Analyzing the influence of gastric intestinal metaplasia on gastric ulcer healing in Helicobacter pylori–infected patients without atrophic gastritis

Chen, Liwei; Chang, Liang‐Che; Hua, Chung-Ching; Hsieh, Bor-Jen; Chen, Shuo‐Wei; Chien, Rong‐Nan

doi:10.1186/s12876-016-0563-8

Cited by 30 publications

(19 citation statements)

References 29 publications

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“…The prevalence of intestinal metaplasia in H. pylori -positive patients is 57% in Japanese aged approximately 70 years[ 26 ]. Although we saw no significant association between the severity of intestinal metaplasia and ulcer healing speed in this study, Chen et al[ 27 ] reported that patients with intestinal metaplasia had a higher healing rate of gastric ulcers than those without intestinal metaplasia, suggesting that patients with severe gastric atrophy accompanied by intestinal metaplasia should be considered as likely candidates for ESD-related complication, due to delayed ulcer healing.…”

Section: Discussioncontrasting

confidence: 81%

Severity of gastric mucosal atrophy affects the healing speed of post-endoscopic submucosal dissection ulcers

Otsuka

Sugimoto

Ban

et al. 2018

WJGE

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AIMTo investigate factors associated with the healing of endoscopic submucosal dissection (ESD)-induced ulcers.METHODSWe enrolled 132 patients with gastric tumors scheduled for ESD. Following ESD, patients were treated with daily lansoprazole 30 mg or vonoprazan 20 mg. Ulcer size was endoscopically measured on the day after ESD and at 4 and 8 wk. The gastric mucosa was endoscopically graded according to the Kyoto gastritis scoring system. We assessed the number of patients with and without a 90% reduction in ulcer area at 4 wk post-ESD and scar formation at 8 wk, and looked for risk factors for slower healing.RESULTSThe mean size of gastric tumors and post-ESD ulcers was 17.4 ± 12.1 mm and 32.9 ± 13.0 mm. The mean reduction rates in ulcer area were 90.4% ± 0.8% at 4 wk and 99.8% ± 0.1% at 8 wk. The reduction rate was associated with the Kyoto grade of gastric atrophy at 4 wk (A0: 97.9% ± 0.6%, A1: 93.4% ± 4.1%, and A2: 89.7% ± 1.0%, respectively). In multivariate analysis, the factor predicting 90% reduction at 4 wk was gastric atrophy (Odds ratio: 5.678, 95%CI: 1.190-27.085, P = 0.029).CONCLUSIONThe healing speed of post-ESD ulcers was associated with the degree of gastric mucosal atrophy, and Helicobacter pylori eradication therapy is required to perform at younger age.

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Section: Discussioncontrasting

confidence: 81%

Severity of gastric mucosal atrophy affects the healing speed of post-endoscopic submucosal dissection ulcers

Otsuka

Sugimoto

Ban

et al. 2018

WJGE

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“…Besides treatment intensification, TDM also includes the possibility of providing insight for reducing the exposure when needed, by re-establishing the standard dosing interval or dose de-escalation. 37,38…”

Section: Discussionmentioning

confidence: 99%

“…In fact, these studies have shown that adjusting ADL doses and administration intervals are a clinically powerful and cost-effective strategy. 37,39–41 For these reasons, there has been increasing effort by the scientific and medical community in research for the development of novel rapid-test assays and monitoring of IBD patients.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of the new rapid test for monitoring adalimumab levels

