Latest news with #ClinicalGastroenterologyandHepatology
Medscape
6 days ago
- Business
- Medscape
Intestinal Ultrasound Wins in Early Crohn's Prognosis
Findings on intestinal ultrasound (IUS) are useful for predicting remission in recent-onset Crohn's disease (CD), a prospective, population-based cohort of newly diagnosed patients in Denmark reported. Adding to the growing body of evidence on the utility of this noninvasive imaging tool in monitoring disease activity in the newly diagnosed, the multicenter study published in Clinical Gastroenterology and Hepatology characterized ultrasonographic features at diagnosis and evaluated IUS's prognostic value. Existing literature has focused on patients with long-standing disease. Investigators led by first author Gorm R. Madsen, MD, PhD, of the Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults at Copenhagen University Hospital, observed continued improvement in most IUS parameters throughout the first year. 'Our findings thereby emphasize the role of IUS in improving patient management, and its use in patient risk stratification already at diagnosis,' the investigators wrote. Some 38% of patients reached ultrasonic transmural remission within 3 months of diagnosis, an achievement associated with higher rates of sustained steroid-free clinical remission and reduced need for treatment escalation. 'Ultrasonic transmural remission is achievable early in Crohn's disease and is associated with favorable outcomes, underscoring the value of intestinal ultrasound in early disease management,' the researchers wrote. Study Details While IUS is increasingly recognized for monitoring CD, little was known about its prognostic value early in the disease course. 'We aimed to determine whether sonographic inflammation at diagnosis — and particularly the achievement pftransmural remission after 3 months — could predict future outcomes,' Madsen told Medscape Medical News . 'This is important, as early identification of patients at risk of surgery or treatment escalation may help guide therapy decisions more effectively.' From May 2021 to April 2023, 201 patients (mean age, 35 years; 54.2% men) with new adult-onset CD were followed by IUS and monitored with symptomatic, biochemical, and endoscopic evaluations. After 3 months, transmural remission was achieved more often by patients with colonic disease, and no associations were found between sonographic inflammation at diagnosis and diagnostic delay. 'We were positively surprised. Nearly 40% of newly diagnosed Crohn's patients achieved transmural remission within 3 months — a higher proportion than seen in earlier studies, which mostly focused on long-standing or trial-selected populations,' Madsen said. 'It was also striking how strongly early IUS findings predicted the need for surgery, outperforming endoscopy and biomarkers.' In other findings, transmural remission at 3 months was significantly associated with steroid-free clinical remission at both 3 months and all subsequent follow-ups within the first year. It was also linked to a lower risk for treatment escalation during the follow-up through to 12 months: 26% vs 53% ( P =.003). At 12 months, 41% had achieved transmural remission. Higher baseline body mass index significantly reduced the likelihood of 12-month transmural remission. For overweight, the odds ratio (OR) was 0.34 (95% CI, 0.12-0.94), while for obesity, the OR was 0.16 (95% CI, 0.04-0.73). The International Bowel Ultrasound Segmental Activity Score in the terminal ileum at diagnosis emerged as the best predictor of ileocecal resection during the first year, with an optimal threshold of 63 (area under the curve, 0.92; sensitivity, 100%; specificity, 73%). The use of IUS has expanded considerably in the past 3 years, and in 2024, the American Gastroenterological Association updated its clinical practice guidance on the role of this modality in inflammatory bowel disease. IUS is noninvasive, radiation-free, inexpensive, and doable at the bedside with immediate results, Madsen said. 'For patients, this means less anxiety and discomfort. For healthcare systems, it enables faster clinical decisions, reduced need for endoscopy or MRI, and closer disease monitoring, particularly valuable in treat-to-target strategies.' In terms of limitations, however, IUS is operator-dependent and consistent training is crucial, he added. 