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2. International Delphi Consensus Study on disposable single-use endoscopy: A path to clinical adoption

Author

AABAKKEN, Lars, ABERE, Sarah, AKROUSH, Maisam W., AL-LEHIBI, Abed, ALBÉNIZ, Eduardo, ALKANDARI, Asma, ALMADI, Majid A., ANDERLONI, Andrea, BAPAYE, Amol, BERTRAND, Napoleon, BICK, Benjamin, BISSCHOPS, Raf, BOURKE, Michael J., BROWN, James F., BRUNO, Marco J., CHIU, Philip Wai Yan, CROAGH, Daniel, de MOURA, Eduardo Guimaraes Hourneaux, DENZER, Ulrike, EMURA, Fabian, FABBRI, Carlo, FEDOROV, Evgeny, FOCKENS, Paul, GABRIELLI, Armando, HAEFNER, Michael, HUCL, Tomas, IBRAHIM, Mostafa, IJOMA, Uchenna, KAFFES, Arthur, KASHIN, Sergey, KHASHAB, Mouen A., KHOR, Christopher, LALEMAN, Wim, LAW, Ryan, LOLLO, Gianluca, MAY, Gary R., DESALEGN MEKONNEN, Hailemichael, MOON, Jong H., MUSAH, Yusuf, MUTHUSAMY, V. Raman, MUTIGNANI, Massimiliano, MWACHIRO, Michael, NAVARRETE, Claudio, NEUHAUS, Horst, NIETO, Jose M., ONYIA, Chinwe, OYELEKE, Ganiyat Kikelomo, PEREZ-MIRANDA, Manuel, PONNUDURAI, Ryan, RAJU, Gottumukkala S., REDDY, D. Nageshwar, RÖSCH, Thomas, SAITO, Yutaka, SETHI, Amrita, SHARMA, Prateek, SIDDIQUI, Uzma D., TARANTINO, Ilaria, HOOFT, Jeanine VAN, WALLACE, Michael B., WEBSTER, George, YAHAGI, Naohisa, YUSOFF, Ian, Repici, Alessandro, Khalaf, Kareem, Troncone, Edoardo, Subramaniam, Sharmila, Hassan, Cesare, and Bhandari, Pradeep

Published
2024
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5. Polyp Detection and Segmentation using Mask R-CNN: Does a Deeper Feature Extractor CNN Always Perform Better?

Author

Qadir, Hemin Ali, Shin, Younghak, Solhusvik, Johannes, Bergsland, Jacob, Aabakken, Lars, and Balasingham, Ilangko

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Machine Learning, Electrical Engineering and Systems Science - Image and Video Processing
Abstract

Automatic polyp detection and segmentation are highly desirable for colon screening due to polyp miss rate by physicians during colonoscopy, which is about 25%. However, this computerization is still an unsolved problem due to various polyp-like structures in the colon and high interclass polyp variations in terms of size, color, shape, and texture. In this paper, we adapt Mask R-CNN and evaluate its performance with different modern convolutional neural networks (CNN) as its feature extractor for polyp detection and segmentation. We investigate the performance improvement of each feature extractor by adding extra polyp images to the training dataset to answer whether we need deeper and more complex CNNs or better dataset for training in automatic polyp detection and segmentation. Finally, we propose an ensemble method for further performance improvement. We evaluate the performance on the 2015 MICCAI polyp detection dataset. The best results achieved are 72.59% recall, 80% precision, 70.42% dice, and 61.24% Jaccard. The model achieved state-of-the-art segmentation performance., Comment: 6

Published
2019
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6. Automatic Colon Polyp Detection using Region based Deep CNN and Post Learning Approaches

Author

Shin, Younghak, Qadir, Hemin Ali, Aabakken, Lars, Bergsland, Jacob, and Balasingham, Ilangko

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Artificial Intelligence
Abstract