Rocha

Afonso

Lago³

et al. 2019

Therap Adv Gastroenterol

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Background: The loss of response to adalimumab (ADL) has been related to low serum concentrations at trough. Currently, most methods commercially available for the quantification of ADL are enzyme-linked immunosorbent assay (ELISA) based, with a turnaround time of approximately 8 h, delaying the target dosage adjustment to the subsequent infusion. In this study, we aimed to evaluate the performance of the newly available rapid-test ADL quantification assay by comparing it with three established ELISA methods, using spiked samples and a set of clinical samples. Methods: Spiked samples from control donors and 120 serum samples from inflammatory bowel disease (IBD) patients undergoing ADL therapy were quantified using lateral flow Quantum Blue ® Adalimumab and, the ELISA formats from Immundiagnostik, R-Biopharm and an in-house assay. Results: The rapid-test assay had intraclass correlation coefficients of 0.590, 0.864 and 0.761 when comparing with the Immundiagnostik, R-Biopharm and in-house assays, respectively. For the five therapeutic windows, the accuracy was high: ADL rapid test compared with the Immundiagnostik (58–88%); R-Biopharm, 68–89%; and in house, 60–88%; and kappa statistics revealed 0.492–0.602, 0.531–0.659 and 0.545–0.682, respectively. Conclusions: The Quantum Blue ® Adalimumab assay can replace the commonly used ELISA-based ADL quantification kits and it is a reliable alternative to these methods. This rapid-test assay enables the quantitative determination of ADL serum trough level in only 15 min. The developed assay allows measurement of ADL over a wide range. Hence, it represents a valuable tool for the clinician to assess the ADL trough level.

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“…In a further meta-analysis (Bayesian network) [ 26 ] involving prokinetics for the treatment of FD, 25 randomized control trials were included with a total of 4473 FD patients who were treated with six different prokinetics or placebo. The authors concluded that TM, metoclopramide, domperidone and mosapride showed better efficacy for the treatment of FD than itopride or acotiamide.…”

Section: Discussionmentioning

confidence: 99%

Trimebutine Maleate Monotherapy for Functional Dyspepsia: A Multicenter, Randomized, Double-Blind Placebo Controlled Prospective Trial

et al. 2020

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Background and Objectives: Functional dyspepsia (FD) is one of the most common functional gastrointestinal disorders; it has a great impact on patient quality of life and is difficult to treat satisfactorily. This study evaluates the efficacy and safety of trimebutine maleate (TM) in patients with FD. Materials and Methods: Α multicenter, randomized, double-blind, placebo controlled, prospective study was conducted, including 211 patients with FD. Participants were randomized to receive TM 300 mg twice per day (BID, 108 patients) or placebo BID (103 patients) for 4 weeks. The Glasgow Dyspepsia Severity Score (GDSS) was used to evaluate the relief of dyspepsia symptoms. Moreover, as a pilot secondary endpoint, a substudy (eight participants on TM and eight on placebo) was conducted in to evaluate gastric emptying (GE), estimated using a 99mTc-Tin Colloid Semi Solid Meal Scintigraphy test. Results: Of the 211 patients enrolled, 185 (87.7%) (97 (52.4%) in the TM group and 88 (47.6%) in the placebo group) completed the study and were analyzed. The groups did not differ in their demographic and medical history data. Regarding symptom relief, being the primary endpoint, a statistically significant reduction in GDSS for the TM group was revealed between the first (2-week) and final (4-week) visit (p-value = 0.02). The 99 mTc-Tin Colloid Semi Solid Meal Scintigraphy testing showed that TM significantly accelerated GE obtained at 50 min (median emptying 75.5% in the TM group vs. 66.6% in the placebo group, p = 0.036). Adverse effects of low to moderate severity were reported in 12.3% of the patients on TM. Conclusion: TM monotherapy appears to be an effective and safe approach to treating FD, although the findings presented here warrant further confirmation.

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Analyzing the influence of gastric intestinal metaplasia on gastric ulcer healing in Helicobacter pylori–infected patients without atrophic gastritis

Cited by 30 publications

References 29 publications

Severity of gastric mucosal atrophy affects the healing speed of post-endoscopic submucosal dissection ulcers

Severity of gastric mucosal atrophy affects the healing speed of post-endoscopic submucosal dissection ulcers

Accuracy of the new rapid test for monitoring adalimumab levels

Trimebutine Maleate Monotherapy for Functional Dyspepsia: A Multicenter, Randomized, Double-Blind Placebo Controlled Prospective Trial

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