Long-term Treatment Outcomes Research Articles

Results of Diabetic Macular Edema Treatment Dependence on Adherence to Antiangiogenic Therapy in Real Clinical Practice

Relevance. Diabetes mellitus (DM) is a chronic disease that can lead to various complications, one of which is diabetic retinopathy (DR), which can occur in more than 30 % of diabetic patients and diabetic macular edema (DME), the most formidable complication of DR. DME results in loss of central vision and significantly reduces quality of life. There are several treatments for DR including laser retinal photocoagulation, intravitreal injections of antivasoproliferative drugs, dexamethasone implant, and vitreoretinal surgery.The aim of the work is to evaluate long-term real results of diabetic macular edema treatment depending on adherence to anti-VEGF therapy in the ophthalmoendocrinological centre of Chelyabinsk city.Materials and methods. 76 patients with DME (including 23/76 (30.3 %) men, 53/76 (69.7 %) women) aged 64.4 [61.8; 70.0] years. In the total sample of patients, type 1 DM was diagnosed in 13/76 (17.1 %) patients, type 2 DM — in 63/76 (82.9 %) patients; nonproliferative stage of DR occurred in 51/76 (67.1 %), proliferative — in 25/76 (32.9 %) patients.Discussion. There was a significant increase in MCOS and a decrease in retinal thickness after 3 loading injections. Stabilization of morphometric and functional results was observed after the 5th injection.Conclusion. The study shows that the efficacy of aflibercept treatment for DME is achieved with five loading injections and regular therapy. When the drug is not administered regularly, the improving effect is not achieved, which may lead to a negative attitude to treatment and withdrawal from further follow-up.

Perioperative and Long-Term Outcomes of Surgical Treatment for Penetrating Aortic Ulcer in the Aortic Arch: A Retrospective Cohort Analysis

Perioperative and Long-Term Outcomes of Surgical Treatment for Penetrating Aortic Ulcer in the Aortic Arch: A Retrospective Cohort Analysis

Long-Term Outcomes of Conservative Endoscopic Treatment in High-Risk Upper Urinary Tract Urothelial Carcinoma

Long-Term Outcomes of Conservative Endoscopic Treatment in High-Risk Upper Urinary Tract Urothelial Carcinoma

THU-512 Long-term real-world outcomes of obeticholic acid treatment for primary biliary cholangitis: insights from a pharmacy-led single-centre study

THU-512 Long-term real-world outcomes of obeticholic acid treatment for primary biliary cholangitis: insights from a pharmacy-led single-centre study

Nonsurgical vs. Surgical Treatment of Endo-Perio Lesions in Diabetic Patients: A 10-Year Retrospective Cohort Study

ABSTRACT Background: Endo-perio lesions are challenging to manage in diabetic patients due to impaired healing and infection risk. This study compared long-term outcomes of nonsurgical and surgical treatments for these lesions. Methods: We analyzed 187 diabetic patients with endo-perio lesions. 92 received nonsurgical treatment (root canal treatment ± scaling and root planing) and 95 underwent surgery (apicoectomy ± guided tissue regeneration). The primary outcome was tooth retention (Kaplan–Meier analysis). Secondary outcomes included lesion resolution, probing depth reduction, clinical attachment level gain, and patient-reported pain/discomfort. Results: At 10 years, tooth retention was 82% (nonsurgical) and 75% (surgical) (P = 0.32). Both groups improved significantly (P < 0.05), but surgery yielded greater probing depth reduction and clinical attachment gain (P < 0.01). Surgical patients initially reported more discomfort, but pain levels were similar at 6 and 12 months. Conclusions: Both approaches showed comparable long-term tooth retention. Surgical treatment enhanced periodontal healing but caused more initial discomfort.

