20 Post-Operative Biologics and the Rate of Recurrence in Crohn’s Disease

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C H Ng ◽  
S R Jain ◽  
Z G W Ow ◽  
W H Lim ◽  
H Y Tham ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Meta Analysis ◽  
Operative Management ◽  
Suitable Alternative ◽  
Significant Challenge ◽  
One Year ◽  
The One

Abstract Introduction Post-operative recurrence after Crohn’s surgery poses a significant challenge to clinicians with an estimated of 70-90% recurrence rate. However, with the advent of biologics, reduction of recurrence after surgery has been observed in various landmark trials. Hence, we aim to quantify the rate of recurrence with post-operative biologics. Method Searches were done on Embase and Medline database for articles using biologics for post-operative management. A single arm meta-analysis with generalized linear mixed model and Clopper-Pearson method confidence interval was applied in the synthesis of the data on six months, one year, two year and five year. Results A total of 1,864 abstracts were identified, with a final total of 24 articles and 1042 patients were included in the meta-analysis. The one-year rate of recurrence for surgical, endoscopic and clinical was 3.08% (CI: 0.74% - 11.95%), 19.93% (15.81% - 24.81%) and 13.06% (CI: 8.18% - 18.92%) respectively. Correspondingly, the five-year recurrence 16.90% (CI: 9.57% - 28.11%), 84.21% (CI: 72.35% - 91.57%), 5.60% (CI: 9.92% -23.66%) respectively. Conclusions An observed reduction in surgical rates was reduced at five years with post-operative Crohn’s disease with biologics. Biologics therapy thus can be considered as a suitable alternative for reducing post-operative recurrence in individuals with higher risk.

Bowel Wall Thickness at Abdominal Ultrasound and the One-Year-Risk of Surgery in Patients with Crohn's Disease

2004 ◽  
Vol 99 (10) ◽  
pp. 1977-1983 ◽  
Author(s):  
Fabiana Castiglione ◽  
Ilario de Sio ◽  
Antonio Cozzolino ◽  
Antonio Rispo ◽  
Francesco Manguso ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Wall Thickness ◽  
Bowel Wall ◽  
Abdominal Ultrasound ◽  
Bowel Wall Thickness ◽  
One Year ◽  
The One

scholarly journals A Time-Based Meta-Analysis on the Incidence of New Onset Diabetes after Liver Transplantation

2021 ◽  
Vol 10 (5) ◽  
pp. 1045
Author(s):  
Yip Han Chin ◽  
Hon Qin Marcus Tan ◽  
Cheng Han Ng ◽  
Darren Jun Hao Tan ◽  
Snow Yunni Lin ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Meta Analysis ◽  
Summary Statistics ◽  
Important Complication ◽  
Onset Diabetes ◽  
One Year ◽  
New Onset

NODAT (new-onset diabetes after transplantation) is an important complication after liver transplant, however, there is variation in the reported incidence of NODAT. Therefore, a meta-analysis was performed to estimate the incidence of NODAT in liver transplant. Electronic databases were searched for articles regarding NODAT incidence after liver transplantation. Incidence of NODAT were analyzed at six different timepoints. Summary statistics were calculated using a generalized linear mixed model in random effects. 28 articles were included and out of a pooled population of 71,257 patients, overall incidence of NODAT was found to be 15.51%, 16.09%, 18.30%, 20.86%, 18.08%, 25.05% for three-months, six-months, one-year, three-year, five-year, and ten-year timepoints respectively. After a sensitivity analysis which only included articles with clear definitions of NODAT, the incidence of NODAT was found to be higher at three-year (21.79%), five-year (25.82%), and ten-year (44.95%) timepoints. Subgroup analysis according to ethnicity found no significant differences for all timepoints. However, studies with predominantly Asian participants generally had a higher incidence of NODAT. In conclusion, this meta-analysis provides a pooled estimate of the incidence of NODAT following liver transplantation. Further studies are required to provide a more comprehensive understanding on how ethnicity can affect the incidence of NODAT.

