Systematic review and meta-analysis of randomised controlled trials: Medical therapies for the treatment and prevention of pouchitis.
Aliment Pharmacol Ther
; 58(3): 268-282, 2023 08.
Article
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| MEDLINE
| ID: mdl-37246609
ABSTRACT
BACKGROUND AND AIMS:
We conducted a systematic review to assess medical therapy for the treatment and prevention of pouchitis.METHODS:
Randomised controlled trials (RCTs) of medical therapy in adults with or without pouchitis were searched to March 2022. Primary outcomes included clinical remission/response, maintenance of remission and prevention of pouchitis.RESULTS:
Twenty RCTs (N = 830) were included. Acute pouchitis One study compared ciprofloxacin with metronidazole. At 2 weeks, 100% (7/7) of ciprofloxacin participants achieved remission, compared with 67% (6/9) of metronidazole participants (RR 1.44, 95% CI 0.88-2.35, very low certainty evidence). One study compared budesonide enemas with oral metronidazole. Fifty percent (6/12) of budesonide participants achieved remission compared with 43% (6/14) of metronidazole participants (RR 1.17, 95% CI 0.51-2.67, low certainty evidence). Chronic pouchitis Two studies (n = 76) assessed De Simone Formulation. Eighty-five percent (34/40) of De Simone Formulation participants maintained remission at 9-12 months compared with 3% (1/36) placebo participants (RR 18.50, 95% CI 3.86-88.56, moderate certainty evidence). One study assessed vedolizumab. Thirty-one percent (16/51) of vedolizumab participants achieved clinical remission at 14 weeks compared with 10% (5/51) of placebo participants (RR 3.20, 95% CI 1.27-8.08, moderate certainty evidence). PROPHYLAXIS Two studies assessed De Simone Formulation. Ninety percent (18/20) of De Simone Formulation participants did not develop pouchitis compared with 60% (12/20) of placebo participants (RR 1.50, 95% CI 1.02-2.21, moderate certainty evidence).CONCLUSIONS:
Apart from vedolizumab and the De Simone formulation, the effects of other medical interventions for pouchitis are uncertain.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Reservoritis
/
Metronidazol
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Idioma:
En
Revista:
Aliment Pharmacol Ther
Asunto de la revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2023
Tipo del documento:
Article