ВЛИЯНИЕ ПОКРЫТИЯ КОСТНЫМ МОРФОГЕНЕТИЧЕСКИМ БЕЛКОМ 2 ПОВЕРХНОСТИ ДЕНТАЛЬНОГО ИМПЛАНТАТА НА ЕГО ОСТЕОГЕНЕРАЦИЮ

One of the urgent tasks of modern dentistry is to solve the problem of optimal osseointegration of a dental implant – a strong structural and functional connection between the implant surface and bone tissue, which is a crucial factor for ensuring positive long-term results of orthopedic treatment. It is known that implantation prosthetics is associated with a fairly wide range of risks, including the possibility of implant rejection. The modern clinical community has proposed a fairly wide range of approaches to the prevention and treatment of osteogenesis disorders as a predictive measure to achieve optimal, including long-term results of dental implantation: the implementation of antiresorption and osteoanabolic therapy, the local use of growth factors and morphogenetic bone proteins as modifying components. The article is devoted to the study of the effect of coating with bone morphogenetic protein 2 (BMP2) on the surface of a dental implant on its osteogenesis. The authors substantiate the relevance and significance of the research topic. Modern methods of biological (biochemical) modification of the surface of dental implants are considered. A review of the literature and an analysis of the experience gained in international preclinical and clinical practice in the field of BMP2 application as a component of osteoinductive materials is carried out. The data on the effect of the BMP2 coating on the surface of a dental implant, including in combination with other bioactive components, on its osteogenesis are summarized. It is concluded that the use of VMR-2 in dentistry is relevant in order to increase the osteogenic potential of dental implantation in patients at risk with impaired bone metabolism, including mineral metabolism in the jawbones. It is pointed out that further in-depth research is needed to clarify the risk factors (side effects) associated with the use of BMP-2 and to develop optimal delivery systems for its long-term monitoring and accurate release of protein over time.

A retrospective analysis of the long-term results of treatment of mallet finger injuries

A retrospective analysis of the long-term results of treatment of mallet finger injuries

The Predictive Role of Bladder Ultrasound in Children with Nocturnal Enuresis: A Comprehensive Overview.

Background/Objectives: Nocturnal enuresis (NE) is a common condition in children, affecting more than 10% of 6-year-olds and typically characterized by involuntary bedwetting during sleep. Although the exact causes remain unclear, ultrasound has emerged as a valuable tool for assessing bladder function and predicting therapy response and relapse, with several studies linking urological abnormalities like reduced bladder capacity and increased wall thickness to treatment outcomes. Methods: We performed a literature review utilizing five distinct search queries on PubMed with the following keywords: "enuresis & ultrasound", "enuresis & bladder ultrasound", "enuresis & bladder wall", "enuresis & bladder capacity", and "enuresis & bladder thickness". We reviewed each article that met the eligibility criteria, and after a thorough selection, we included 17 studies. Results: Bladder ultrasound is a valuable tool for assessing bladder function and structure in children with NE, providing crucial insights into bladder capacity, wall thickness, and the bladder wall thickness index (BVWI). These ultrasound measurements correlate with the severity of NE and treatment success, aiding in personalized therapy, particularly for children with smaller bladder capacities and thicker bladder walls. Although studies have explored the link between ultrasound findings and treatment response, further research is needed to standardize methods and confirm these connections. Conclusions: The review highlights the predictive role of ultrasound in enuresis management, focusing on the response rate and choice of therapy. Future studies should investigate how bladder imaging can predict both short-term and long-term treatment outcomes, with current evidence supporting its use in customizing NE treatment for improved results.

Long-term Clinical Efficacy of Radiotherapy for Patients with Stage I-II Gastric Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue: A Retrospective Multi-institutional Study.

This study aimed to evaluate long-term treatment outcomes in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma treated with radiotherapy (RT). A total of 229 patients who received RT in 10 tertiary hospitals between 2010 and 2019 were included in this multicenter analysis. Response after RT was based on esophagogastroduodenoscopy after RT. Locoregional relapse-free survival (LRFS) and disease-free survival (DFS), and overall survival (OS) were evaluated. After a median follow-up time of 93.2 months, 5-year LRFS, DFS, and OS rates were 92.8%, 90.4%, and 96.1%, respectively. LRFS, DFS, and OS rates at 10 years were 90.3%, 87.7%, and 92.8%, respectively. Of 229 patients, 228 patients (99.6%) achieved complete remission after RT. Five-year LRFS was significantly lower in patients with stage IIE than in those with stage IE (77.4% vs. 94.2%, p=0.047). Patients with age ≥ 60 had significantly lower LRFS than patients with age < 60 (89.3% vs. 95.1%, p=0.003). In the multivariate analysis, old age (≥ 60 years) was a poor prognostic factor for LRFS (hazard ratio, 3.72; confidence interval, 1.38 to 10.03; p=0.009). Grade 2 or higher gastritis was reported in 69 patients (30.1%). Secondary malignancies including gastric adenocarcinoma, malignant lymphoma, lung cancer, breast cancer, and prostate cancer were observed in 11 patients (4.8%) after RT. Patients treated with RT for localized gastric MALT lymphoma showed favorable 10-year outcomes. Radiation therapy is an effective treatment without an increased risk of secondary cancer. The toxicity for RT to the stomach is not high.

