Ponencia del Dr. Álvaro Santos Laso en la Sesión Póster Blast del 48º Congreso Anual de la Asociación Española para el Estudio del Hígado (AEEH) mostrando que la quinurenina, un metabolito derivado del metabolismo del triptófano y regulado por la composición de la microbiota intestinal, puede representar un potencial biomarcardor no invasivo de la enfermedad hepática metabólica y una potencial estrategia terapéutica para dicha enfermedad mediante la modulación de sus niveles hepáticos. Esta interesante propuesta presentada por el Dr. Santos, se fundamenta en la existencia, tanto de mayores niveles serológicos de quinurenina en pacientes con enfermedad hepática metabólica como de una correlación positiva y significativa de estos niveles con algunos parámetros elastográficos (i.e., CAP y rigidez hepática), a la vez que el tratamiento con quinurenina de modelos in vitro de enfermedad hepática metabólica reduce la acumulación de lípidos y mejora la función celular. Estos resultados han sido generados gracias a la obtención de un proyecto financiado de manera competitiva por la Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL) en su convocatoria Next generation Valdecilla 2021 (Cod: NVAL21/28)
Etiqueta: Higado
A high-level training activity took place during the 48ª Congress of the Spanish Association for the Study of the Liver: a Masterclass focused on the Prevention of liver diseases, highlighting the importance of Public Health policies. This activity, led by Profs José Luis Calleja (Gastroenterology and Hepatology Service; Puerta de Hierro University Hospital, Spain) and Javier Crespo (Gastroenterology and Hepatology Department, Marqués de Valdecilla University Hospital, Santander, Spain), was attended by the Prof. Manal El-Sayed (Professor of Pediatric Medicine, Chair of the Pediatric Department and founder and Director of the Clinical Research Center, Faculty of Medicine, Ain Shams University (MASRI-CRC), Cairo, Egypt), the Prof. Shira Zelber-Sagi (Head and professor at the School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel. Department Gastroenterology, Tel-Aviv Medical Center, Tel-Aviv) and Prof. Ramón Bataller (Chair of the Liver Unit, Hospital Clinic in Barcelona). In addition, the debate was joined by Prof. María Buti (Digestive Service, Vall d’Hebron University Hospital, Barcelona) and Prof. Jeffrey V. Lazarus (Health Systems Research Group, Barcelona Institute For Global Health, ISGlobal). A discussion forum where the change from the «old» Hepatology to the new hepatology was glimpsed, which could well be summed up with these phrases «tweeted» by Dr. Ramón Bataller: Old Hepatology focused on advanced cases and current Hepatology focuses on early detection. Future Hepatology should focus on Prevention. From reactive to predictive, preventive and personalized hepatology.
Authors: Díaz-González Á, Hernández-Guerra M, Pérez-Medrano I, Sapena V, Riveiro-Barciela M, Barreira-Díaz A, Gómez E, Morillas RM, Del Barrio M, Escudé L, Mateos B, Horta D, Gómez J, Conde I, Ferre-Aracil C, El Hajra I, Arencibía A, Zamora J, Fernández A, Salcedo M, Molina E, Soria A, Estévez P, López C, Álvarez-Navascúes C, García-Retortillo M, Crespo J, Londoño MC; ColHai Registry.
Hepatology. 2023 Jan 3. doi: 10.1097/HEP.0000000000000018. Online ahead of print.
Abstract
Background and aims: In patients with non-severe acute or chronic autoimmune hepatitis (AIH) without cirrhosis, clinical practice guidelines recommend indistinct use of prednisone or budesonide. However, budesonide is infrequently used in clinical practice. We aimed to describe its use and compare its efficacy and safety with prednisone as first-line options.
Approach and results: This was a retrospective, multicenter study of 105 naive AIH patients treated with budesonide as the first-line drug. The control group included 276 patients treated with prednisone. Efficacy was assessed using logistic regression and validated using inverse probability of treatment weighting propensity score. The median time to biochemical response (BR) was 3.1 months in patients treated with budesonide and 4.9 months in those with prednisone. The BR rate was significantly higher in patients treated with prednisone (87% vs. 49% of patients with budesonide, p < 0.001). The probability of achieving BR, assessed using the inverse probability of treatment weighting propensity score, was significantly lower in the budesonide group (OR = 0.20; 95% CI: 0.11-0.38) at any time during follow-up, and at 6 (OR = 0.51; 95% CI: 0.29-0.89) and 12 months after starting treatment (0.41; 95% CI: 0.23-0.73). In patients with transaminases <2 × upper limit of normal, BR was similar in both treatment groups. Prednisone treatment was significantly associated with a higher risk of adverse events (24.2% vs. 15.9%, p = 0.047).
Conclusions: In the real-life setting, the use of budesonide as first-line treatment is low, and it is generally prescribed to patients with perceived less disease activity. Budesonide was inferior to prednisone as a first-line drug but was associated with fewer side effects.
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El Servicio de Digestivo del Hospital Universitario Marqués de Valdecilla se enorgullece enormemente de la participación de sus componentes. Os resumimos las diversas actividades, desde ponencia en el Curso de Posgrado, comunicaciones orales, posters y participación en los diversos registros que promociona la Asociación Española para el Estudio del Hígado.
En el área de comunicaciones orales, los Dres. Aitor Odriozola, María del Barrio, Álvaro Díaz, Marta Alonso, expusieron con maestría los trabajos y defendieron con templanza el turno de preguntas.
El Grupo Joven de la AEEH tuvo la oportunidad de entrevistarse con el Prof. Thomas Berg, Secretario General EASL, tras una magnífica sesión plenaria. Y dirigir la sesión con dos comunicaciones orales de investigadores jóvenes y tres exposiciones de beneficiarios de las becas AEEH que describieron su experiencia y vivencias en el desarrollo de las mencionadas becas.