Gastroenterology

Advanced therapies reduce antibiotic dependence in many patients with chronic pouchitis

In this multicenter retrospective cohort of chronic pouchitis, incident users of advanced therapies had mean antibiotic time fall from 38% to 33% after AT initiation. Overall, 61% of incident AT users experienced reduced antibiotic use, and anti‑interleukin therapy was overrepresented among responders (46% vs 15%, adjusted OR 11.1). Prevalent AT users remained frequently antibiotic‑dependent, with 79% (22/28) requiring antibiotics while on AT. A pooled meta‑analysis estimated antibiotic use prevalence during AT at 0.46 (95% CI 0.35–0.57), indicating variable benefit across studies. 1

Aerobic walking alters gut microbiota more in malnourished octogenarians than in healthy peers

In a 12‑week brisk walking program (3×/week; 1 h/session), malnourished octogenarians showed higher post‑intervention microbial richness and diversity than healthy peers. The malnourished group had enrichment of taxa including Faecalibacterium prausnitzii and Streptococcus salivarius and upregulated amino‑acid biosynthesis pathways. No non‑exercise control group and a 72.1% dropout rate limit causal inference and generalizability. 2

EASL‑AASLD Delphi defines surrogate and real‑world evidence priorities for PBC trials

An international Delphi of 62 panellists produced agreement on 16 statements and 42 recommendations to align PBC endpoints with regulatory expectations. The consensus highlights limitations of relying solely on biochemistry and fibrosis and urges validated surrogate endpoints and standardized PRO integration. These recommendations provide a pragmatic framework for trial design and real‑world evidence incorporation, but individual endpoints still require validation for regulatory approval. 3