Long-term outcomes of surgical correction of aortic coarctation in newborns: a pilot prospective two-center study

Introduction. Resection of the narrowed aortic segment is the treatment of choice for coarctation of the aorta in newborns, but the issue of recurrent coarctation remains relevant (26% of cases in the long term period). The question of the optimal patch type and the necessity of ductal tissue removal remains open.Aim: To assess the long-term outcomes of surgical treatment of coarctation of the aorta in newborns using patches and native tissue on the aortic arch.Material and Methods. The study included 105 newborns that underwent surgeries from 2017 to 2023 at the Federal Center for Cardiovascular Surgery (Krasnoyarsk) and Meshalkin National Medical Research Center (Novosibirsk). Three methods were used: arch reconstruction with patch plasty also known as “Norwood Type” (“NP group”), resection with patch plasty (“RPP group”), and resection with end-to-end anastomosis (“REtEA group”). The gradient across the aortic arch was assessed echocardiographically at 6, 12 and 60 months (recoarctation criterion: gradient &gt; 20 mm Hg).Results. The peak gradient at the isthmus did not differ at 6 and 12 months. Differences were noted during 60 months: in the “Norwood Type” group 18.0 [18.25; 24.25], in the “RPP” group 15.0 [13.13; 21.25], and in the “REtEA” group 13.5 [8.75; 18.62]. The reoperation risk in the “NT” group was 13.3%, higher than in other groups (3.4% and 0%).Conclusions. Ductal tissue excision and arch enlargement reduce the risk of recoarctation. A residual pressure gradient greater than 23 mm Hg at discharge is a predictor of restenosis.

The transition between M1 and M2 macrophage phenotypes is associated with the disease status following CD19 CAR-T therapy for B cell lymphoma/leukemia

Although anti-CD19 chimeric antigen receptor (CAR-T) cells demonstrate high response rates in relapsed/refractory B-cell lymphomas, a considerable proportion of patients eventually encounter disease progression or relapse. The short-term and long-term outcomes of CAR-T treatment are intricately linked to the tumor microenvironment (TME), wherein macrophages with polarized characteristics can exhibit either anti-tumorigenic or pro-tumorigenic roles. Despite evidence implicating the crucial involvement of macrophages in CAR-T cell-treated lymphoma, their dynamic distribution and immune function related to lymphoma progression remain poorly understood. Immunocompetent mice were utilized to establish syngeneic A20 lymphoma/leukemia models. The distribution and polarization of macrophages were detected using immunohistochemistry (IHC) and flow cytometry techniques. We observed that CD19 CAR-T therapy exhibited significant efficacy in protecting mice against lymphoma, leading to increased infiltration of macrophages into the tumor tissue. Notably, during remission stages, M1-like macrophages (CD11b+F4/80+C206−CD80+) were predominant, whereas in relapsed mice, there was a shift towards M2-like phenotypes (CD11b+F4/80+C206+CD80+). The transition from remissive to relapsed status was accompanied by a reduction in the M1/M2 ratio and a decrease in pro-inflammatory cytokines. Furthermore, quantitative real-time polymerase chain reaction (qRT-PCR) analysis confirmed differential expression levels of CD206 and CD163 between remissive and relapsed mice, while signaling pathways involving PI3K and STAT3 may contribute to the skewing towards M2 polarization. In summary, our findings highlight the dynamic transformation of macrophage polarization during different stages of lymphoma progression and underscore its potential implications for immunotherapeutic interventions.

Knowledge of Traumatic Dental Injuries Among Dentists and Dentistry Students in Bosnia and Herzegovina.

Traumatic dental injuries (TDI) are among the most common public health issues in dentistry. The dentist's role in the immediate treatment of traumatic injuries is crucial, as it impacts the long-term outcome of treatment and the patient's quality of life. Dentists should have good knowledge of dentoalveolar trauma to be ready to act promptly in emergencies and to be able to provide appropriate guidance and advice to eyewitnesses or injured individuals at the scene of an accident. This study aimed to assess the level of knowledge regarding TDI among dental students and dentists. Participants included fourth- and sixth-year dental students, dentists, oral surgery residents and specialists, with a response rate of 61.99% from 1059 participants. Data collection involved face-to-face and email methods. Quantitative data analysis utilised Student's t-test and ANOVA, while categorical data was analysed using Pearson chi-square test, with RStudio and Excel for data analysis. Dental students had a mean score of 15.0 ± 4.7, indicating the highest theoretical knowledge of TDI compared to other examined groups. However, 83.5% reported never experiencing TDI. Oral surgical residents scored lowest at 7.8 ± 2.3. Interestingly, dentists with less than 5 years of experience outperformed those with 5-10 years of practice. Most participants (92.4%) prioritised direct tooth replacement, but only 67.7% identified proper tooth-preserving media, and just 38.0% understood the ideal splint for avulsed teeth. While dental students demonstrated a strong understanding of TDI management, there are areas needing further education, especially among oral surgical residents. Since TDI knowledge tends to decline throughout the years of practice, continuous education on TDI for dental practitioners is essential.

