Data review supports intermittent PPI therapy for ulcers | Experts say hepatitis C genotype 3 may be next treatment challenge | Antidepressants, some psychological therapies effective treatments for IBS, leading researchers suggest
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September 15, 2014
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Clinical Updates
Data review supports intermittent PPI therapy for ulcers
Yale University researchers reviewed data from 13 clinical trials and found intermittent proton pump inhibitor therapy worked as well as continuous PPI treatment for patients with high-risk bleeding ulcers. Data from 10 of the studies, which looked at recurrent bleeding within one week of receiving treatment, showed intermittent therapy resulted in a 28% lower risk of recurrent bleeding. Medscape (free registration)/HealthDay News (9/12)
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Experts say hepatitis C genotype 3 may be next treatment challenge
Hepatitis experts said hepatitis C genotype 3, the second-most-common genotype, is more aggressive, can lead to more liver damage than other types and may be the most difficult to treat. Dr. Samuel Lee at the University of Calgary said a cause and effect has not been fully established but patients with HCV3 tend to have resistant and more advanced disease, while New Zealand specialist Dr. Catherine Stedman said the genotype may alter the natural course of hepatitis. Healio (free registration)/HCV Next (9/11)
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Antidepressants, some psychological therapies effective treatments for IBS, leading researchers suggest
There have been increasing data on the impact of antidepressants and psychological therapies, including hypnotherapy, for patients with irritable bowel syndrome (IBS). This systematic review and meta-analysis of randomized controlled trials (RCTs) identified 48 RCTs, 31 with psychological therapy, 16 with antidepressants and one with both. The studies suggested that there is benefit with both tricyclic antidepressants and selective serotonin reuptake inhibitors, in addition to significantly likely improvement with various psychologically based therapies. The authors suggest that this accumulating evidence should lead gastroenterologists to more frequent use of antidepressants as well as psychological therapies for patients suffering from IBS. Learn about this study in the September issue of The American Journal of Gastroenterology. Read the abstract.
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Legal & Regulatory will be better but not perfect, CMS official says
The upcoming Affordable Care Act open-enrollment season will see a federal website that features a more streamlined application process and better back-end communications with carriers, CMS Principal Deputy Administrator Andy Slavitt told a House subcommittee. Slavitt said will work better than it did for the 2014 enrollment season, but he cautioned lawmakers not to expect perfection. Kaiser Health News (9/10)
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Open Payments site is on track for Sept. 30 launch, CMS says
The Open Payments database will be ready for its public launch on Sept. 30 despite technical glitches, according to the CMS. The American Medical Association sent a letter to the CMS last month requesting more time for physicians to register before the launch and verify information in the database. The Pharmaceutical Research and Manufacturers of America has voiced concerns about the accuracy and completeness of data posted. Kaiser Health News/Capsules blog (9/9)
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Practice News
GI physicians, insurers work to forge better relationships
Gastroenterologists and health insurers are creating better relationships and working together to reduce the cost of endoscopic interventions. Dr. Michael Lustberg of Digestive Health Consultants in Santa Rosa, Calif., said the best of these relationships focuses on quality of care measures but also responds to the needs of local markets. "The greatest obstacles that centers and payers must overcome together are related to breaking out of traditional models of reimbursement care," he said. (9/12)
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Colonoscopy's strengths highlighted in response to op-ed on CT colonography
Virginia gastroenterologists Dr. David Balaban and Dr. David Johnson authored an op-ed to counter a recent Huffington Post blog post about CT colonography. They review the evidence in their piece, "Five Reasons Why Colonoscopy is Better than CT Colonography." The Huffington Post/Post50 (9/12)
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Business & Market Trends
Price of drugmaker's next hep C drug to exceed sofosbuvir's $84,000
Gilead Sciences' next-generation version of hepatitis C drug sofosbuvir will cost more than the current $84,000, but a shorter treatment regimen could reduce overall costs. Executive Vice President Gregg Alton said the price of the new drug would be based on the current treatment's overall cost of $95,000, which includes the drugs interferon and ribavirin. Reuters (9/12)
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Analysis IDs cities most affected by physician shortage
Data from the Association of American Medical Colleges suggest the U.S. may suffer a shortage of more than 130,000 physicians by 2025. According to online directory BetterDoctor, New York City tops the list of the 25 cities most acutely affected by the shortage, with 912 people per primary care doctor. San Antonio, Los Angeles, Jacksonville, Fla., and Greensboro, N.C., round out the top five. (9/10)
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Patient's Perspective
Poll: Americans remain divided over ACA
Forty-eight percent of registered voters responding to a Wall Street Journal/NBC News poll said they oppose the Affordable Care Act and 34% said they support the law. Similarly, 47% of respondents to a Kaiser Family Foundation poll said they disapprove of the law and 35% said they approve of it. The Wall Street Journal (tiered subscription model)/Washington Wire blog (9/9)
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ACG News
ACG's one-day Hepatitis School, Friday, Sept. 19, Chicago
Join colleagues for ACG's Hepatitis School, a day-long interactive educational program providing an immersion in hepatitis B and C management and a clinical update on new therapeutic modalities and approaches. The program will focus on the epidemiology and treatment of hepatitis B, the epidemiology of hepatitis C, assessing candidates for therapy, the currently approved therapies for hepatitis C, the pipeline of new drug development for the treatment of hepatitis C, and more. The program will take place at the InterContinental Chicago Magnificent Mile in Chicago. Review the course brochure and register online (click the link for ACG Women in Gastroenterology Forum and scroll to the bottom of the form), OR download the registration form and fax or mail to ACG.
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Experts outline how to apply current guidelines to practice at ACG 2014
Join colleagues at the ACG 2014 Annual Scientific Meeting and Postgraduate Course in Philadelphia to hear leading experts review current guidelines and provide diagnosis and management strategies to implement guidelines into practice. ACG 2014 begins on Friday, Oct. 17, with optional Friday courses, including What's New in GI Pharmacology, Practice Management, and Pathology & Imaging, and an ASGE endoscopy course. Saturday and Sunday, Oct. 18 and 19, the Annual Postgraduate Course takes place and provides a broad clinical review with focused sessions on the Esophagus, Colon, Biliary Disease, Pancreas, and Genetic Disorders, plus optional Learning Luncheons and Simultaneous Symposia offered each day. Poster presentations begin on Sunday at 3:30 p.m. and will be held in the Exhibit Hall. Monday through Wednesday, Oct. 20 to 22, the Annual Scientific Meeting will take place. Free to members, it will feature dozens of oral presentations, simultaneous symposia, featured lectures, and optional breakfast sessions. Additional poster sessions will be offered on Monday and Tuesday in the Exhibit Hall. Register for ACG 2014 today.  Learn more about ACG 2014.
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Look for a way to lift someone up. If that's all you do, it's enough."
-- Elizabeth Lesser,
American entrepreneur
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