Automatic detection of colonic polyps is still an unsolved problem due to the large variation of polyps in terms of shape, texture, size, and color, and the existence of various polyp-like mimics during colonoscopy. In this study, we apply a recent region based convolutional neural network (CNN) approach for the automatic detection of polyps in images and videos obtained from colonoscopy examinations. We use a deep-CNN model (Inception Resnet) as a transfer learning scheme in the detection system. To overcome the polyp detection obstacles and the small number of polyp images, we examine image augmentation strategies for training deep networks. We further propose two efficient post-learning methods such as, automatic false positive learning and off-line learning, both of which can be incorporated with the region based detection system for reliable polyp detection. Using the large size of colonoscopy databases, experimental results demonstrate that the suggested detection systems show better performance compared to other systems in the literature. Furthermore, we show improved detection performance using the proposed post-learning schemes for colonoscopy videos., Comment: 9 pages

Published
2019
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8. OS-076-YI Bile extracellular vesicles hold protein biomarkers for the early diagnosis of cholangiocarcinoma in individuals with primary sclerosing cholangitis

Author

Lapitz, Ainhoa, primary, Grimsrud, Marit, additional, Rodrigues, Pedro Miguel, additional, Hov, Johannes R., additional, Vesterhus, Mette, additional, Azkargorta, Mikel, additional, Grzyb, Krzysztof, additional, Reims, Henrik Mikael, additional, Elortza, Felix, additional, Izquierdo-Sánchez, Laura, additional, Perugorria, María Jesús, additional, Bujanda, Luis, additional, Aabakken, Lars, additional, Paulsen, Vemund, additional, Karlsen, Tom Hemming, additional, Banales, Jesus Maria, additional, and Folseraas, Trine, additional

Published
2024
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12. Molecular testing for personalized therapy is underutilized in patients with borderline resectable and locally advanced pancreatic cancer – real world data from the NORPACT-2 study.

Author

Farnes, Ingvild, Lund-Iversen, Marius, Aabakken, Lars, Verbeke, Caroline, and Labori, Knut Jørgen

Subjects
CANCER patients, PANCREATIC cancer, PANCREATIC surgery, ONCOLOGIC surgery, SURGICAL excision
Abstract

Background: International guidelines currently recommend the use of molecular testing in patients with advanced pancreatic cancer. The rate of actionable molecular alterations is low. The utility of molecular testing in patients with borderline resectable (BRPC) or locally advanced (LAPC) pancreatic cancer in real world clinical practice is unclear. Methods: 188 consecutive patients included in a prospective, population-based study (NORPACT-2) in patients with BRPC and LAPC (2018–2020) were reviewed. Molecular testing was performed at the discretion of the treating oncologist and was not recommended as a routine investigation by the national guidelines. All patients were considered fit to undergo primary chemotherapy and potential surgical resection. The frequency and the results of molecular testing (microsatellite instability (MSI) and/or KRAS status) were assessed. Results: Thirty patients (16%) underwent molecular testing. MSI tumour was detected in one (3.6%) of 28 tested patients. The patient received immunotherapy and subsequently underwent surgical resection. Histological assessment of the resected specimen revealed a complete response. KRAS wild type was detected in one (14.3%) of seven tested patient. Patients who initiated FOLFIRINOX as the primary chemotherapy regimen (p = 0.022), or were being treated at one of the eight hospital trusts (p = 0.001) were more likely to undergo molecular testing. Conclusions: Molecular testing was rarely performed in patients with BRPC or LAPC. Routine molecular testing for all patients with BRPC and LAPC should be considered to increase identification of targetable mutations and improve outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Per-oral cholangioscopy in patients with primary sclerosing cholangitis: a 12-month follow-up study

Author

Mohamed, Rachid, additional, Tejaswi, Sooraj, additional, Aabakken, Lars, additional, Ponsioen, Cyriel Y, additional, Bowlus, Christopher L, additional, Adler, Douglas G, additional, Forbes, Nauzer, additional, Paulsen, Vemund, additional, Voermans, Rogier P, additional, Urayama, Shiro, additional, Peetermans, Joyce, additional, Rousseau, Matthew J, additional, and Eksteen, Bertus, additional