Long-term results of treatment of varicose veins of the lower extremities

Objective. To improve the results of standard treatment of varicose veins of the lower extremities, to evaluate the effectiveness of sclerosurgical and surgical interventions in the long-term postoperative period. Materials and methods. The results of the examination and treatment of 228 patients with varicose veins of the lower extremities in the surgical clinic of the Transcarpathian Regional Clinical Hospital named after Andriy Novak from 2012 to 2015 were analyzed. The study included patients with varicose veins of classes C2-C6 according to the CEAP classification, in whom sclerotherapy was used as surgical treatment - 153 (67.1%) patients (group 1) or classical phlebectomy - 75 (32.9%) patients (group 2). Results. On the basis of duplex angioscopy of the operated limbs (189 in group 1 and 96 in group 2), technical and tactical errors of surgical intervention were revealed: pathologic stump of the great saphenous vein with varicose transformation of the near-octopus tributaries in 8 (4.2%) limbs in group 1 and 6 (6.3%) limbs in group 2; "additional" mistakenly left trunk of the great saphenous vein - in 5 (2.6%) and 11 (11.5%) limbs, respectively; varicose transformation of the anterior accessory vein of the thigh on 42 (22.2%) and 25 (26.0%) limbs, respectively; partial and complete recanalization of the trunk of the great saphenous vein on 54 (28.6%) and 30 (15.9%) limbs, respectively, in group 1; "lateral" varicose veins on 5 (2.6%) limbs in group 1 and 18 (18.8%) limbs in group 2. Partial and complete recanalization of the trunk of the great saphenous vein, in our opinion, was associated with poor compression after sclerotherapy and a failed femoral vein on 18 (9.5%) limbs. Conclusions. A comparative analysis of the dynamics of varicose veins and the results of treatment of patients in the long-term postoperative period confirmed the higher effectiveness of phlebectomy, after which good results were recorded statistically significantly (p&lt;0.05) more often than after surgery. The total frequency of good and satisfactory (positive) treatment results demonstrated comparable efficacy of phlebectomy and scleroscopic intervention - 85.4 and 89.9%, respectively.

Long-term outcomes and the association between early detection of retinal pigment epithelial atrophy and remission after loading dose in eyes with retinal angiomatous proliferation.

To investigate the association between early detection of retinal pigment epithelial (RPE) atrophy after anti-vascular endothelial growth factor (VEGF) treatment and the long-term treatment outcomes in eyes with retinal angiomatous proliferation (RAP). A retrospective observational study METHODS: All patients with treatment-naive RAP initially received three monthly anti-VEGF administration with or without photodynamic therapy (PDT), followed by as-needed anti-VEGF administration. At 12 months post-injection, they were divided into two groups depending on the presence or absence of RPE atrophy. The visual and anatomic outcomes, and the incidence of 12-month remission were investigated within a 48-month follow-up. Thirty-seven eyes of 37 patients were included. The mean age was 80.4 ± 7.0 years, 54% were women. In the atrophy (+) group, 58.3% of patients achieved 12-month remission, significantly higher than the atrophy (-) group (p = 0.04). During the study period, best corrected visual acuity in the atrophy (+) group deteriorated from 0.50 ± 0.43 logMAR to 0.66 ± 0.47 logMAR (p = 0.14), while in the atrophy (-) group, it deteriorated significantly from 0.48 ± 0.27 logMAR to 0.76 ± 0.42 logMAR (p = 6.7×10-3). The mean additional injections in the atrophy (+) group were significantly smaller compared with the atrophy (-) group at 3.5 ± 4.7 versus 15.3 ± 4.3, respectively (p = 9.0×10-6). Early detection of RPE atrophy was associated with the incidence of 12-month remission and reduced number of additional injections. The formation of RPE atrophy might suggest a decrease in the disease activity of RAP.

Response to cabergoline treatment, gonadal axis recovery, and outcomes of drug withdrawal, in men with microprolactinoma: a retrospective cohort study.

