Gastroenterology

Patients and gastroenterologists prioritize remission when escalating to first-line advanced therapy in UC

In a web-based discrete choice experiment of AT‑naïve moderately‑to‑severely active UC patients (N=514) and gastroenterologists (N=397), probability of 1‑year remission had the highest relative importance (patients 45.3%, gastroenterologists 48.5%). Five‑year cancer risk, serious infection, and MACE were also influential attributes, with notable heterogeneity across latent preference classes. Both groups were willing to accept some safety risk for higher remission probability, but preferences varied across identified subgroups. Conclusion: incorporate explicit discussion of remission probability and individualized safety trade‑offs when offering first‑line AT. 1

Probiotics show supportive benefit for chemotherapy and perioperative GI outcomes in cancer

Systematic review of trials and meta‑analyses found probiotic supplementation associated with reduced clinically relevant diarrhea, especially severe diarrhea, during chemotherapy. Perioperative probiotics/synbiotics improved GI recovery and reduced infections and length of stay in some colorectal surgery pooled analyses. Evidence is heterogeneous across strains, formulations, and endpoints, and large, strain‑defined trials with harmonized outcomes are scarce. Clinical takeaway: probiotics may be useful as adjunctive supportive care in selected oncology settings, not yet guideline‑standard across indications. 2

Network meta‑analysis identifies classes with superior fibrosis and resolution signals in MASH

Network meta‑analysis of 69 RCTs (16,180 patients) found SGLT2 inhibitors, THR‑β agonists, incretins, and FGF21 analogs improved fibrosis and MASH resolution versus placebo. Subgroup signals included FGF21 analogs OR 4.25 for resolution in cirrhosis and incretins OR 5.92 in non‑cirrhotic MASH. SGLT2 inhibitors associated with higher fibrosis improvement odds in patients with T2D (OR 9.48) and without T2D (OR 4.67). Caveat: subgroup evidence depth is limited; apply findings to individual patients cautiously while awaiting head‑to‑head and long‑term outcome data. 3