Published
2024
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22. Resection rates and intention-to-treat outcomes in borderline and locally advanced pancreatic cancer: real-world data from a population-based, prospective cohort study (NORPACT-2)

Author

Farnes, Ingvild, primary, Kleive, Dyre, additional, Verbeke, Caroline S, additional, Aabakken, Lars, additional, Issa-Epe, Aart, additional, Småstuen, Milada Cvancarova, additional, Fosby, Bjarte V, additional, Dueland, Svein, additional, Line, Pål-Dag, additional, and Labori, Knut J, additional

Published
2023
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24. Uniting the Global Gastroenterology Community to Meet the Challenge of Climate Change and Nonrecyclable Waste

Author

Leddin, Desmond, Omary, M. Bishr, Veitch, Andrew, Metz, Geoffrey, Amrani, Naima, Aabakken, Lars, Ali, Raja A.R., Alvares-da-Silva, Mario R., Armstrong, David, Boyacioglu, Sedat, Chen, Ye, Elwakil, Reda, Fock, Kwong-Ming, Hamid, Saeed S., Makharia, Govind, Macrae, Finlay, Malekzadeh, Reza, Mulder, Chris J., Piscoya, Alejandro, Perman, Mai Ling, Sadeghi, Anahita, Sáenz, Roque, Saurin, Jean-Christophe, Butt, Amna S., Wu, Kaichun, and Lee, Yeong Yeh

Published
2021
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25. Performance and safety of diagnostic EUS FNA/FNB and therapeutic ERCP in patients with borderline resectable and locally advanced pancreatic cancer - results from a population-based, prospective cohort study.

Author

Farnes, Ingvild, Paulsen, Vemund, Verbeke, Caroline Sofie, Tønnesen, Christer Julseth, Aabakken, Lars, and Labori, Knut Jørgen

Subjects
PANCREATIC cancer, NEEDLE biopsy, ENDOSCOPIC retrograde cholangiopancreatography, COHORT analysis, LONGITUDINAL method, HOSPITAL records, CANCER patients
Abstract

Objective: Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS FNA/FNB) and potential endoscopic retrograde cholangiopancreatography (ERCP) for biliary decompression are indicated in patients with pancreatic cancer before initation of primary chemotherapy. This study aims to investigate the performance and safety of these two procedures in patients with borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC). Methods: Endoscopy and pathology reports, and hospital records of consecutive patients with a radiological diagnosis of BRPC/LAPC included in a population based, protocol-driven study (NORPACT-2) were reviewed. Results: Of 251 patients, 223 (88.9%) underwent EUS-FNA/FNB, and 133 (53%) underwent ERCP. Repeated EUS attempts were performed in 33 (14.8%), eight (3.6%), and four (1.8%) patients. FNA was performed in 155 procedures, FNB in 30, and combined EUS-FNA/FNB in 83. Diagnostic accuracy was 86.1% for first EUS-FNA/FNB. The cumulative diagnostic accuracy for all attempts was 96%. False positive rate for malignancy was 0.9%. Of a total of 149 ERCP procedures, 122 (81.9%) were successful, and 27 (18.1%) were unsuccessful. Success rate of first ERCP attempt was 80.5% (107/133). Sixteen patients (12%) underwent a second attempt with a success rate of 93.8% (15 of 16). Combined EUS and ERCP was performed in 41 patients. Complications occurred in eight procedures (3%) after EUS-FNA/FNB, 23 procedures (15.3%) after ERCP, and four (9.8%) patients after combined EUS-FNA/FNB and ERCP. Conclusion: EUS-FNA/FNB and ERCP with biliary stenting in patients with BRPC/LAPC demonstrated acceptable performance and safety. Repeat procedures were performed with high success rates. Same session EUS-FNA/FNB and ERCP for biliary decompression is safe. [ABSTRACT FROM AUTHOR]

Published
2024
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27. International Delphi Consensus Study on disposable single-use endoscopy: A path to clinical adoption