Due to the low incidence of male microprolactinoma, there is a paucity of data in the literature regarding its management. Our aim was to investigate the long-term outcomes of cabergoline treatment in men with microprolactinoma. In this single-center retrospective cohort study, we reviewed patient's records at prolactinoma diagnosis, following cabergoline discontinuation (if occurred), and at the last clinic visit. We collected all available clinical data, laboratory tests, and pituitary magnetic resonance imaging. We report response rates, gonadal axis recovery, and outcomes following cabergoline discontinuation. The study cohort included 47 men with microprolactinoma [age at diagnosis 45.6 ± 17.6 years; median prolactin 70.0 ng/ml (IQR 51.0-103.4); low testosterone, 34 men (72.3%); adenoma diameter 5.6 ± 2.0 mm; median follow-up 7.1 years (IQR 3.5-10.4)]. Forty-two patients (89.4%) achieved normal prolactin levels within a median treatment time of 4.0 months (IQR 3.0-5.5) and had normal testosterone at last clinic visit. Five men (10.6%) did not achieve prolactin normalization, of whom 3 men remained hypogonadal. Mild side effects occurred in 4.3% of patients and disappeared with dose reduction. Thirteen men that achieved normal prolactin attempted drug discontinuation, but only 5 remained with normoprolactinemia. Men who maintained normal prolactin levels were treated longer with cabergoline [median treatment of 10 years (IQR 4.6-10.3) vs 2.0 years (IQR 1.5-3.2); p < 0.01]. Ninety percent of men harboring microprolactinoma achieved normoprolactinemia and subsequent testosterone normalization with cabergoline treatment. Men that discontinued cabergoline after prolonged prolactin suppression (>5 years) achieved sustained remission. These findings assist informed decision-making, between medical and surgical treatment.

Endovascular aortic repair in a patient with secondary aortoenteric fistula and critical lower limb ischemia

The authors present successful treatment of a patient with aortoenteric fistula and chronic critical lower limb ischemia after previous aortobifemoral bypass grafting (ABF). Examination revealed intimate contact of inferior duodenal wall near proximal anastomosis and thrombosis of the right branch. The patient underwent hybrid surgery, i.e. unilateral endovascular repair and crossover replacement. Despite severe status upon admission and concomitant diseases, postoperative period was uneventful. The authors reviewed literature data regarding pathogenesis and diagnosis of secondary aortoenteric fistulas, immediate and long-term results of open and endovascular treatment, advantages and limitations of various surgical tactics and materials.

Long-term results of surgical treatment of femoral neck fractures using dynamic derotational osteosynthesis

BACKGROUND: Femoral neck fractures are among the most common injuries of the human skeleton. If in 2004 in Russia the incidence of fractures of the proximal femur in patients over 50 years of age was 105.9 per 100,000 of the population (and in women this figure was almost twice as high as in men), it is expected that by 2025 the number of victims worldwide will have doubled, and by 2050 it will be almost 4.5 million. Existing osteosynthesis techniques do not take into account the peculiarities of the uneven distribution of bone density in the femoral head, which can lead to the placement of fixators in a deliberately weakened area, reduced strength of osteosynthesis, migration of fixators and, as a result, non-union of the fracture. AIM: To compare the long-term results of dynamic derotation osteosynthesis with the results of femoral neck fracture osteosynthesis with cannulated screws, dynamic hip screws, and V-wires. MATERIALS AND METHODS: The study was based on the analysis of the results of surgical treatment of 259 patients with femoral neck fractures. In the treatment of 114 (44%) patients (study group), the titanium dynamic derotational fixator Targon FN manufactured by Aesculap B. Braun (Germany) was used. The comparison group included 145 (56%) patients who underwent osteosynthesis using a dynamic femoral screw (40 patients), tensioned V-wires (60 patients) or 3 AO screws (40 patients). There were no significant differences in the distribution of patients by age in the groups considered, which was confirmed by pairwise tests using Holm's multiple comparison correction method. RESULTS: In Garden III femoral neck fractures, 59.6% of the study group achieved consolidation compared to 34.5% with dynamic hip screw implantation, 22.7% with V-wires and 28.0% with cannulated screws. In Garden IV fractures, consolidation did not occur in any of the observations. The incidence of avascular necrosis of the femoral head is highest in Garden III fractures: 39.2% with dynamic femoral screw implantation, 30.1% with V-wires, 34.2% with cannulated screws and 21.8% with dynamic derotational osteosynthesis. When evaluating the long-term results in patients with consolidated fractures, claudication of the operated limb was observed (in Garden III type fractures in 64% of cases — when using a dynamic derotational fixator, 65% — when using a derotational femoral screw, 100% - when using cannulated screws and V-wires). The maximum femoral neck offset shortening of more than 15% was observed in 7 patients (39%) with dynamic derotational osteosynthesis, in 6 patients (67%) with dynamic femoral screw implantation, in 5 patients (60%) with cannulated screws and in 8 patients (80%) with V-wires. CONCLUSION: Garden I fractures of the femoral neck do not lead to avascular necrosis of the femoral head. As the angle of the fracture plane increases and the blood supply to the femoral head decreases, the incidence of avascular necrosis increases. The development of claudication in the patients was caused by the reduction in femoral offset length due to osteolysis, which occurred as a result of both the localisation of the fracture plane (fracture factor) and the dynamic function of the implant (fixator factor). Lameness was therefore considered to be the 'payback' for the consolidation of the fracture.