'Certain anatomical regions, particularly the proximal small bowel, can be more challenging to evaluate. Additionally, while IUS is highly effective for assessing inflammatory activity, it becomes more difficult to accurately assess disease involvement when inflammation extends beyond approximately 20 cm of the small bowel.' Key Insights Commenting on the Danish study from a US perspective, Anna L. Silverman, MD, a gastroenterology fellow at Icahn School of Medicine at Mount Sinai in New York City, agreed the findings in adult patients with newly diagnosed, rather than long-standing, CD contribute to the growing body of evidence supporting IUS's applicability for both treatment monitoring and prognosis. 'By focusing on early-stage CD, the study provides clearer insights into initial disease activity and response to therapy, reinforcing the value of this noninvasive, point-of-care modality,' she told Medscape Medical News . 'These findings enhance our understanding of IUS as a tool to help guide early management decisions in CD.' Ashwin Ananthakrishnan, MBBS, MPH, director of the Crohn's and Colitis Center at Massachusetts General Hospital and an associate professor at Harvard Medical School, both in Boston, concurred that this is an important study. 'It includes newly diagnosed patients — so a very 'clean' cohort in terms of not being influenced by confounders,' he told Medscape Medical News . 'We don't fully know yet the best treatment target in CD, and this study highlights the importance of early transmural healing in determining outcomes at 1 year,' he noted. In addition, the study highlighted a convenient tool that can increasingly be applied at point of care in the United States. 'Colonoscopy at 3 months is not practical and has low patient acceptability, so using IUS in this circumstance would have value and impact.' Ananthakrishnan pointed to several unanswered questions, however. 'Are there patients who may not have healing early but may take some extra time to achieve transmural remission, and if so, what are their outcomes? What is the best timepoint for transmural healing assessment? What is the incremental value of measuring it at 3 vs 6 months?' In addition, he wondered, how much is the added value of IUS over clinical symptoms and/or markers such as calprotectin and C-reactive protein? 'In the subset of patients with clinical and transmural remission, there was no difference in endoscopic outcomes at 1 year, so this is an unanswered question,' Ananthakrishnan said. This study was funded by an unrestricted grant from the Novo Nordisk Foundation.
Medscape
02-06-2025
- Business
- Medscape
EoE Prevalence in US Reaches 1 in 700, Costs $1B Annually
The prevalence of eosinophilic esophagitis (EoE) has increased fivefold in the United States since 2009, now affecting about 1 in 700 people and totaling $1.32 billion in annual healthcare costs, according to recent research. Although EoE has been considered a rare disease, the chronic condition is becoming more common, and healthcare providers should expect to encounter EoE in clinical settings, the study authors wrote. 'Our last assessment of the prevalence and burden of EoE was more than 10 years ago, and we had a strong suspicion we would continue to see increased numbers of patients with EoE and an increasing cost burden related to the condition in the United States,' said senior author Evan S. Dellon, MD, MPH, professor of gastroenterology and hepatology and director of the Center for Esophageal Diseases and Swallowing at the University of North Carolina School of Medicine, Chapel Hill, North Carolina. 'EoE is becoming more common,' Dellon said. 'Healthcare providers should expect to see EoE in their practices, including in the primary care setting, emergency departments, allergy practices, GI [gastrointestinal] practices, ENT [ear, nose, and throat] clinics, and endoscopy suites.' The study was published in Clinical Gastroenterology and Hepatology . Estimating EoE Prevalence Dellon and colleagues analyzed the Merative MarketScan Commercial Claims and Encounters and Medicare Fee-for-Service databases to calculate the annual prevalence of EoE, as well as age- and sex-stratified estimates standardized to the US population. They also calculated healthcare utilization, including medications and endoscopic procedures, to estimate annual EoE-associated costs. Since the EoE billing code was introduced in 2008, the analysis included 2009-2022 MarketScan and 2009-2017 Medicare data. In the MarketScan database, the research team