scholarly journals Efficacy of enteral nutrition in patients with Crohn’s disease on maintenance anti-TNF-alpha antibody therapy: a meta-analysis

2019 ◽  
Vol 55 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Fumihito Hirai ◽  
Teruyuki Takeda ◽  
Yasumichi Takada ◽  
Masahiro Kishi ◽  
Tsuyoshi Beppu ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Cohort Studies ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Antibody Therapy ◽  
Tnf Alpha ◽  
Remission Induction ◽  
Level Of Evidence

Abstract Enteral nutrition (EN) is effective in Crohn’s disease (CD) patients and has been shown to have an inhibitory effect on loss of response to anti-tumor necrosis factor (TNF)-alpha antibody therapy; however, the current level of evidence is not sufficient. The objective of this meta-analysis was to determine whether EN in combination anti-TNF-alpha antibody therapy is useful in maintaining remission. PubMed was used to identify all relevant studies. A total of nine articles were identified including one randomized control trial, two prospective cohort studies, and six retrospective cohort studies. We performed a meta-analysis on all these articles to assess the remission maintenance effect of EN (n = 857). The remission or response maintenance effect in the EN group was 203/288 (70.5%), which was higher than 306/569 (53.8%) in the non-EN group. The odds ratio for long-term remission or response using fixed effects model and random effects model were 2.23 (95% CI 1.60–3.10) and 2.19 (95% CI 1.49–3.22), respectively. The usefulness of EN was unclear in two prospective studies that were conducted immediately after remission induction with anti-TNF-alpha antibody therapy was detected. Differences in the definition of relapse and the observation period among articles were considered to be limitations. This analysis suggests that EN is effective for maintaining remission in patients already in remission or response as a result of anti-TNF-alpha antibody maintenance therapy.

Meta-analysis of enteral nutrition as a primary treatment of active crohn's disease

1995 ◽  
Vol 108 (4) ◽  
pp. 1056-1067 ◽  
Author(s):  
Anne M. Griffiths ◽  
Arne Ohlsson ◽  
Philip M. Sherman ◽  
Lloyd R. Sutherland
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Meta Analysis ◽  
Primary Treatment

scholarly journals Enteral Nutrition in Patients with Inflammatory Bowel Disease. Systematic Review, Meta-Analysis, and Meta-Regression

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2657 ◽  
Author(s):  
Jose M. Comeche ◽  
Pablo Caballero ◽  
Ana Gutierrez-Hervas ◽  
Sofia García-Sanjuan ◽  
Iris Comino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Long Term Treatment ◽  
Inflammatory Bowel ◽  
Meta Regression

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and is characterized by inflammation of the gastrointestinal tract. One of the possible treatments for this pathology is a change in the type of diet, of which enteral nutrition (EN) is one. This study is to understand how the use of EN can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis, and a meta-regression. On the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS), we found 363 registers with an accuracy of 12% (44 registers). After a full-text review, only 30 research studies were selected for qualitative synthesis and 11 for meta-analysis and meta-regression. The variables used were Crohn’s disease activity index (CDAI), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). EN has been shown to have efficacy for the treatment of Crohn’s disease and is compatible with other medicines. As for the CDAI or rates of remission, there were no differences between enteral and parenteral nutrition. Polymeric formulas have shown better results with respect to the CRP. The long-term treatment could dilute the good CDAI results that are obtained at the start of the EN treatment.

The relationship between endoscopic and clinical recurrence in postoperative Crohn’s disease: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Alessandro Ble ◽  
Cecilia Renzulli ◽  
Fabio Cenci ◽  
Maria Grimaldi ◽  
Michelangelo Barone ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Mixed Effects ◽  
Spearman Correlation ◽  
Clinical Recurrence ◽  
Endoscopic Recurrence ◽  
Meta Regression ◽  
The Relationship

Abstract Background and Aims We aimed to quantify the magnitude of the association between endoscopic recurrence and clinical recurrence [symptom relapse] in patients with postoperative Crohn’s disease. Methods Databases were searched to October 2, 2020 for randomised controlled trials [RCTs] and cohort studies of adult patients with Crohn’s disease with ileocolonic resection and anastomosis. Summary effect estimates for the association between clinical recurrence and endoscopic recurrence were quantified by risk ratios [RR] and 95% confidence intervals [95% CI]. Mixed-effects meta-regression evaluated the role of confounders. Spearman correlation coefficients were calculated to assess the relationship between these outcomes as endpoints in RCTs. An exploratory mixed-effects meta-regression model with the logit of the rate of clinical recurrence as the outcome and the rate of endoscopic recurrence as a predictor was also evaluated. Results Thirty-seven studies [N=4053] were included. For 8 RCTs with available data, the RR for clinical recurrence for patients who experienced endoscopic recurrence was 10.77 [95% CI 4.08-28.40; GRADE moderate certainty evidence]; the corresponding estimate from 11 cohort studies was 21.33 [95% CI 9.55-47.66; GRADE low certainty evidence]. A single cohort study showed a linear relationship between Rutgeerts score and clinical recurrence risk. There was a strong correlation between endoscopic recurrence and clinical recurrence treatment effect estimates as trial outcomes [weighted Spearman correlation coefficient 0.51]. Conclusions The associations between endoscopic recurrence and subsequent clinical recurrence lend support to the choice of endoscopic recurrence to monitor postoperative disease activity and as a primary endpoint in clinical trials of postoperative Crohn’s disease.

scholarly journals Association between ATG16L1 gene polymorphism and the risk of Crohn’s disease

2016 ◽  
Vol 45 (6) ◽  
pp. 1636-1650
Author(s):  
Bei-Bei Zhang ◽  
Yu Liang ◽  
Bo Yang ◽  
Ying-Jun Tan
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Gene Polymorphism ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Additive Model ◽  
Recessive Model ◽  
Genetic Models ◽  
Fixed Effects Model ◽  
Case Control Studies

Objective To perform a meta-analysis to evaluate studies investigating the association between ATG16L1 gene polymorphism and Crohn’s disease. Methods PubMed, Embase and Web of Science databases were searched for all studies focusing on the association of ATG16L1 and Crohn’s disease. Combined odds ratios with 95% confidence intervals were calculated for four genetic models (allelic model: G allele versus A allele; additive model: GG versus AA; dominant model: GA + GG versus AA; recessive model: GG versus GA + AA) using either a random effects or fixed effects model. Results A total of 47 case–control studies involving 18 638 cases and 30 181 controls were included in the final meta-analysis. There was a significant association between ATG16L1 and Crohn’s disease for all four genetic models. Significant associations were also shown in subgroup analyses when stratified by study design (population- or hospital-based). Conclusion In this meta-analysis, the ATG16L1 genotype was significantly associated with the risk of developing Crohn’s disease.

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