New Hampshire, told Healio. Read more.

Unrecognized alcoholic hepatitis linked to higher mortality, hospitalization

A significant proportion of alcoholic hepatitis cases remain unrecognized and correlate with higher 30-day mortality, hospital length of stay and ICU admission, according to results presented at Digestive Disease Week 2022.

“Whether this increased mortality is from being left untreated vs. decreased tendency in that group to seek medical care (presence of other comorbidities) remains to be determined,” Julton Tomanguillo Chumbe, MD, of the division of gastroenterology at Charleston Area Medical Center in West Virginia, and colleagues wrote. Read more.

Data suggest no increase in pediatric hepatitis, adenovirus above pre-pandemic levels

Data reported in Morbidity and Mortality Weekly Report did not demonstrate an increase in pediatric hepatitis or adenovirus types 40/41 above pre-COVID-19 pandemic baseline levels.

“Following identification of pediatric hepatitis cases of unknown etiology in the United States and the United Kingdom, CDC issued a request in April 2022 for U.S. providers to report additional cases,” Anita K. Kambhampati, MPH, of the division of viral diseases at the CDC National Center for Immunization and Respiratory Diseases, and colleagues wrote. “Many reported cases had test results positive for adenovirus, which is not known to cause hepatitis in immunocompetent children.” Read more.

‘Surprisingly high’ remission rates for both ustekinumab, adalimumab in Crohn’s patients

Ustekinumab and adalimumab demonstrated equally high rates of clinical remission in biologic-naïve patients with moderate to severe Crohn’s disease through 1 year of treatment, according to results of the SEAVUE study in The Lancet.

“Although SEAVUE did not demonstrate superior efficacy of ustekinumab over adalimumab, both agents showed surprisingly high rates of clinical remission at 1 year of treatment in this population of patients who were naïve to biologic agents,” Bruce E. Sands, MD, MS, chief of gastroenterology at Mount Sinai Health System and lead study author, told Healio. “This is important information for clinicians and underscores that early treatment with either class of agent — anti-TNF antibody or anti-p40 IL-12/23 antibody — can be quite effective. These results should be contextualized with the known safety profiles of each agent, which may guide the choice of therapy for a specific patient.” Read more.

AGA releases position statements to improve CRC screening, eliminate existing barriers

The AGA has released a series of evidence-based position statements that support a nationwide colorectal cancer screening approach and aim to eliminate current barriers in the screening process.

“CRC screening saves lives, but only if people get screened,” David Lieberman, MD, AGAF, chair of the AGA executive committee on the screening continuum and professor of medicine at Oregon Health & Science University in Portland, said in a released statement. “Cost sharing is an important barrier to screening, which contributes to racial, ethnic and socioeconomic inequities in colorectal cancer outcomes. The full cost of screening — including noninvasive tests and follow-up colonoscopies — should be covered without cost to patients.” Read more.