identified 20,435 EoE cases in 2022, with a mean age of 38 years, 16% younger than 18 years, 62% men, and 41% with a comorbid allergic disease code. The most common symptoms and diagnoses were dysphagia (39%), abdominal pain or dyspepsia (24%), and esophageal stricture (19%). Over time, patients also had previous codes for comorbid allergic diseases (64%), dysphagia (62%), or esophageal stricture (32%). In the Medicare database, the research team identified 1913 EoE cases in 2017, with a mean age of 73 years, 47% men, 90% non-Hispanic White, and 36% with a comorbid allergic disease. The most common symptoms and diagnoses were dysphagia (49%), abdominal pain or dyspepsia (35%), and esophageal stricture (30%). Over time, patients also had codes for comorbid allergic diseases (64%), dysphagia (65%), or esophageal stricture (42%). The database numbers translated to EoE prevalences of about 163 cases per 100,000 people in MarketScan in 2022 and 64 cases per 100,000 people in Medicare in 2017. Since 2009, there has been a fivefold increase in prevalence in both databases. In MarketScan, the prevalence was higher among men than among women, at 204 vs 122 cases per 100,000 people. For both sexes, peak prevalence occurred between ages 40 and 44. In Medicare, prevalence was also higher among men than among women, at 79 vs 55 cases per 100,000 people. Peak prevalence occurred between ages 65 and 69. Standardized to the US population, EoE prevalence was 142.5 cases per 100,000 people, extrapolating to 472,380 cases. The overall prevalence was approximately 1 in 700, with rates of 1 in 617 for those younger than 65 years and 1 in 1562 for those aged ≥ 65 years. 'The rapidly increasing prevalence year over year for the entire timeframe of the study was surprising, as were our estimates of the total number of EoE patients in the US, which suggests that EoE is no longer a rare disease and is now seen in about 1 in 700 people,' Dellon said. 'This almost triples our prior estimates of 1 in 2000 from 10 years ago, with all trends suggesting that the prevalence will continue to increase.' Calculating EoE Costs In terms of procedures, endoscopy with dilation or biopsy was used in about 60%-70% of patients with EoE in both MarketScan and Medicare during the years analyzed. In addition, upper endoscopy with biopsy was coded in 80%-90% of patients, guidewire-based dilation in 11%-17% of patients, and balloon-based dilation in 13%-20% of patients. In terms of prescription medications, proton pump inhibitors (41%) and topical steroids (26%) were the most common in MarketScan in 2022, as well as in Medicare in 2017, at 32% and 9%, respectively. When looking at costs by age and sex, the male cohort with the highest costs was aged 10-14 years, estimated at $106.7 million. Among the female cohort, the highest costs were associated with ages 15-19, estimated at $46.5 million. Overall, total EoE-associated healthcare costs were estimated to be $1.04 billion in 2017, and when adjusted for inflation, the costs were estimated at $1.32 billion in 2024. This is likely an underestimate, the authors wrote, given that EoE prevalence has likely increased for ages 65 or older since 2017 and for all ages since 2022. 'Researching the prevalence and costs is essential to improving patient care by highlighting the growing burden of this recently recognized and growing chronic disease, guiding policy and insurer decisions, and advocating for better access to effective treatments and support for patients,' said Joy Chang, MD, assistant professor of medicine in the Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan. Chang, who wasn't involved with this study, specializes in eosinophilic GI diseases and researches patient-physician preferences and decision-making in EoE care. 'Clinicians should remain vigilant for symptoms, utilize guideline-based diagnostic approaches, and consider both medical and dietary treatment strategies to optimize patient outcomes and reduce long-term costs,' she said. 'Increased awareness and timely intervention can help mitigate the growing impact of this chronic condition.' The study was supported by a National Institutes of Health grant and used resources from the University of North Carolina Center for Gastrointestinal Biology and Disease. Dellon reported receiving research funding from and having consultant roles with numerous pharmaceutical companies and organizations. Chang reported having no relevant disclosures.
