Hugo Cedrón

Interception Vs Primary Prevention in #IBD Consider: scalability , practicality , bang for the buck , cost , global impact Please debate this : we thought long and hard before this 👇 paper

JAKs may have ⬇️risk of serious infections that previously thought compared to TNFs. Could it be related to more rapid 🔥 control or JAKs safer in IBD population as we suspected after ORAL trial?

¿Es posible tener síntomas de diarrea después de una cirugía de vesícula biliar? La respuesta es sí: se llama diarrea por malabsorción de ácidos biliares (MAB) y es más frecuente de lo que pensamos.

Let’s go @YOGI_IBD !!! 💪🏻

💜✨ Día Mundial de la EII ✨💜 No te acostumbres a vivir mal. Dolor, diarrea, sangrado o cansancio constante NO son normales. 🚨 La Enfermedad Inflamatoria Intestinal puede afectar el día a día, pero con diagnóstico y tratamiento adecuados, se puede volver a vivir con libertad.

Fascinating study with real clinical implications: PPIs → altered microbiome → ↑ endogenous ethanol → MASLD Time to rethink long-term PPI use in patients with MASLD?

May the fourth be with you

📢 ¡Artículo de acceso gratuito en nuestra revista 'Gastroenterología y Hepatología'! 📕Nuevo "Documento de consenso sobre el diagnóstico, manejo y tratamiento de la infección crónica por el virus de la #hepatitisB y por el virus de la #hepatitisD en España". 🔎Coordinado por @SaSi_Lens. Accede aquí: ➡️ elsevier.es/es-revista-gas…

“Semaglutide shifts MASH therapy from glycemic control to multi-organ disease modification—but fibrosis still demands time and combination strategy.” Semaglutide in MASH with F2–F3 Fibrosis (ESSENCE Trial Perspective) 🔬 MASH with F2–F3 fibrosis represents a critical therapeutic window, where timely intervention can prevent progression to cirrhosis, HCC, and liver-related mortality. 💉 Semaglutide: Disease-Modifying Potential Once-weekly semaglutide 2.4 mg demonstrates true disease-modifying signals, not just metabolic improvement. 🧠 Histological Efficacy (Key Takeaway) Semaglutide significantly increases: Resolution of steatohepatitis without worsening fibrosis (~2/3 vs ~1/3 placebo) ≥1-stage fibrosis improvement (~1/3 vs ~1/5 placebo) 👉 Number needed to treat (NNT): ~3–4 for MASH resolution ~6–8 for fibrosis improvement ⚖️ Weight Loss: The Central Driver Semaglutide induces ~10–11% weight loss vs ~2% with placebo, a threshold strongly linked to: MASH resolution Fibrosis regression 👉 ≥10% weight loss remains a biological pivot point in MASLD management. ❤️ Cardiometabolic Amplification Semaglutide delivers multi-organ protection, including: HbA1c reduction Blood pressure lowering Improved lipid profile Reduced inflammatory markers (hs-CRP) 👉 Important: Cardiovascular disease remains the leading cause of mortality in MASLD. 🧪 Non-Invasive Markers Align with Histology Consistent improvements seen in: ELF score VCTE (FibroScan stiffness) PRO-C3 FAST score ALT/AST 👉 This supports a future biopsy-sparing strategy in MASH monitoring. ⚙️ Mechanistic Insight (Very Important) Semaglutide works via dual pathways: Weight-dependent effects (dominant) Reduced caloric intake Improved insulin sensitivity Reduced adipose inflammation Weight-independent (partial) Anti-inflammatory pathways Gut–liver axis modulation 👉 However: GLP-1 receptors are not expressed in hepatocytes, suggesting indirect hepatic benefits. ⚠️ Fibrosis: The Hard Endpoint Fibrosis improvement is: Slower and less weight-dependent Likely requires longer duration and targeted antifibrotic pathways 👉 Cirrhosis (F4) shows limited reversibility with semaglutide alone. 🛡️ Safety Profile GI side effects (nausea, vomiting) are common but transient No major hepatotoxicity signal Similar serious adverse events vs placebo 👉 Caution: Gallbladder disease Rare pancreatitis 🔄 Therapeutic Positioning Semaglutide is best suited for: Obese / T2DM phenotype MASH (commonest in India) High cardiometabolic risk patients 🔬 Future Strategy: Combination Therapy Semaglutide (systemic metabolic drug) + Resmetirom (liver-directed THR-β agonist) offers: Upstream metabolic unloading + direct hepatic antifibrotic action 👉 Likely future paradigm: Multi-target therapy for MASLD ❗ Clinical Gaps Long-term outcomes (cirrhosis, HCC, mortality) not yet confirmed Limited data in: Lean MASH Diverse ethnic populations Need for omics-based patient stratification 🔴 CME INDIA key point “Semaglutide shifts MASH therapy from glycemic control to multi-organ disease modification—but fibrosis still demands time and combination strategy.” 📚 Key Reference Pirola CJ, Sookoian S. Semaglutide in MASH with F2–F3 fibrosis: ESSENCE phase 3 perspective. Metab Target Organ Damage. 2026. oaepublish.com/articles/mtod.…

Gastric Cancer, A Review jamanetwork.com/journals/jama/… #GIpath

“Mamá: Ganamos!” #PANCCO2026 @pancco_org @GECCOL1 @DraVivianaParra @hcedron @johnepm @Paulinunezfigue @kennethernest

@Mr_Jeffry @puentesfabi And Dr. @hcedron using a Rebel Alliance pin 🤩

Final section in #PANCCO2026 IUS Dr. @hcedron 🇵🇪

Europa y América juntos en torno a la #IBD 🇧🇪 🇵🇹 🇺🇸 #PANCCO2026 en Cartagena 🇨🇴

Should GLP-1s be held before endoscopy? The OCULUS trial provides prospective data. 🛑 Continuing GLP-1 ⬆️ risk of clinically significant residual gastric volume (25.0% vs 3.1%). Key finding: a clear liquid diet 24h prior mitigated this risk. 🔗 doi.org/10.1001/jamain…

☔ #BavenoVIII teasers on the EASL #TalkLiverToMe podcast I ask @MattiasMandorf1 & Cristina Ripoll about... 🟦cACLD & the big picture 🟦Non-invasive tests 🟦First decompensation 🟦Quick-fire updates on variceal bleeding 🎧Spotify, Apple & EASL Campus: easlcampus.eu/tltm/episode-06

🎙️ #BavenoVIII takeaways — distilled by @tom_marjot, @MattiasMandorf1 & Cristina Ripoll 🎧 Listen now: - EASL Campus: easlcampus.eu/tltm/episode-06 - Spotify: open.spotify.com/episode/4TfvNE… - Apple: podcasts.apple.com/us/podcast/tal… #LiverTwitter #LiverX

Gastric Polyps AGA 2026: Not all are the same, and their histology is essential 🕵🏻‍♂️ Assess the surrounding mucosa: atrophy and/or metaplasia. 🦠 Test for H. pylori in hyperplastic polyps/adenomas 💊 In FGP: No discontinue PPIs if they are appropriately indicate. #GITwitter

📢 ¡Nuevo número disponible! En línea el N.º 1 de @RevGastroPeru. Este número realizado junto con @pancco_org , está dedicado a la EII. Incluye artículos originales, revisiones y actualizaciones en EII. 🧠🩺 🔗 revistagastroperu.com/index.php/rgp/… #Gastroenterología #EII #IBD #Investigación