2017-02-22 22:44:51 UTC

New AGA Guidelines Released

Feb. 22, 2017

Guidelines on Crohn’s disease after surgical resection and acute liver failure will help GIs efficiently manage patient care.

AGA recently released new clinical guidelines that provide evidence-based recommendations to help guide your clinical practice decisions based on rigorous systematic reviews of the medical literature.

AGA Institute Guideline on the Management of Crohn’s Disease After Surgical Resection: AGA developed this guideline, technical review and Clinical Decision Support Tool to outline strategies to reduce disease recurrence in Crohn’s disease patients who have achieved remission following bowel resection. Prevention of endoscopic recurrence, a strong surrogate measure of surgical recurrence, was evaluated for the development of the guideline. 

The guidelines are intended to reduce practice variation and promote high-value care. The current evidence supports the early prophylactic use of thiopurines and/or anti-TNF therapy in patients who are at higher risk for clinical recurrence. However, some patients at lower risk may opt for close endoscopic monitoring instead. Although all patients should undergo ileocolonoscopy at six to 12 months after surgical resection, surveillance for endoscopic recurrence is most important for patients not on any pharmacological prophylaxis. In general, those with endoscopic recurrence should undergo treatment with anti-TNF and/or thiopurine therapy. Read more

AGA Institute Guidelines for the Diagnosis and Management of Acute Liver Failure: AGA developed this guideline and technical review to provide recommendations about controversial diagnostic and treatment strategies and predictive models for outcome of acute liver failure (ALF), which have arisen since acute liver failure is difficult to study in randomized clinical trials. 

Recommendations include a strong recommendation for the use of N-acetyl cysteine (NAC) in patients with ALF related to acetaminophen, but there remains a lack of data to allow recommendations for testing for Wilson’s disease and varicella zoster virus in patients with ALF. Although there are low-quality data, because there are therapies that may be beneficial in patients with ALF, recommendations to test for herpes simplex virus and autoimmune hepatitis are supported, as is hepatitis E virus testing in pregnant women with ALF. Read more

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