Yahoo
29-01-2025
- Business
- Yahoo
Endoscopic Retrograde Cholangiopancreatography (ERCP) Market Analysis, 2025-2030 - Gallstone Prevalence Expected to Surge, Boosting ERCP Adoption
Endoscopic Retrograde Cholangiopancreatography Market Dublin, Jan. 29, 2025 (GLOBE NEWSWIRE) -- The "Endoscopic Retrograde Cholangiopancreatography Market Size, Share & Trends Analysis by Product, Procedure Type, End-use, and Region, 2025-2030" report has been added to global endoscopic retrograde cholangiopancreatography market size was estimated at USD 2.17 billion in 2024 and is anticipated to grow at a CAGR of 8.26% from 2025 to 2030. The growth of the endoscopic retrograde cholangiopancreatography (ERCP) market is primarily driven by the rising incidence of pancreatic and biliary diseases, such as gallstones, pancreatitis, and bile duct obstructions. As the population ages and lifestyles change, these conditions are becoming more prevalent, increasing the demand for ERCP procedures. A study published in Clinical Gastroenterology and Hepatology in February 2024 estimates a global gallstone prevalence of 6%, with higher rates in females and in South America. The incidence of gallstones is expected to rise sharply over the forecast period, further fueling ERCP demand. Advancements in endoscopic technology have improved ERCP safety and efficacy. For example, in January 2023, Advantech introduced the MIO-5377R single-board computer, designed to enhance endoscopic performance, reliability, and functionality. Innovations such as high-definition imaging, improved endoscope maneuverability, and advanced therapeutic accessories have made ERCP a more precise and effective diagnostic and treatment tool, attracting both healthcare providers and patients. The growing adoption of minimally invasive surgical techniques is also driving ERCP demand. According to the American Cancer Society's annual report (January 2024), an estimated 41,630 new liver cancer cases will be diagnosed in the U.S. Liver cancer is more prevalent in Southeast Asia and sub-Saharan Africa, where it is the most common cancer type, with over 800,000 new cases diagnosed globally each year. It is also a leading cause of cancer-related deaths, claiming over 700,000 lives annually. The high burden of cholangiocarcinoma and hepatocellular carcinoma is expected to further boost ERCP adoption for early cancer detection. Increased awareness of the benefits of early diagnosis and treatment of pancreatic and biliary diseases has heightened demand for minimally invasive procedures. In October 2023, the Biliary Atresia Awareness Committee launched a campaign under the auspices of Gauteng Provincial Solid Organ Transplant Division and the University of the Witwatersrand at Charlotte Maxeke Academic Hospital. The initiative aimed to raise awareness and support for children with biliary atresia, a rare and life-threatening liver disease affecting infants. It focused on educating diverse populations, providing resources to affected families, advancing diagnostic research, and fostering global medical collaboration. An aging population is another key driver of market growth. As chronic conditions such as coagulopathy and anemia become more common in older adults, the demand for ERCP and related procedures, including those requiring blood transfusions, is rising. Currently, over 40 million people in the U.S. are aged 65 or older, a number expected to double by 2050. Japan, home to the world's largest geriatric population, presents significant growth opportunities. According to the WHO, the geriatric population is projected to reach 22% globally by 2050. Healthcare organizations are increasingly investing in research and partnerships to drive innovation. A Optica Publishing Group study (July 2022) highlighted the development of a photoacoustic imaging endoscope probe, which can be inserted into a medical needle as small as 0.6 mm in diameter. Researchers also suggested AI could accelerate imaging procedures. Strategic initiatives by market players, including mergers, acquisitions, and product launches, are expected to further propel growth. For instance, in April 2022, Olympus partnered with EndoClot Plus, a company specializing in hemostasis technologies. EndoClot PHS, a nonthermal, nontraumatic solution for gastrointestinal bleeding, is a key product in its portfolio. This partnership aims to improve accessibility to EndoClot PHS, enabling gastroenterologists to stop bleeding quickly