P226 Systematic review with meta-analysis of individual data: impact of cut-off values on the performance of faecal calprotectin to detect endoscopic recurrence after intestinal resection in patients with Crohn’s disease

Objective. To assess the benefits of different treatments that aim to prevent the endoscopic recurrence of Crohn’s disease (CD) after ileal resection. Methods. Randomized controlled trials (RCTs) were searched from MEDLINE, Embase, and the Cochrane Central Database. All the included RCTs with an endoscopic recurrence outcome which was defined as Rutgeerts’ score ≥ i2 have a duration of more than 1 year. The quality of the included RCTs was assessed by the Cochrane Risk of Bias Tool. Pairwise treatment effects were estimated through a Bayesian random effects network meta-analysis by using the OpenBUGS 1.4 software and reported as odds ratios (ORs) with a 95% credible interval (CI). Results. Fourteen RCTs (877 participants) were included. Two strategies were superior to placebo for preventing endoscopic recurrence of CD at 1 year after surgery: infliximab (d, −5.475; 95% CI, −10.47 to –1.632) and adalimumab (d, −7.273; 95% CI, −13.84 to −2.585). Nine strategies were not effective: budesnoid, mesalazine (in both high and low dose), azathioprine, Tripterygium wilfordii, mesalazine + infliximab, ornidazole, untreated intervention, and Lactobacillus GG. Conclusions. Except for infliximab and adalimumab, other strategies included in our analysis were not effective for preventing endoscopic recurrence of CD at 1 year after ileal resection.

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P193 Faecal calprotectin differentially predicts postoperative endoscopic recurrence in Crohn's disease according to therapy. A prospective multicenter study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjx002.318 ◽

2017 ◽

Vol 11 (suppl_1) ◽

pp. S174-S175

Author(s):

C. Verdejo Gil ◽

A.J. Lucendo Villarin ◽

D. Hervías Cruz ◽

Ó. Roncero García-Escribano ◽

A. Bouhmidi ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Multicenter Study ◽

Prospective Multicenter Study ◽

Faecal Calprotectin ◽

Endoscopic Recurrence

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Methotrexate for the Treatment of Pediatric Crohn’s Disease: A Systematic Review and Meta-analysis

Inflammatory Bowel Diseases ◽

10.1093/ibd/izy078 ◽

2018 ◽

Vol 24 (10) ◽

pp. 2135-2141 ◽

Cited By ~ 5

Author(s):

Ruben J Colman ◽

Rachel C Lawton ◽

Marla C Dubinsky ◽

David T Rubin

Keyword(s):

Systematic Review ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Combination Therapy ◽

Treatment Efficacy ◽

Clinical Remission ◽

Meta Analysis ◽

Cochrane Library ◽

Free Text ◽

Pediatric Ibd

Abstract Background Methotrexate (MTX) is an immunomodulator used for the treatment of pediatric inflammatory bowel disease (IBD). There are currently no RCTs that assess the treatment efficacy of methotrexate within the pediatric IBD patient population. This systematic review and meta-analysis assesses the efficacy of MTX therapy among the existing pediatric literature. Methods A systematic literature search was performed using MEDLINE and the Cochrane library from inception until March 2016. Synonyms for ‘pediatric’, ‘methotrexate’ and ‘IBD’ were utilized as both free text and MESH search terms. The studies included contained clinical remission (CR) rates for MTX treatment of pediatric IBD patients 18 yrs old, as mono- or combination therapy. Case studies with <10 patients were excluded. Quality assessment was performed with the Newcastle-Ottawa Scale. Meta-analysis calculated pooled CR rates. A random-effects meta-analysis with forest plots was performed using R. Results Fourteen (11 monotherapy, 1 combination therapy, 2 both; n = 886 patients) observational studies were eligible out of 202 studies. No interventional studies were identified. The pooled achieved CR rate for pediatric CD patients on monotherapy within 3-6 months was 57.7% (95% CI 48.2-66.6%), (P =0.22; I2 = 29.8%). The CR was 37.1% (95% CI 29.5-45.5%), (P = 0.20; I2 = 37.4%) for maintenance therapy at 12 months. Sub-analysis could not identify CR differences between MTX administration types, thiopurine exposure. Conclusions This meta-analysis demonstrated that, over 50% of pediatric Crohn’s disease patients induced with methotrexate achieved clinical remission, while 12-month remission rate was only 37%. Prospective controlled interventional trials should assess treatment efficacy among patient subgroups.

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Efficacy of ustekinumab for active perianal fistulizing Crohn’s disease: a systematic review and meta-analysis of the current literature

Scandinavian Journal of Gastroenterology ◽

10.1080/00365521.2020.1854848 ◽

2020 ◽

Vol 56 (1) ◽

pp. 53-58

Author(s):

Mohamed Attauabi ◽

Johan Burisch ◽

Jakob Benedict Seidelin

Keyword(s):

Systematic Review ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Current Literature ◽

Meta Analysis

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

Nutrients ◽

10.3390/nu11112657 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2657 ◽

Cited By ~ 6

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.

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