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Gastroenterology by Recog- Nopathy and Vascular Architecture Is Maintained mdedge.com/gihepnews September 2019 Volume 13 / Number 9 Test could inform INSIDE FROM THE AGA JOURNALS care of patients with Inflammation in NAFLD pancreatic cysts It reduces quality of life, not fibrosis. • 12 BY JENNIFER SMITH those who need no addi- MDedge News tional care. AGA PRESIDENTIAL . Simeon Springer, PhD, PLENARY EIRING newly developed of Ring Therapeutics in M test could help Cambridge, Mass., and GI’s stars present clinicians more colleagues described the essential information UZANNE S A . Get the details. • 22 R accurately identify which development and testing D patients with pancreatic of CompCyst in Science cysts require surgery, ac- Translational Medicine. AGA POSTGRADUATE OURTESY C cording to researchers. The researchers collect- Dr. Annieke C.G. van Baar found that endoscopic duodenal mucosal The test, CompCyst, ed data from 875 patients COURSE SUMMARIES resection improved glycemia in patients with type 2 diabetes. incorporates clinical and who had undergone Moderators imaging data as well surgical resection of pan- summarize DDW® as data on genetic and creatic cysts. The team sessions Endoscopic duodenal biochemical markers as- used clinical, imaging, Read news from GI’s sociated with pancreatic and molecular data from subspecialties. • 27 cancer. 436 of those patients to mucosal resection CompCyst proved more train CompCyst to clas- effective than standard sify patients into three AGA GUIDELINE practice in estimating categories. Diagnosis of watery found effective in T2D the risk of cancer so as • Patients with benign, diarrhea to differentiate patients nonmucin-producing It’s important to rule out BY DOUG BRUNK crease in liver transaminase who should undergo sur- cysts who do not require things first. • 28 MDedge News levels at 24 weeks, which gery from patients who surgery or monitoring was sustained at 12 months require monitoring and See Cysts · page 31 mong patients with post procedure,” researchers suboptimally con- led by Annieke C.G. van Baar, Atrolled type 2 diabetes MD, wrote in a study pub- Vitamin D supplementation may who use oral glucose-lower- lished online in Gut. ing medication, endoscopic For the study, Dr. van Baar, improve ulcerative colitis duodenal mucosal resection of the department of gastro- (DMR) can be implemented enterology and hepatology at BY WILL PASS bo-controlled trial involv- MD, of the Postgraduate In- safely and effectively, results Amsterdam University Med- MDedge News ing 60 patients with active stitute of Medical Education from a multicenter, interna- ical Center, and colleagues at disease. and Research in Chandi- tional, phase 2 study demon- seven clinical sites enrolled itamin D supplemen- Those who achieved vi- garh, India, and colleagues. strated. 46 patients with type 2 di- tation may lead to tamin D levels greater than They noted that the find- “DMR elicited a substantial abetes who were on stable Vsignificant improve- 40 ng/mL were most likely ings contribute much-need- improvement in parameters glucose-lowering medication ments in ulcerative colitis to benefit, reported lead ed clinical data to a largely of glycemia as well as a de- See Resection · page 20 (UC), based on a place- author Rizwan Ahamed Z, See Vitamin D · page 32 DETECT EARLY. TREAT EARLY. IN MORE WAYS THAN EVER. Lift GI lesions Assess esophageal health Visualize colon polyps Eleview®* submucosal Cytosponge™* cell collection kit PillCam™ COLON 2 system injectable composition Rosemont, IL 60018 IL Rosemont, Lebanon Jct. KY Jct. Lebanon Suite 280 Suite Permit No. 384 No. Permit US190815c © 2019 Medtronic. All rights reserved. Medtronic, Medtronic logo and Further, Together are ® PAID trademarks of Medtronic. * and ™* Third party brands are trademarks of their respective owners. All other 10255 W Higgins Road, Road, Higgins W 10255 U.S. Postage U.S. brands are trademarks of a Medtronic company. *These images do not represent all components of the system. Presorted Standard Presorted CHANGE SERVICE REQUESTED SERVICE CHANGE GI & Hepatology News Hepatology & GI This advertisement is not available for the digital edition. hNEWS LETTER FROM THE EDITOR: The month of new beginnings is here This month’s Letter from the Editor is guest Our September issue also emphasizes authored by Dr. Megan A. Adams the importance of professional advocacy by Quick quiz chronicling the participation of four AGA lead- eptember is a month of new beginnings, ers (Dr. Carr, Dr. Kaufman, Dr. Ketwaroo, and Q1. A 43-year-old woman presents to the office as summer transitions to fall, kids go Dr. Mathews) in the 2019 Alliance of Specialty after Roux-en-Y surgery for weight loss. She has a Sback to school, and we return to more Medicine Fly In, a multisociety effort to lobby