Su1820 A SYSTEMATIC REVIEW: ARE THE QUALITY METRICS IN INFLAMMATORY BOWEL DISEASE PROPOSED BY PROFESSIONAL GASTROENTEROLOGY AND INFLAMMATORY BOWEL DISEASE ORGINIZATIONS ROOTED ON SUBSTANTIAL QUALITY EVIDENCE?

Abstract Background and Aims Quality metrics were established to develop standards to help assess quality of care, yet variation in inflammatory bowel disease [IBD] clinical practice exists. We performed a systematic review to assess the overall quality of evidence cited in formulating IBD quality metrics. Methods A systematic search was performed on PubMed, MEDLINE, and EMBASE. All major national and international IBD societies were included. Quality metrics were assessed for evidence quality and categorised as category A [guideline based], category B [primarily retrospective and observational studies], or category C [expert opinion]. Quality metrics were examined for the type of metric, and the quality, measurability, review, existing conflicts of interest [COI], and patient participation of the metric. Statistical analysis was conducted in R. Results A total of 143 distinct, and an aggregate total of 217 quality metrics were included and analysed; 68%, 3.2%, and 28.6% of IBD quality metrics were based on low, moderate, and high quality of evidence, respectively. The proportion of high-quality evidence across societies was significantly different [p <0.01]. Five organisations included patients in quality metric development, three reported external review, not all reported measurable outcomes or stated the presence of a COI. Finally, 43% of quality metrics were published more than 5 years ago. Conclusions Quality metrics are important to standardise practice. As more than two-thirds of the quality metrics in IBD are based on low-quality evidence, further studies are needed to improve the overall quality of evidence supporting the development of quality measures.

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Efficacy and Safety of Vedolizumab for Pediatrics With Inflammatory Bowel Disease: a Systematic Review

10.21203/rs.3.rs-1022122/v1 ◽

2021 ◽

Author(s):

Shengbo Fang ◽

Yanqing Song ◽

Chunyan Zhang ◽

Libo Wang

Keyword(s):

Systematic Review ◽

Inflammatory Bowel Disease ◽

Children And Adolescents ◽

Bowel Disease ◽

Clinical Remission ◽

Mucosal Healing ◽

Efficacy And Safety ◽

Remission Rates ◽

Inflammatory Bowel ◽

Quality Evidence

Abstract Background: Vedolizumab use in pediatrics is still off-label and the data are limited. We conducted a systematic review evaluating the efficacy and safety of vedolizumab in children and adolescents with inflammatory bowel disease (IBD). Methods: PubMed, EMBASE and Cochrane databases were systematically searched for studies of vedolizumab in children and adolescents with IBD reporting clinical remission, response, corticosteroid-free (CS-free) remission, mucosal healing, or safety up to November 21 2020. Results: 7 studies, comprising 238 patients were included. For CD, the pooled clinical remission rates were 25% (19/75) at 6 weeks, 28% (19/67) at 14 weeks, 32% (17/53) at 22 weeks, and 25% (1/4) at 1 year. For UC/IBD-U, the pooled clinical remission rates were 36% (25/70) at 6 weeks, 52% (32/61) at 14 weeks, 53% (24/45) at 22 weeks, and 60% (6/10) at 1 year. Mucosal healing was found in 17%-39% of CD and 15%-34% of UC/IBD-U respectively. Six percent of patients reported serious adverse events.Conclusions: According to low-quality evidence based on case series, approximately one-third and one-half of patients for CD and UC/IBD-U respectively achieved remission within 22 weeks. Long-term benefit profile data and high quality evidence are still needed.

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