The American College of Gastroenterology Annual Scientific Meeting and Postgraduate Course took place Oct. 23 to 28 in San Diego and attracted about 5,000 attendees from around the world. The meeting featured a wide range of sessions highlighting current clinical gastrointestinal updates and science for practicing gastroenterologists.
One of the meeting's hot topics addressed the ongoing controversy over the concomitant use of proton pump inhibitors and clopidogrel. "There has been a recent debate in the literature as to whether dual therapy with clopidogrel and proton pump inhibitors reduces the efficacy of clopidogrel, thus increasing the risk of major cardiac events," said educational affairs chair, Jean-Paul Achkar, M.D., of the Cleveland Clinic. "There were two related original research scientific presentations, and an excellent feature lecture by Loren Laine, M.D., who suggested that the evidence to date is insufficient to conclude whether there is a valid statistical association, and that we are unable to infer causality."
In one of the scientific studies, Ekta Gupta, M.D., of the University of Arkansas for Medical Sciences in Little Rock, presented a study of 315 patients who underwent percutaneous coronary intervention and were discharged on clopidogrel, including 72 patients who also were discharged on proton pump inhibitors. After a mean follow-up of 50 months, the researchers found that the rate of major adverse cardiovascular events was significantly higher in the dual-therapy group (56 versus 38 percent).
Another important theme at the meeting was the emergence of new technologies to improve the detection rate for adenomas on screening colonoscopy. "There were several studies looking at high-definition colonoscopy, high-definition chromocolonoscopy, and a new tool called the Third Eye Retroscope," Achkar said. "Basically, each of those studies showed improving rates of adenoma detection."
In one study, Peter Siersema, M.D., of the University Medical Center Utrecht in the Netherlands, reported the results of a preliminary analysis of 126 patients who underwent same-day colonoscopy and colonoscopy with the Third Eye Retroscope, which showed that standard colonoscopy was more likely to miss polyps.
"When endoscopists used the colonoscope alone, they missed 2.57 times more polyps than when they used the retrograde viewing device along with the colonoscope," Siersema said in a statement.
Avantis, the manufacturer of the Third Eye Retroscope, supported this study.
Another important study suggested that a new combination therapy is significantly more effective than standard treatment at eliminating Helicobacter pylori, the bacterium associated with peptic ulcer disease, Achkar said.
In that study, Patrick Basu, M.D., and colleagues at the Columbia University College of Physicians and Surgeons in New York City randomly assigned 135 patients to receive either a course of LOAD (levofloxacin, omeprazole, nitazoxanide, and doxycycline, or LAC (lansoprazole, amoxicillin, and clarithromycin). They found that the LOAD regimen was associated with a significantly higher eradication rate of H. pylori (95 versus 80.9 percent).
"H. pylori gastritis is a global threat for gastric carcinoma and many therapies have been explored to eradicate this infection with variable success rates," Basu said in a statement. "Our study demonstrates the therapeutic superiority of LOAD therapy over LAC therapy in a treatment-naive population of patients with H. pylori."
William Sanborn, M.D., of the Mayo Clinic in Rochester, Minn., presented results of the industry-supported QDIEM study, which compared the effects of once-daily dosing of delayed- release oral mesalamine against twice-daily dosing for maintenance of remission in 1,023 patients with ulcerative colitis. After six months, they found that there were no significant group differences in the number of patients with sustained remission (90.5 versus 91.8 percent).
"That has very important clinical implications because if we can tell our patients to take something once per day they'll be much more likely to stick to that than if we tell them to take something two, three, or four times per day," Achkar said.
Several authors of the study reported financial relationships with Procter & Gamble Pharmaceuticals Inc.
In another industry-supported study from the Mayo Clinic, Darrell Pardi, M.D., and colleagues analyzed 385 cases of Clostridium difficile infection that occurred between 1991 and 2005. Although 192 cases were hospital-acquired and 35 were residents of nursing homes, the researchers found that 158 cases were community-acquired. Compared to hospital-acquired cases, community-acquired cases had a median younger age (50 versus 72 years) but still had a high rate of severe illness (22 versus 35 percent).
"The growing incidence of C. difficile infection in both inpatient and outpatient settings could be linked to the increasing usage of antibiotics and to the possibility that C. difficile may be getting resistant to some of our newer antibiotics," Pardi said in a statement.
The study was supported by a grant from ViroPharma.
ACG: Racial Disparities Seen in Colorectal Cancer
WEDNESDAY, Oct. 28 (HealthDay News) -- Compared to other racial and ethnic groups, African-Americans have a significantly increased risk of developing colorectal cancer and receiving a diagnosis of late-stage disease, according to a paper presented at the American College of Gastroenterology Annual Scientific Meeting, held from Oct. 23 to 28 in San Diego.
ACG: New Bowel Preparations Found Effective
TUESDAY, Oct. 27 (HealthDay News) -- Two new bowel preparations may be effective prior to colonoscopy, according to two studies presented this week at the American College of Gastroenterology Annual Scientific Meeting, held from Oct. 23 to 28 in San Diego.
ACG: Bowel Disease Linked to Non-Melanoma Skin Cancer
TUESDAY, Oct. 27 (HealthDay News) -- In patients with inflammatory bowel disease, the risk of non-melanoma skin cancer may be elevated, especially in those receiving the thiopurine class of medications, according to research presented this week at the American College of Gastroenterology Annual Scientific Meeting, held from Oct. 23 to 28 in San Diego.
ACG: GI Disorders in Military, 9/11 Responders Studied
MONDAY, Oct. 26 (HealthDay News) -- Active-duty military personnel and World Trade Center (WTC) workers have an increased risk of gastrointestinal disorders, according to two studies presented this week at the American College of Gastroenterology Annual Scientific Meeting, held from Oct. 23 to 28 in San Diego.
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