Advancing patient evidence in XLH (APEX): rationale and design of a real-world XLH global data unification program.

X-linked hypophosphatemia (XLH) is a rare, genetic, progressive, lifelong disorder caused by pathogenic variants in the phosphate-regulating endopeptidase homolog, X-linked (PHEX) gene, resulting in excess fibroblast growth factor 23 (FGF23) and consequent renal phosphate wasting. Chronic hypophosphatemia leads to deficits of the musculoskeletal system affecting bone, muscle, joint, and dental health. XLH treatments include oral phosphate and active vitamin D-which are associated with a burdensome dosing regimen, gastrointestinal disturbances, hyperparathyroidism, and nephrocalcinosis-or burosumab, a fully human anti-FGF23 antibody. Randomized clinical trials (RCTs) demonstrated burosumab to be well tolerated and efficacious in improving serum phosphate, rickets, bone turnover, and patient-reported outcomes. However, there are limited data on the natural history of XLH or real-world comparisons of the safety, effectiveness, and long-term outcomes of XLH treatments. Advancing Patient Evidence in XLH (APEX) is a global data unification project aiming to describe the burden and lifelong progression of XLH, collect real-world data on treatment effectiveness and safety, and investigate regional differences in treatment outcomes. Participants from three observational, noninterventional, retrospective and prospective, multicenter, longitudinal (10-year) studies of patients with XLH will be included: XLH Disease Monitoring Program (NCT03651505), International XLH Registry (NCT03193476), and SUNFLOWER (NCT03745521). Data collected in the Americas, Europe, Israel, Japan, and South Korea will be processed to unify identical and similar data elements. Data unification will be an iterative process with a clinical and programming review, ensuring validity and accuracy. In this observational study, unified data involving approximately 2000 pediatric and adult participants with XLH will be analyzed to address research questions in an exploratory manner. Long-term observational studies and patient registries provide opportunities to generate real-world data and address knowledge gaps in rare diseases. APEX aims to improve clinical decision-making and practice by bridging evidence gaps that cannot be addressed by RCTs or regional registries.

Long-Term Outcomes of Angioplasty and Stent Placement for Portomesenteric Vein Obstruction Following Hepatobiliary and Pancreatic Surgery.

Long-Term Outcomes of Angioplasty and Stent Placement for Portomesenteric Vein Obstruction Following Hepatobiliary and Pancreatic Surgery.

Novel outcomes in inflammatory bowel disease.

Inflammatory bowel diseases (IBD), Crohn's disease (CD), and ulcerative colitis (UC) are lifelong chronic, relapsing, and remitting conditions that culminate in disease progression in many patients. Effective management of CD and UC requires consideration of both short- and long-term treatment outcomes. Historically, short-term outcomes such as clinical and endoscopic remission and symptom relief have been evaluated in clinical trials. With the expansion of treatments targeting underlying disease pathophysiology, there is the opportunity to develop management strategies that improve disease control and patients' lives in both the short and the long term. Researchers have been examining novel outcomes for assessing the efficacy of CD and UC treatments that are important to patients, and also those that go beyond symptomatic improvements or clinical remission. These include new patient-reported outcomes for symptoms, as well as transmural/histological healing and disease clearance that can be more reflective of deeper remission states and disease modification. This review analyses published clinical studies involving patients with UC and CD treated with biologics or small molecule therapies. It highlights novel IBD endpoints employed in published clinical trials and discusses their likely value for assessing disease activity and disease modification, and as predictors of reduced risk of complications and morbidities.