Author

Repici, Alessandro, primary, Khalaf, Kareem, additional, Troncone, Edoardo, additional, Subramaniam, Sharmila, additional, Hassan, Cesare, additional, Bhandari, Pradeep, additional, AABAKKEN, Lars, additional, ABERE, Sarah, additional, AKROUSH, Maisam W., additional, AL-LEHIBI, Abed, additional, ALBÉNIZ, Eduardo, additional, ALKANDARI, Asma, additional, ALMADI, Majid A., additional, ANDERLONI, Andrea, additional, BAPAYE, Amol, additional, BERTRAND, Napoleon, additional, BICK, Benjamin, additional, BISSCHOPS, Raf, additional, BOURKE, Michael J., additional, BROWN, James F., additional, BRUNO, Marco J., additional, CHIU, Philip Wai Yan, additional, CROAGH, Daniel, additional, de MOURA, Eduardo Guimaraes Hourneaux, additional, DENZER, Ulrike, additional, EMURA, Fabian, additional, FABBRI, Carlo, additional, FEDOROV, Evgeny, additional, FOCKENS, Paul, additional, GABRIELLI, Armando, additional, HAEFNER, Michael, additional, HUCL, Tomas, additional, IBRAHIM, Mostafa, additional, IJOMA, Uchenna, additional, KAFFES, Arthur, additional, KASHIN, Sergey, additional, KHASHAB, Mouen A., additional, KHOR, Christopher, additional, LALEMAN, Wim, additional, LAW, Ryan, additional, LOLLO, Gianluca, additional, MAY, Gary R., additional, DESALEGN MEKONNEN, Hailemichael, additional, MOON, Jong H., additional, MUSAH, Yusuf, additional, MUTHUSAMY, V. Raman, additional, MUTIGNANI, Massimiliano, additional, MWACHIRO, Michael, additional, NAVARRETE, Claudio, additional, NEUHAUS, Horst, additional, NIETO, Jose M., additional, ONYIA, Chinwe, additional, OYELEKE, Ganiyat Kikelomo, additional, Perez-MIRANDA, Manuel, additional, PONNUDURAI, Ryan, additional, RAJU, Gottumukkala S., additional, REDDY, D. Nageshwar, additional, RÖSCH, Thomas, additional, SAITO, Yutaka, additional, SETHI, Amrita, additional, SHARMA, Prateek, additional, SIDDIQUI, Uzma D., additional, TARANTINO, Ilaria, additional, HOOFT, Jeanine VAN, additional, WALLACE, Michael B., additional, WEBSTER, George, additional, YAHAGI, Naohisa, additional, and YUSOFF, Ian, additional

Published
2023
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30. No Superiority of Stents vs Balloon Dilatation for Dominant Strictures in Patients With Primary Sclerosing Cholangitis

Author

Ponsioen, Cyriel Y., Arnelo, Urban, Bergquist, Annika, Rauws, Erik A., Paulsen, Vemund, Cantú, Paolo, Parzanese, Ilaria, De Vries, Elisabeth M., van Munster, Kim N., Said, Karouk, Chazouillères, Olivier, Desaint, Benoit, Kemgang, Astrid, Färkkilä, Martti, Van der Merwe, Schalk, Van Steenbergen, Werner, Marschall, Hanns-Ulrich, Stotzer, Per-Ove, Thorburn, Douglas, Pereira, Stephen P., and Aabakken, Lars

Published
2018
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31. The association between cholestatic biochemical markers and clinical symptoms in patients with non-end-stage primary sclerosing cholangitis

Author

Middelburg, Tim, primary, Mostafavi, Nahid, additional, Akbulut, Seval, additional, Bergquist, Annika, additional, Chazouilleres, Olivier, additional, Kemgang, Astrid, additional, Marschall, Hanns-Ulrich, additional, Pereira, Stephen, additional, Aabakken, Lars, additional, and Ponsioen, Cyriel, additional

Published
2023
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32. YIELD OF EARLY PER-ORAL CHOLANGIOSCOPY IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS

Author

Mohamed, Rachid, primary, Forbes, Nauzer, additional, Aabakken, Lars, additional, Paulsen, Vemund, additional, Ponsioen, Cyriel, additional, Voermans, Rogier, additional, Tejaswi, Sooraj, additional, Bowlus, Christopher, additional, Urayama, Shiro, additional, Adler, Douglas, additional, Peetermans, Joyce, additional, Rousseau, Matthew, additional, and Eksteen, Bertus, additional

Published
2023
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36. Primær skleroserende kolangitt.

