Efficacy and safety of thalidomide for the treatment of recurrent bleeding due to small-intestinal angiodysplasia

A recent study suggests that thalidomide is safe and efficacious for use in treating recurrent bleeding due to small-intestinal angiodysplasia (SIA). This study’s results were published in The New England Journal of Medicine.

This multicenter, randomized, double-blind, placebo-controlled trial included 150 patients with at least four episodes of recurrent bleeding during the previous year due to SIA. They were randomized to receive either 100 mg (n=51) or 50 mg (n=49) of oral thalidomide or placebo (n=50) for four months. The patients were followed up for at least one year after the treatment period. The primary endpoint of the study was effective response, marked by reduction of at least 50% of bleeding episodes after thalidomide treatment.

At the end of the treatment period, it was seen that 68.6%, 51.0%, and 16.0% of the patients in the 100-mg thalidomide group, 50-mg thalidomide group, and placebo group, respectively showed effective response. From the above results, it can be concluded that treatment with thalidomide may result in a reduction in bleeding in patients with recurrent bleeding due to SIA.

Fexuprazan shows therapeutic efficacy superior to placebo in patients with acute or chronic gastritis

According to a recent study, fexuprazan, a novel potassium-competitive acid blocker, shows safety and efficacy over placebo in patients with acute or chronic gastritis. This study was published in the journal, Gut and Liver.

This study included 327 patients with acute or chronic gastritis who had one or more gastric erosions on endoscopy and were randomized into three groups. The groups received 20 mg once a day (q.d.) fexuprazan, 10 mg twice a day (b.i.d.) fexuprazan, or placebo for 2 weeks. Erosion improvement rate was the primary endpoint of the study.

At the end of the study, it was found that 57.8%, 65.7%, and 40.6% of patients showed erosion improvement after 2 weeks in the fexuprazan 20 mg q.d., fexuprazan 10 mg b.i.d., and placebo groups, respectively. Both doses of fexuprazan showed superior efficacy to the placebo. Similarly, both doses of fexuprazan showed higher erosion healing rates than the placebo.

From the above results, it can be concluded that fexuprazan at 20 mg q.d. and 10 mg b.i.d. for 2 weeks may show safety and efficacy over placebo in treating patients with acute or chronic gastritis.

Nomogram model can effectively predict the risk of postoperative intestinal fistula in patients with Crohn disease

A recent study demonstrated that a nomogram prediction model can effectively assess the independent factors affecting patients with postoperative intestinal fistula from Crohn disease (CD). This study was published in the journal, Medicine.

This was a retrospective multicenter case-control study that included 240 patients with CD, who were randomly divided into a training set (n=168) and a validation set (n=72). Univariate analysis was conducted for relevant factors and the statistically significant factors were further analyzed using multivariate logistic regression to determine the independent influencing factors. Subsequently, a nomogram model was developed to predict the occurrence of postoperative intestinal fistula in patients with CD, and the accuracy of this model was assessed using calibration curves.

Univariate analysis demonstrated that disease behavior, intestinal perforation, abdominal abscess, systemic immunoinflammatory index, neutrophil-to-lymphocyte ratio, and prognostic nutrition index were all factors affecting postoperative intestinal fistula in CD patients. After the multivariate logistic regression analysis, it was found that the independent influencing factors were the neutrophil-to-lymphocyte ratio, disease behavior, prognostic nutrition index, and Crohn disease activity index score. The area under the curve, after assessing the validation set was 0.899, indicating good predictive accuracy of the nomogram model.

Based on the above findings of the study, it can be concluded that the nomogram prediction model can effectively predict the risk of postoperative intestinal fistula in patients with CD.