Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
-
Clin. Gastroenterol. Hepatol. · Apr 2014
Randomized Controlled Trial Multicenter StudyEffect of linaclotide on severe abdominal symptoms in patients with irritable bowel syndrome with constipation.
Patients with irritable bowel syndrome with constipation (IBS-C) have abdominal symptoms that vary in severity. Linaclotide, a guanylate cyclase-C agonist, improves abdominal and bowel symptoms in these patients. We examined the prevalence of severe abdominal symptoms in patients with IBS-C and assessed the effects of linaclotide on abdominal symptoms, global measures, and quality of life (QOL). ⋯ NCT00938717, NCT00948818.
-
Clin. Gastroenterol. Hepatol. · Jan 2014
Multicenter StudyA phase 2 study of allogeneic mesenchymal stromal cells for luminal Crohn's disease refractory to biologic therapy.
Transplantation of peripheral blood stem cells has been successful therapy for small numbers of patients with Crohn's disease (CD), but requires prior myeloconditioning. Mesenchymal stromal cells (MSCs) escape immune recognition, so myeloconditioning is not required before their administration. We investigated the efficacy of allogeneic MSCs in patients with luminal CD. ⋯ In a phase 2 study, administration of allogeneic MSCs reduced CDAI and CDEIS scores in patients with luminal CD refractory to biologic therapy. ClinicalTrials.gov number, NCT01090817.
-
Clin. Gastroenterol. Hepatol. · Mar 2013
Randomized Controlled Trial Multicenter StudyFerric carboxymaltose prevents recurrence of anemia in patients with inflammatory bowel disease.
Iron-deficiency anemia is the most common systemic complication of inflammatory bowel diseases (IBD). Iron-deficiency anemia recurs frequently and rapidly after iron-replacement therapy in patients with IBD. We performed a randomized, placebo-controlled trial to determine if administration of ferric carboxymaltose (FCM) prevents anemia in patients with IBD and low levels of serum ferritin. ⋯ FCM prevents recurrence of anemia in patients with IBD, compared with placebo. Nevertheless, the high rate of anemia recurrence warrants optimization of the frequency and requirements for FCM treatment.
-
Clin. Gastroenterol. Hepatol. · Oct 2012
Randomized Controlled Trial Multicenter Study Comparative StudyThe combination of octreotide and midodrine is not superior to albumin in preventing recurrence of ascites after large-volume paracentesis.
Large-volume paracentesis (LVP) is the treatment of choice for patients with cirrhosis and refractory ascites. However, LVP can lead to postparacentesis circulatory dysfunction (PCD), which is associated with faster ascites recurrence and renal failure. PCD results from vasodilatation, which reduces effective blood volume, and is prevented by intravenous administration of albumin. Vasoconstrictors could be used instead of albumin and, with longer use, prevent PCD and delay ascites recurrence. ⋯ The combination of midodrine and octreotide after LVP is not superior to albumin in delaying recurrence of ascites or preventing PCD in patients with cirrhosis. Outcomes appear to be worse in patients given octreotide and midodrine. ClinicalTrials.gov number, NCT00108355.
-
Clin. Gastroenterol. Hepatol. · Jun 2012
Multicenter StudyEtiologies and outcomes of acute liver failure in Germany.
Acute liver failure (ALF) is a severe form of acute liver injury that can progress to multiple organ failure. We investigated causes and outcomes of ALF. ⋯ In Germany, drug toxicity, indeterminate etiology, and viral hepatitis appear to be the major causes of primary ALF, which has high mortality. Patients with ALF are at great risk of progressing to multiple organ failure, but 80% of patients who receive ELT survive until discharge from the hospital.