Author

HELGADOTTIR, HOLMFRIDUR, FOLSERAAS, TRINE, KEMMERICH, GUNTER, AABAKKEN, LARS, JØRGENSEN, KRISTIN KAASEN, and VESTERHUS, METTE

Published
2023

37. Effects of faecal microbiota transplantation on the small intestinal mucosa in systemic sclerosis.

Author

Strahm, Noemi, Didriksen, Henriette, Fretheim, Håvard, Molberg, Øyvind, Midtvedt, Øyvind, Farstad, Inger Nina, Midtvedt, Tore, Lundin, Knut E A, Aabakken, Lars, Błyszczuk, Przemysław, Distler, Oliver, Kania, Gabriela, and Hoffmann-Vold, Anna-Maria

Subjects
RESEARCH, BIOPSY, IMMUNOGLOBULINS, TIME, IMMUNOHISTOCHEMISTRY, ENDOPLASMIC reticulum, SYSTEMIC scleroderma, FIBROSIS, CIRCADIAN rhythms, HEALTH outcome assessment, DUODENUM, RANDOMIZED controlled trials, PRE-tests & post-tests, CELLULAR signal transduction, MATRIX metalloproteinases, T-test (Statistics), PEARSON correlation (Statistics), SMALL intestine, GENE expression profiling, RESEARCH funding, FECAL microbiota transplantation, INTESTINAL mucosa, STATISTICAL sampling, CHEMOKINES, DATA analysis software
Abstract

Objectives In SSc, gastrointestinal tract (GIT) involvement is a major concern, with no disease-modifying and limited symptomatic therapies available. Faecal microbiota transplantation (FMT) represents a new therapeutic option for GIT-affliction in SSc, showing clinical promise in a recent controlled pilot trial. Here, we aim to investigate effects of FMT on duodenal biopsies collected from SSc patients by immunohistochemistry and transcriptome profiling. Methods We analysed duodenal biopsies obtained pre-intervention (week 0) and post-intervention (weeks 2 and 16) from nine SSc patients receiving an intestinal infusion of FMT (n  = 5) or placebo (n  = 4). The analysis included immunohistochemistry (IHC) with a selected immune function and fibrosis markers, and whole biopsy transcriptome profiling. Results In patients receiving FMT, the number of podoplanin- and CD64-expressing cells in the mucosa were lower at week 2 compared with baseline. This decline in podoplanin- (r  = 0.94) and CD64-positive (r  = 0.89) cells correlated with improved patient-reported lower GIT symptoms. Whole biopsy transcriptome profiling from week 2 showed significant enrichment of pathways critical for cellular and endoplasmic reticulum stress responses, microvillus and secretory vesicles, vascular and sodium-dependent transport, and circadian rhythm. At week 16, we found enrichment of pathways mandatory for binding activity of immunoglobulin receptors, T cell receptor complexes, and chemokine receptors, as well as response to zinc-ions. We found that 25 genes, including Matrix metalloproteinase-1 were upregulated at both week 2 and week 16. Conclusion Combining selective IHC and unbiased gene expression analyses, this exploratory study highlights the potential for disease-relevant organ effects of FMT in SSc patients with GIT involvement. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov , NCT03444220. [ABSTRACT FROM AUTHOR]

Published
2023
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38. Effects of faecal microbiota transplantation on small intestinal mucosa in systemic sclerosis