strong family history of gallstones, and asks about consistent work routines, refreshed and re- legislators on key issues such as reducing measures to prevent gallstone formation after her invigorated after some well-deserved surgery. time off with family and friends. A large study by Dr. Paul Among our cover stories this month is Moayyedi and colleagues Which of the following agents has potential efficacy a study showing a novel application of to reduce gallstone formation for this patient? deep learning to inform clinical care of demonstrates that PPI therapy A. Conjugated estrogens patients with pancreatic cysts. We also may be unnecessary in the B. Ursodeoxycholic acid feature several high-impact studies C. Fenofibrate from AGA’s journals, including a large majority of patients on oral D. Simvastatin randomized controlled trial by Dr. Paul anticoagulants, despite current E. Cholestyramine Moayyedi and colleagues, demonstrat- ing that PPI therapy may be unneces- Dr. Adams guideline recommendations. Q2. A 56-year-old male with known chronic pan- sary in the majority of patients on oral creatitis presents with progressive abdominal pain, anticoagulants, despite current guideline rec- prior authorization burdens and minimizing weight loss, and obstructive jaundice and a bilirubin ommendations. This study has the potential to the strict constraints of step-therapy proto- of 8 mg/dL. A CT scan with contrast reveals a 4-cm substantially change clinical practice, partic- cols. We also are pleased to acknowledge the mass in the pancreas head. There is no lymphade- ularly in the context of the current discussion future leaders of gastroenterology by recog- nopathy and vascular architecture is maintained. regarding PPI benefits and harms, and our nizing the 17 exceptional fellows who demon- transition to value-based care. We also high- strated their passion for advancing GI clinical What is the next best step in management? light a proof-of-concept study demonstrating care by presenting their institutional quality A. Pancreaticoduodenectomy (Whipple procedure) a potential role for probiotics (specifically Bi- improvement projects at a special session at B. Lateral pancreaticojejunostomy procedure (Peus- fidobacteria) in reducing the risk of NSAID-re- DDW® 2019. We hope you find these stories tow) procedure lated gastrointestinal bleeding, and another to be thought provoking, inspiring, and direct- C. EUS +/- FNA study showing a possible role for clopidogrel ly relevant to your clinical practice – thank D. MRI/MRCP in chemoprevention of colorectal cancer. Both you for reading! E. ERCP with bile duct brushing and stent articles are accompanied by expert commen- taries highlighting their potential effect on Megan A. Adams, MD, JD, MSc The answers are on page 20. clinical practice. Associate Editor mdedge.com/gihepnews EDITOR IN CHIEF, GI & HEPATOLOGY NEWS GI & HEPATOLOGY NEWS is the official newspaper of the American FRONTLINE MEDICAL COMMUNICATIONS SOCIETY PARTNERS John I. Allen, MD, MBA, AGAF Gastroenterological Association (AGA) Institute and provides the gastroenterologist VP/Group Publisher; Director, FMC Society Partners Mark Branca EDITOR IN CHIEF, THE NEW GASTROENTEROLOGIST with timely and relevant news and commentary about clinical developments Editor in Chief Mary Jo M. Dales Bryson Katona, MD, PhD and about the impact of health care policy. Content for GI & HEPATOLOGY NEWS is developed through a partnership of the newspaper’s medical board of editors Executive Editors Denise Fulton, Kathy Scarbeck ASSOCIATE EDITORS Megan A. Adams, MD, JD, MSc (Editor in Chief and Associate Editors), Frontline Medical Communications Inc. Editor Lora T. McGlade Ziad Gellad, MD, MPH, AGAF and the AGA Institute Staff. “News from the AGA” is provided exclusively by the Creative Director Louise A. Koenig AGA, AGA Institute, and AGA Research Foundation. All content is reviewed by the Kim L. Isaacs, MD, PhD, AGAF Director, Production/Manufacturing Rebecca Slebodnik Gyanprakash A. Ketwaroo, MD, MSc medical board of editors for accuracy, timeliness, and pertinence. To add clarity and context to important developments in the field, select content is reviewed by and National Account Manager Artie Krivopal, 973-290-8218, Larry R. Kosinski, MD, MBA, AGAF cell 973-202-5402, [email protected] Sonia S. Kupfer, MD commented on by external experts selected by the board of editors. Digital Account Manager Rey Valdivia, 973-206-8094, [email protected] Wajahat Mehal, MD, PhD The ideas and opinions expressed in GI & HEPATOLOGY NEWS do not necessarily Senior Director of Classified Sales Tim LaPella, 484-921-5001, reflect those of the AGA Institute or the Publisher. The AGA Institute and Frontline EDITORS EMERITUS [email protected] Colin W. Howden, MD, AGAF Medical Communications Inc.
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