Meta-Analysis of the Effectiveness of Current Drug Therapy of Ulcerative Colitis

Background and aims: Hyperbaric oxygenation therapy has been used in the treatment of ulcerative colitis in the past few years. However, its efficacy still remains unclear. The aim of the study was to investigate the efficacy of hyperbaric oxygen combination therapy in patients with ulcerative colitis. Methods: We conducted a comprehensive study search up to September 2020, from the online databases Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, WanFang and VIP. Results: Thirteen studies comprising 780 patients were included. We found that compared with conventional therapy, hyperbaric oxygen combination therapy was superior in reaching clinical remission [risk ratio (RR)=1.62; 95% confidence interval (CI) 1.42 to 1.84; p < 0.001] and clinical response (RR=1.29; 95% CI 1.21 to 1.38; p < 0.001), with lower disease activity scores [standard mean difference (SMD)= −1.19; 95%CI −1.74 to −0.65; p < 0.001]. An obvious reduction of serum levels of tumor necrosis factor-α (SMD= −1.96; 95%CI −2.50 to −1.41; p < 0.001) and interleukin (IL)-6 (SMD= −2.49; 95% CI −2.84 to −2.15; p < 0.001), and elevation of IL-10 level (SMD=2.40; 95% CI 0.68 to 4.12; p = 0.006) were also observed. Conclusion: Hyperbaric oxygen combination therapy was effective in patients with ulcerative colitis, and has potential as a complementary method for its treatment.

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Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review

Journal of Clinical Medicine ◽

10.3390/jcm10040710 ◽

2021 ◽

Vol 10 (4) ◽

pp. 710

Author(s):

Abel Botelho Quaresma ◽

Fernanda da Silva Barbosa Baraúna ◽

Fábio Vieira Teixeira ◽

Rogério Saad-Hossne ◽

Paulo Gustavo Kotze

Keyword(s):

Ulcerative Colitis ◽

Postoperative Complications ◽

Meta Analysis ◽

Qualitative Evaluation ◽

Complication Rates ◽

Surgical Morbidity ◽

Randomized Studies ◽

Pubmed Database ◽

Increased Risk ◽

The Impact

Background: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications in ulcerative colitis (UC) patients still remains controversial. Aims: We aimed to analyze the literature, searching for studies that correlated postoperative complications and preoperative exposure to biologics in UC patients, and synthesize these data qualitatively in order to check the possible impact of biologics on postoperative surgical morbidity in this population. Methods: Included studies were identified by electronic search in the PUBMED database according to the PRISMA (Preferred Items of Reports for Systematic Reviews and Meta-Analysis) guidelines. The quality and bias assessments were performed by MINORS (methodological index for non-randomized studies) criteria for non-randomized studies. Results: 608 studies were initially identified, 22 of which were selected for qualitative evaluation. From those, 19 studies (17 retrospective and two prospective) included preoperative anti-TNF. Seven described an increased risk of postoperative complications, and 12 showed no significant increase postoperative morbidity. Only three studies included surgical UC patients with previous use of vedolizumab, two retrospective and one prospective, all with no significant correlation between the drug and an increase in postoperative complication rates. Conclusions: Despite conflicting results, most studies have not shown increased complication rates after abdominal surgical procedures in patients with UC with preoperative exposure to biologics. Further prospective studies are needed to better establish the impact of preoperative biologics and surgical complications in UC.

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META-ANALYSIS OF CATHETER ABLATION COMPARED WITH DRUG THERAPY AS A FIRST LINE TREATMENT STRATEGY OF PAROXYSMAL ATRIAL FIBRILLATION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)01669-7 ◽

2021 ◽

Vol 77 (18) ◽

pp. 310

Author(s):

Ahmad Al-Abdouh ◽

Ashish Kumar ◽

Harshvardhan Zala ◽

Mahmoud Barbarawi ◽

Waiel Abusnina ◽

...

