Hugo Cedrón

Gastroenterólogo, con interés en enfermedad inflamatoria, cápsula endoscópica y enteroscopía. Editor Principal de la Revista de Gastroenterología del Perú

[Gastroenterology @AGA_Gastro]

Vonoprazan-Tetracycline dual therapy achieved non-inferior H. pylori eradication vs. bismuth quadruple therapy, with markedly fewer adverse events. Click the link to read the full article:
🔗 https://t.co/dL0GhscMqY

[Hugo Cedrón @hcedron]

@pancco_org

[PANCCO @pancco_org]

https://t.co/rNSWhfpjhw

Resúmenes de los Trabajos enviados a PANCCO 2026 Cartagena.

[Seb @ibdseb]

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

[Phillip Gu @DrPhil_Gu]

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?

[Sociedad Española de Patología Digestiva (SEPD) @sepdigestiva]

¿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.

[ignacio catalan @ign76]

Let’s go @YOGI_IBD !!! 💪🏻

[Hugo Cedrón @hcedron]

💜✨ 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.

[Ramon Bataller @rabataller]

Fascinating study with real clinical implications:

PPIs → altered microbiome → ↑ endogenous ethanol → MASLD

Time to rethink long-term PPI use in patients with MASLD?

[Harrison Ford @HarrisonFordLA]

May the fourth be with you

[Asociación Española para el Estudio del Hígado @AEEHLiver]

📢 ¡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: ➡️ https://t.co/C7ttGjdsIa

[CME INDIA @CMEINDIA1]

“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.

https://t.co/KG024CiBtF

[Adriana Zucchiatti @zucchiatti_]

Gastric Cancer, A Review
https://t.co/TzcM4JNZHm
#GIpath

[Fabi An E. Puentes M. @puentesfabi]

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

[PANCCO @pancco_org]

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

[PANCCO @pancco_org]

Final section in #PANCCO2026
IUS

Dr. @hcedron 🇵🇪

[PANCCO @pancco_org]

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

#PANCCO2026 en Cartagena 🇨🇴

[Dr. Santiago Blanco Rey, MD, MSc @SantiBlancoRey]

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.

🔗 https://t.co/f2fnOphXAS

[Tom Marjot @tom_marjot]

☔ #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:
https://t.co/mMCkjTDoqR