Author

Strahm, Noemi, Didriksen, Henriette, Fretheim, Håvard, Molberg, Øyvind, Midtvedt, Øyvind, Farstad, Inger Nina, Midtvedt, Tore, Lundin, Knut E A, Aabakken, Lars, Błyszczuk, Przemysław, Distler, Oliver, Kania, Gabriela, Hoffmann-Vold, Anna-Maria, and University of Zurich

Subjects
10051 Rheumatology Clinic and Institute of Physical Medicine, 610 Medicine & health
Published
2023

40. Comparison between Enteroscopy-, Laparoscopy- and Endoscopic Ultrasound-Assisted Endoscopic Retrograde Cholangio-Pancreatography in Patients with Surgically Altered Anatomy: A Systematic Review and Meta-Analysis

Author

Gkolfakis, Paraskevas, primary, Papaefthymiou, Apostolis, additional, Facciorusso, Antonio, additional, Tziatzios, Georgios, additional, Ramai, Daryl, additional, Dritsas, Spyridon, additional, Florou, Theodosia, additional, Papanikolaou, Ioannis S., additional, Hassan, Cesare, additional, Repici, Alessandro, additional, Triantafyllou, Konstantinos, additional, Aabakken, Lars, additional, Devière, Jacques, additional, Beyna, Torsten, additional, and Arvanitakis, Marianna, additional

Published
2022
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43. Randomised clinical trial and meta‐analysis: mesalazine treatment in irritable bowel syndrome—effects on gastrointestinal symptoms and rectal biomarkers of immune activity

Author

Castro Tejera, Valeria, primary, Öhman, Lena, additional, Aabakken, Lars, additional, Fellström, Bengt, additional, Hausken, Trygve, additional, Hovde, Øistein, additional, Hreinsson, Johann P., additional, Lindberg, Greger, additional, Venge, Per, additional, Simrén, Magnus, additional, and Törnblom, Hans, additional

Published
2022
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44. Contributors

Author

Aabakken, Lars, AbiMansour, Jad P., Advani, Rashmi R., Ahlawat, Sushil K., Ahmad, Jawad, Al-Kawas, Firas H., Baron, Todd H., Benias, Petros C., Bilal, Mohammad, Bomman, Shivanand, Boškoski, Ivo, Bourke, Michael J., Bucobo, Juan Carlos, Buscaglia, Jonathan M., Canakis, Andrew, Carr-Locke, David Leslie, Chandrasekhara, Vinay, Costamagna, Guido, Coté, Gregory A., Cotton, Peter B., Coughlin, Sarah E., Das, Koushik K., Duloy, Anna M., Edelson, Jerome C., Edmundowicz, Steven A., El Abiad, Rami G., Faigel, Douglas O., Feld, Andrew, Fogel, Evan L., Fox, Victor L., Freeman, Martin L., Gan, S. Ian, Gelrud, Andres, Ginsberg, Gregory G., Grover, Amit S., Hatter, Katherine Herbert, Hawes, Robert H., Hernandez, Lyndon, Hyun, Jong Jin, Irani, Shayan, Issa, Danny, Itoi, Takao, Jacob, Bobby, Jain, Avni, Jamidar, Priya A., Jang, Sung Ill, Jeong, Seok, Jonica, Emily R., Kalloo, Anthony N., Khan, Muhammad A., Khashab, Mouen A., Kochman, Michael L., Kodama, Tadashi, Korman, Andrew, Koshitani, Tatsuya, Kozarek, Richard A., Krafft, Matthew R., Kwok, Karl, Lakhtakia, Sundeep, Larsen, Michael, Lau, James Y.W., Law, Ryan, Lee, Dong Ki, Lehman, Glen, Leung, Joseph W., Ligresti, Dario, Lo, Simon K., Maple, John T., Mariani, Alberto, May, Gary Robert R., McHenry, Lee, Millatiner, Noa, Mizrahi, Meir, Montminy, Eric M., Nabi, Zaheer, Neuhaus, Horst, Norton, Ian D., Oh, Dongwook, Pal, Partha, Parsons, David, Perez-Miranda, Manuel, Pleskow, Douglas, Ramchandani, Mohan, Rao, G. Venkat, Reddy, D. Nageshwar, Ross, Andrew S., Saleem, Nasir, Schepis, Tommaso, Seo, Dong-Wan, Shah, Raj J., Sharaiha, Reem Z., Sherman, Stuart, Shrigiriwar, Apurva, Slivka, Adam, Tang, Raymond S.Y., Tarantino, Ilaria, Tarnasky, Paul R., Teoh, Anthony Yuen Bun, Alberto, Pier, Testoni, Sabrina, Tobin, Catherine Dawson, Topazian, Mark, Trieu, Judy A., Veitch, Andrew, Wani, Sachin, Yen, Andrew W., and Yoo, Timothy