Keyword(s):

Atrial Fibrillation ◽

Drug Therapy ◽

Catheter Ablation ◽

Paroxysmal Atrial Fibrillation ◽

Treatment Strategy ◽

Meta Analysis ◽

Line Treatment ◽

First Line ◽

First Line Treatment

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Integrating efficacy and safety of vedolizumab compared with other advanced therapies to assess net clinical benefit of ulcerative colitis treatments: a network meta-analysis

Expert Review of Gastroenterology & Hepatology ◽

10.1080/17474124.2021.1880319 ◽

2021 ◽

Author(s):

Vipul Jairath ◽

Keith Chan ◽

Karen Lasch ◽

Sam Keeping ◽

Christian Agboton ◽

...

Keyword(s):

Ulcerative Colitis ◽

Clinical Benefit ◽

Meta Analysis ◽

Efficacy And Safety ◽

Advanced Therapies ◽

Net Clinical Benefit

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Recent Advances in Nanoparticle-Mediated Treatment of Inflammatory Bowel Diseases

Applied Sciences ◽

10.3390/app11010438 ◽

2021 ◽

Vol 11 (1) ◽

pp. 438

Author(s):

Andreea Nedelcu ◽

Ofelia Mosteanu ◽

Teodora Pop ◽

Teodora Mocan ◽

Lucian Mocan

Keyword(s):

Ulcerative Colitis ◽

Drug Delivery ◽

Inflammatory Bowel Disease ◽

Drug Therapy ◽

Immune Responses ◽

Biomedical Engineering ◽

Target Therapy ◽

Incidence Rates ◽

Bowel Diseases ◽

Inflammatory Bowel

There have been continuous advances in nanoscience since the beginning of the 21st century, and the emerging field of computational nanomedicine, the development of nanomaterial-based sensors or the prominent biomedical engineering applications should be mentioned. Intestinal disorders causing prolonged inflammation of the digestive tract, largely known as inflammatory bowel disease (IBD), include Crohn’s disease (CD) and ulcerative colitis (UC), have seen a significant increase in incidence rates. Nanoparticle-based approaches to locally target therapy could help regulate immune responses and act as an anti-inflammatory in individual patients diagnosed with IBD. The results of the paper emphasize the major role that nanoparticle-mediated drug delivery has in IBD treatment, giving IBD patients in remission the chance for a more effective drug therapy with a decreased medication load.

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19 Colectomy Rate for Moderate to Severe Ulcerative Colitis with Biologics

British Journal of Surgery ◽

10.1093/bjs/znab134.188 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

J W H Koh ◽

C H Ng ◽

M H Lee ◽

Y H Chin ◽

Z H Ong ◽

...

Keyword(s):

Ulcerative Colitis ◽

Current Literature ◽

Biologic Therapy ◽

Meta Analysis ◽

Severe Ulcerative Colitis ◽

Before And After ◽

Arcsine Transformation ◽

One Year

Abstract Introduction Biologics are recommended by both the ACG and ECCO community for the treatment of ulcerative colitis. Yet, current literature has yet to estimate the rate of colectomies after biologic therapy, and thus a pooled meta-analysis was conducted the rate of colectomies in 1month, 6 months, 1 year, 2years and five years after biologics. Method Medline and Embase were searched for articles examining biologics use in moderate to severe UC or acute severe UC (ASUC) from inception to 21st May 2020. Analysis of proportions were undertaken after a freeman-tukey double arcsine transformation. Results The pooled overall colectomy rates of ASUC and moderate to severe UC were 9% (CI: 4% - 14%) at one month, 18% (CI: 13% - 25%) at six months, 21% (CI:16% - 27%) at one year, 29% (CI:24% - 34%) at two years and 38% (CI:30% - 45%) at five years. Additionally, colectomy rates were consistently lower comparing between articles before and after 2010. At one-year, overall colectomy rate following infliximab use was at 25%, golimumab at 15%, vedolizumab at 14%, and adalimumab at 3%. Conclusions Colectomy rates in the era of biologics ranged from 8% to 38% and lower post-2010 showing significant improvement in management and supporting the utility of biologics in Ulcerative colitis management.

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