scholarly journals Effect of Adalimumab on Work Productivity and Indirect Costs in Moderate to Severe Crohn’s Disease: A Meta-Analysis

2011 ◽  
Vol 25 (9) ◽  
pp. 492-496 ◽  
Author(s):  
David G Binion ◽  
Edouard Louis ◽  
Bas Oldenburg ◽  
Parvez Mulani ◽  
Arielle G Bensimon ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Indirect Cost ◽  
Meta Analysis ◽  
Work Productivity ◽  
Cost Savings ◽  
Indirect Costs ◽  
Activity Impairment ◽  
One Year

OBJECTIVE: To assess the effect of adalimumab on work productivity and indirect costs in patients with Crohn’s disease (CD) using a meta-analysis of clinical trials.METHODS: Study-level results were pooled from all clinical trials of adalimumab for moderate to severe CD in which work productivity outcomes were evaluated. Work Productivity and Activity Impairment Questionnaire outcomes (absenteeism, presenteeism and total work productivity impairment [TWPI]) were extracted from adalimumab trials. Meta-analyses were used to estimate pooled averages and 95% CIs of one-year accumulated reductions in work productivity impairment with adalimumab. Pooled averages were multiplied by the 2008 United States national average annual salary ($44,101) to estimate per-patient indirect cost savings during the year following adalimumab initiation.RESULTS: The four included trials (ACCESS, CARE, CHOICE and EXTEND) represented a total of 1202 employed adalimumab-treated patients at baseline. Each study followed patients for a minimum of 20 weeks. Pooled estimates (95% CIs) of one-year accumulated work productivity improvements were as follows: −9% (−10% to −7%) for absenteeism; −22% (−26% to −18%) for presenteeism; and −25% (−30% to −20%) for TWPI. Reductions in absenteeism and TWPI translated into per-patient indirect cost savings (95% CI) of $3,856 ($3,183 to $4,529) and $10,964 ($8,833 to $13,096), respectively.CONCLUSION: Adalimumab provided clinically meaningful improvements in work productivity among patients with moderate to severe CD, which may translate into substantial indirect cost savings from an employer’s perspective.

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 P276 Risk matrix model for prediction of one-year surgery in Crohn’s disease

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S240-S241
Author(s):  
N Imperatore ◽  
A Rispo ◽  
A Testa ◽  
L Bucci ◽  
G Luglio ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Matrix Model ◽  
Risk Matrix ◽  
One Year

scholarly journals Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Peng Yuan ◽  
Peng Chen ◽  
Yeben Qian
Keyword(s):  
Hepatocellular Carcinoma ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Curative Therapy ◽  
B Virus ◽  
Effect Of Treatment ◽  
Long Term Prognosis ◽  
One Year ◽  
The One ◽  
The Impact

Background.The long-term prognosis after curative therapy for hepatitis B virus- (HBV-) related hepatocellular carcinoma (HCC) remains unsatisfactory due to the high incidence of recurrence. The effect of treatment with nucleotide analogues (NAs) in patients with HBV-related HCC after curative therapy remains unclear.Objective.To assess the impact of using NAs after curative therapy.Method.A computerized literature search was performed; eligible studies were identified from databases. The pooled risk ratios (RRs) and 95% CIs were calculated using Review Manager 5.3.Result.The meta-analysis included a total of 15 studies with 8060 patients. The one-year and three-year recurrence (one-year recurrence: RR 0.41 [95% CI 0.28 to 0.61];P<0.00001; three-year recurrence: RR 0.63 [95% CI 0.43 to 0.94];P=0.001) and the one-, three-, and five-year overall survival (OS) and disease-free survival (DFS) were significantly better in the treatment group.Conclusion.NAs can reduce the recurrence and improve the prognosis of HBV-related HCC after curative therapy.

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