The incidence and prevalence of inflammatory bowel disease (IBD) are significantly increasing not only in industrialized countries, but also in numerous newly industrialized and emerging regions. A comprehensive analysis of global epidemiological data suggests that the prevalence of IBD in Europe may triple by 2040, reaching approximately 1.5% of the population. These projections underscore the need for effective strategies for prevention, early detection, and management of IBD (Hracs et al.). In the pharmacologic management of Crohn’s disease, IL-23 inhibitors represent a significant therapeutic advance. In the GALAXI studies, treatment with the IL-23 antibody guselkumab was not only superior to placebo but also produced significantly improved outcomes after 48 weeks across multiple endpoints compared with ustekinumab (Panaccione et al.). 

To date, the diagnostic utility of laboratory markers such as CA 19-9 for the early detection of pancreatic cancer has been limited. Plasma-based metabolic profiling using mass spectrometry may offer improved performance. In the German METAPAC study, two plasma multimetabolite signatures demonstrated significantly better accuracy in ruling out pancreatic ductal adenocarcinoma in patients with diagnostically relevant lesions than CA 19-9 alone (Mahajan et al.).

There continues to be significant progress in the field of metabolic dysfunction-associated steatotic liver disease (MASLD). In this issue, we focus on several high-impact therapeutic trials that advance different treatment approaches toward clinical applicability in different patient populations. In addition to glucagon-like peptide-1 (GLP-1) analogues (Sanyal et al.), new evidence is presented on the efficacy of fibroblast growth factor 21 (FGF21) analogues (Noureddin et al., Noureddin et al., Loomba et al.), and of an antisense inhibitor of diacylglycerol-O-acyltransferase 2 (DGAT2) (Loomba et al.).

In the area of hepatobiliary tumors, this issue features important advances in both the early detection and systemic treatment of hepatocellular carcinoma (HCC). With respect to imaging, recent findings suggest that non-contrast MRI offers advantages over ultrasonography in HCC surveillance (Rhee et al.), while AI-assisted, contrast-enhanced ultrasound models may improve the differentiation of focal liver lesions (Ding et al.). Therapeutically, two key topics are addressed: the management of patients with HCC who achieve a complete response to immunotherapy (Scheiner et al.), and the comparative efficacy of nivolumab plus ipilimumab versus tyrosine kinase inhibitors in HCC treatment (Yau et al.).

We hope the selected publications give you a helpful overview of current research and clinical trials in the field. May you find these articles both inspiring and informative. We wish you a happy holiday season and all the best in the new year.

Yours sincerely,

Peter Hasselblatt and Tobias Böttler
Department of Internal Medicine II, University Medical Center Freiburg (Germany)