Published
2025
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46. Impact of artificial intelligence on colorectal polyp detection for early-career endoscopists: an international comparative study

Author

Ainechi, Diba, primary, Misawa, Masashi, additional, Barua, Ishita, additional, Larsen, Solveig Linnea Veen, additional, Paulsen, Vemund, additional, Garborg, Kjetil Kjeldstad, additional, Aabakken, Lars, additional, Tønnesen, Christer Julseth, additional, Løberg, Magnus, additional, Kalager, Mette, additional, Kudo, Shin-Ei, additional, Hotta, Kinichi, additional, Ohtsuka, Kazuo, additional, Saito, Shoichi, additional, Ikematsu, Hiroaki, additional, Saito, Yutaka, additional, Matsuda, Takahisa, additional, Itoh, Hayato, additional, Mori, Kensaku, additional, Bretthauer, Michael, additional, and Mori, Yuichi, additional

Published
2022
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50. Randomised clinical trial and meta-analysis : mesalazine treatment in irritable bowel syndrome-effects on gastrointestinal symptoms and rectal biomarkers of immune activity.

Author

Castro Tejera, Valeria, Öhman, Lena, Aabakken, Lars, Fellström, Bengt, Hausken, Trygve, Hovde, Øistein, Hreinsson, Johann P, Lindberg, Greger, Venge, Per, Simrén, Magnus, Törnblom, Hans, Castro Tejera, Valeria, Öhman, Lena, Aabakken, Lars, Fellström, Bengt, Hausken, Trygve, Hovde, Øistein, Hreinsson, Johann P, Lindberg, Greger, Venge, Per, Simrén, Magnus, and Törnblom, Hans

Abstract

BACKGROUND: Low-grade immune activation in the gut is a potential treatment target in irritable bowel syndrome (IBS). AIMS: To determine improvement in IBS symptoms after mesalazine treatment, and the utility of measures of immune activity in the rectal mucosa METHODS: This was a randomised, double-blind, placebo-controlled, parallel-arm, multicentre trial in subjects with IBS (Rome III criteria), with an eight-week treatment period of mesalazine 2400 mg or plcebo once-daily. The primary endpoint was the global assessment of satisfactory relief of IBS symptoms in ≥50% of weeks during intervention. IBS symptoms were also measured with the IBS severity scoring system; immune activity was measured by mucosal patch technology. A post hoc meta-analysis of randomised placebo-controlled trials of mesalazine in IBS was added. RESULTS: Of 181 included patients, 91 received mesalazine and 90 received placebo. The primary endpoint was met by 32 (36%) patients after mesalazine and 27 (30%) after placebo (p = 0.40). There were no differences in response rates related to IBS subtype or post-infection symptom onset. More reduction of abdominal bloating was noted in the mesalazine group (p = 0.02). The meta-analysis showed no effect of mesalazine on IBS symptoms. No mucosal patch technology measure could predict response to mesalazine, and found no differences in the effects of intervention on levels of immune markers. CONCLUSIONS: Mesalazine is ineffective in reducing IBS symptoms. Rectal measures of immune activity by the mucosal patch technology cannot predict a higher chance of response to mesalazine.

Published
2022
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