and effectively during procedures. Why should you buy this report? Comprehensive Market Analysis: Gain detailed insights into the global market across major regions and segments. Competitive Landscape: Explore the market presence of key players worldwide. Future Trends: Discover the pivotal trends and drivers shaping the future of the global market. Actionable Recommendations: Utilize insights to uncover new revenue streams and guide strategic business decisions. This report addresses: Market intelligence to enable effective decision-making Market estimates and forecasts from 2018 to 2030 Growth opportunities and trend analyses Segment and regional revenue forecasts for market assessment Competition strategy and market share analysis Product innovation listing for you to stay ahead of the curve Key Attributes Report Attribute Details No. of Pages 120 Forecast Period 2024-2030 Estimated Market Value (USD) in 2024 $2.17 billion Forecasted Market Value (USD) by 2030 $3.51 billion Compound Annual Growth Rate 8.2% Regions Covered Global Key Topics Covered Chapter 1. Methodology and Scope1.1. Market Segmentation and Scope1.2. Segment Definitions1.3. Research Methodology1.4. Information Procurement1.5. Information or Data Analysis1.6. Market Formulation & Validation1.7. Model Details1.8. List of Secondary Sources1.9. List of Primary Sources1.10. Objectives Chapter 2. Executive Summary2.1. Market Outlook2.2. Segment Outlook2.3. Regional Outlook2.4. Competitive Insights Chapter 3. Endoscopic Retrograde Cholangiopancreatography Market Variables, Trends & Scope3.1. Market Lineage Outlook3.2. Market Dynamics3.3. Endoscopic Retrograde Cholangiopancreatography Market Analysis Tools Chapter 4. Endoscopic Retrograde Cholangiopancreatography Market: Product Estimates & Trend Analysis4.1. Segment Dashboard4.2. Endoscopic Retrograde Cholangiopancreatography Market: Product Movement Analysis4.3. Endoscopic Retrograde Cholangiopancreatography Market by Product Outlook (USD Million)4.4. Market Size & Forecasts and Trend Analyses, 2018 to 2030 for the Following4.5. Endoscopes4.6. Endotherapy Devices4.7. Visualization Systems4.8. Energy Devices4.9. Others Chapter 5. Endoscopic Retrograde Cholangiopancreatography Market: Procedure Estimates & Trend Analysis5.1. Segment Dashboard5.2. Endoscopic Retrograde Cholangiopancreatography Market: Procedure Movement Analysis5.3. Endoscopic Retrograde Cholangiopancreatography Market by Procedure Outlook (USD Million)5.4. Market Size & Forecasts and Trend Analyses, 2018 to 2030 for the Following5.5. Biliary Sphincterotomy5.6. Biliary Stenting5.7. Biliary Dilatation5.8. Pancreatic Sphincterotomy5.9. Pancreatic Duct Stenting5.10. Pancreatic Duct Dilation Chapter 6. Endoscopic Retrograde Cholangiopancreatography Market: End Use Estimates & Trend Analysis6.1. Segment Dashboard6.2. Endoscopic Retrograde Cholangiopancreatography Market: End Use Movement Analysis6.3. Endoscopic Retrograde Cholangiopancreatography Market by End Use Outlook (USD Million)6.4. Market Size & Forecasts and Trend Analyses, 2018 to 2030 for the Following6.5. Hospitals6.6. Outpatient Facilities Chapter 7. Endoscopic Retrograde Cholangiopancreatography Market: Regional Estimates & Trend Analysis7.1. Regional Dashboard7.2. Regional Endoscopic Retrograde Cholangiopancreatography Market Movement Analysis7.3. Endoscopic Retrograde Cholangiopancreatography Market: Regional Estimates & Trend Analysis by Technology & End Use7.4. Market Size & Forecasts and Trend Analyses, 2018 to 2030 for the Following7.5. North America7.6. Asia-Pacific7.7. Latin America7.8. Middle East & Africa Chapter 8. Competitive Landscape8.1. Market Participant Categorization8.2. Key Company Profiles8.2.1. Olympus Corporation8.2.2. CONMED Corporation8.2.3. Boston Scientific Corporation8.2.4. Medtronic plc8.2.5. Telemed System, Inc.8.2.6. AMBU, Inc.8.2.7. Fujifilm Holdings Corporation8.2.8. Hobbs Medical, Inc.8.2.9. Cook Group8.2.10. Streis plc8.2.11. HOYA Group8.2.12. Karl Storz SE & Co. KG For more information about this report visit About is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends. Attachment Endoscopic Retrograde Cholangiopancreatography Market CONTACT: CONTACT: Laura Wood,Senior Press Manager press@ For E.S.T Office Hours Call 1-917-300-0470 For U.S./ CAN Toll Free Call 1-800-526-8630 For GMT Office Hours Call +353-1-416-8900Sign in to access your portfolio Error while retrieving data Error while retrieving data Error while retrieving data
