Comment

Biomedical ‘big data’ has opened opportunities for data repurposing to reveal new insights into complex diseases. Public data on IBD have been repurposed for novel diagnostics and therapeutics, and these datasets continue to grow. Here, we discuss the practicalities and implications of open data informatics for IBD.

More than 250 million people worldwide are chronically infected with the hepatitis B virus (HBV). In this Comment, members of the International Coalition to Eliminate HBV appraise the current policy environment and the need for appropriate cure research and preparedness to complement the WHO global elimination strategy, the HBV vaccine and the well-tolerated but poorly accessed therapy.

According to a meta-analysis of twin research studies, only a minority addressed gastrointestinal diseases, and mainly IBD and IBS. Here, we discuss similarities and differences between twin research in IBD and IBS, using these diseases as an example of the potential benefits that twin studies can offer gastroenterology.

Faecal microbiota transplantation (FMT), a highly effective treatment for Clostridium difficile infection, is now being explored for complex diseases, but innovative trial design and collaborative approaches are essential for unlocking its therapeutic potential. If ‘superstool’ capable of treating a complex disease exists, then FMT trials should aim to find and use it.

CRISPR–Cas9 has revolutionized biomedical research. Studies in the past few years have achieved notable successes in hepatology, such as correction of genetic disease genes and generation of liver cancer animal models. Where does this technology stand at the frontier of basic and translational liver research?

Alcohol use and 'social' drinking are increasing among the young and particularly in women. However, gender equity does not extend to the risk of alcohol-associated liver disease and alcoholic hepatitis, which are increased and often caused by as little as half as much cumulative alcohol consumption in women compared with men.

Surrogate end points are often used in clinical trials where the time to clinical outcomes is long. In patients with liver disease, these surrogate outcomes are rarely validated. Without validation, treatment effects reported in trials might not directly translate to patient benefit after licensing.

More people die from viral hepatitis than from HIV, yet the public health response is lacking. The ACHIEVE Coalition urges governments in Europe and elsewhere to improve hepatitis B and hepatitis C monitoring so that a reliable evidence base will be available to guide the drive towards disease elimination.

In April 2015, in partnership with the US Centers for Disease Control and Prevention and Gilead Sciences, the country of Georgia launched the world's first national HCV elimination programme, aiming to reduce HCV prevalence by 90% by 2020. After 2 years of progress, how can the Georgia experience inform global approaches to eliminating HCV?

The WHO listed Helicobacter pylori among 16 antibiotic-resistant bacteria that pose the greatest threat to human health. Given the alarmingly high H. pylori antibiotic resistance rates, antibiotic stewardship programmes need to be developed and implemented. Future research should explore provider and systems-level barriers to H. pylori antibiotic susceptibility testing.

The treatment of IBD is currently suboptimal. Continuous monitoring of patients with IBD, patient engagement and early treatment adjustments are still difficult hurdles. E-Health could be an efficient tool to improve these aspects, but the current evidence for its use in IBD is poor. An integrated cost-effective e-health system supported by a stable legal framework is eagerly needed.