scholarly journals Trends in Inflammatory Bowel Disease Therapy: A Meta-Analytic Approach

1995 ◽  
Vol 9 (7) ◽  
pp. 405-411 ◽  
Author(s):  
Gregory W Whiting ◽  
Joseph Lau ◽  
Bruce Kupelnick ◽  
Thomas C Chalmers
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Analytic Approach ◽  
Disease Therapy ◽  
The Matrix ◽  
Inflammatory Bowel ◽  
Acute Attacks ◽  
New Treatments

OBJECTIVE: To illustrate the current meta-analytic approach to extracting clinically useful information from the glut of randomized controlled trials (RCTs) of the treatment of acute attacks of Crohn's disease.PROCEDURE: Acceptable RCTs were classified in a matrical format so that the feasibility of a meta-analysis of each treatment could be quickly determined. Each potential inclusion was then photocopied after blinding the source and outcome to minimize bias by the investigators.RESULTS AND CONCLUSIONS: The search was started in 1990, when a previous meta-analysis was completed. Over 100 citations in MEDLINE contained 21 RCTs of the treatment of acute attacks of Crohn's disease, and 11 more were culled from the references of recent papers. The meta-analysis most indicated by the matrix was a comparison of several different immunosuppressive regimens with a placebo. The previously demonstrated statistical significance was confirmed and the point made that it is no longer justified to compare any new treatments with a placebo. Cumulative meta-analysis, the process of performing a new analysis every time a new trial is published, revealed the importance of employing both random and fixed effect models when heterogeneity of treatment results is appreciable, as in this case.

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.

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

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2865 ◽  
Author(s):  
Jose M. Comeche ◽  
Iris Comino ◽  
Cesare Altavilla ◽  
Jose Tuells ◽  
Ana Gutierrez-Hervas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Parenteral Nutrition ◽  
Bowel Disease ◽  
Activity Index ◽  
Meta Analysis ◽  
Inflammatory Bowel ◽  
Meta Regression

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and characterized by the inflammation of the gastrointestinal tract. This study is to understand how the use of parenteral nutrition (PN) can affect the adult population diagnosed with IBD. We conducted a systematic review, meta-analysis, and meta-regression. From the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, WOS), we found 119 registers with an accuracy of 16% (19 registers). After a full-text review, only 15 research studies were selected for qualitative synthesis and 10 for meta-analysis and meta-regression. The variables used were Crohn’s Disease Activity Index (CDAI), albumin, body weight (BW), and postoperative complications (COM). PN has shown to have efficacy for the treatment of IBD and is compatible with other medicines. The CDAI and albumin improve, although the effect of PN is greater after a while. However, the effect on the albumin could be less than the observed value in the meta-analysis due to possible publication bias. The BW does not change after intervention. COM utilizing PN has been observed, although the proportion is low. More studies specifically referring to ulcerative colitis (UC) and Crohn’s disease (CD) are needed to develop more concrete clinical results.

scholarly journals The association between inflammatory potential of diet and disease activity: results from a cross-sectional study in patients with inflammatory bowel disease

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Carlijn R. Lamers ◽  
Nicole M. de Roos ◽  
Ben J. M. Witteman
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Activity Index ◽  
Statistical Significance ◽  
Inflammatory Bowel ◽  
Anti Inflammatory

Abstract Background Diet may play a role in disease status in patients with inflammatory bowel disease. We tested whether the inflammatory potential of diet, based on a summation of pro- and anti-inflammatory nutrients, is associated with disease activity in patients with Crohn’s disease and ulcerative colitis. Methods Participants completed a disease activity questionnaire (short Crohn’s Disease Activity (sCDAI) or Patient Simple Clinical Colitis Activity Index (P-SCCAI)) and a Food Frequency Questionnaire (FFQ). FFQ data were used to calculate the Dietary Inflammatory Index (DII) which enables categorization of individuals’ diets according to their inflammatory potential on a continuum from pro- to anti-inflammatory. Associations with disease activity were investigated by multiple linear regression. Results The analysis included 329 participants; 168 with Crohn’s disease (median sCDAI score 93 [IQR 47–156]), and 161 with ulcerative colitis (median P-SCCAI score 1 [IQR 1–3]). Mean DII was 0.71 ± 1.33, suggesting a slightly pro-inflammatory diet. In Crohn’s disease, the DII was positively associated with disease activity, even after adjustment for confounders (p = 0.008). The mean DII was significantly different between participants in remission and with mild and moderately active disease (0.64, 0.97 and 1.52 respectively, p = 0.027). In ulcerative colitis, the association was not significant. Conclusions Disease activity was higher in IBD participants with a more pro-inflammatory diet with statistical significance in Crohn’s disease. Although the direction of causality is not clear, this association strengthens the role for diet in medical treatment, which should be tested in an intervention study.

scholarly journals Glutathione S-Transferase T1 Null Genotype is Associated with Susceptibility to Inflammatory Bowel Disease

2017 ◽  
Vol 41 (6) ◽  
pp. 2545-2552 ◽  
Author(s):  
Jun Qian ◽  
Zhangfa Song ◽  
Yinxiang Lv ◽  
Xuefeng Huang ◽  
Binliang Mao
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Glutathione S Transferase ◽  
Gstt1 Null Genotype ◽  
Inflammatory Bowel ◽  
Increased Susceptibility

Background: The published literature contains conflicting results regarding the impact of the glutathione S-transferase T1 (GSTT1) null genotype on the susceptibility to inflammatory bowel disease. Therefore, we conducted a meta-analysis of observational studies to assess the association. Methods: We searched four online databases for eligible studies. The odds ratio (OR) with 95% CI was used to assess the gene-disease association. We also performed subgroup analyses by type of inflammatory bowel disease and ethnicity. Results: There were 16 individual studies from 11 publications included in the analysis. There were 3366 cases with inflammatory bowel disease and 6013 controls. The meta-analysis of all 16 studies showed the GSTT1 null genotype was associated with increased susceptibility to inflammatory bowel disease (OR = 1.98, 95%CI 1.39-2.84, P < 0.001). The subgroup analysis by ethnicity further identified an association between the GSTT1 null genotype and inflammatory bowel disease in Caucasians, Asians, and Africans. The GSTT1 null genotype was associated with both ulcerative colitis (OR = 1.96, P = 0.004) and Crohn’s disease (OR = 2.01, P = 0.022). The GSTT1 null genotype was still significantly associated with ulcerative colitis (OR = 1.63, P < 0.0001) and Crohn’s disease (OR = 1.40, P = 0.023) after adjusting for study heterogeneity. Conclusion: The GSTT1 null genotype is significantly associated with an increased susceptibility to inflammatory bowel disease and is a risk factor for both ulcerative colitis and Crohn’s disease.

scholarly journals HLA-DR and -DQ phenotypes in inflammatory bowel disease: a meta-analysis

Gut ◽  
1999 ◽  
Vol 45 (3) ◽  
pp. 395-401 ◽  
Author(s):  
P C F Stokkers ◽  
P H Reitsma ◽  
G N J Tytgat ◽  
S J H van Deventer
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Meta Analysis ◽  
Class Ii ◽  
Hla Class Ii ◽  
Negative Association ◽  
Hla Dr ◽  
Inflammatory Bowel

BACKGROUNDSusceptibility to inflammatory bowel disease (IBD) is partially genetically determined and the HLA class II genes are candidates for a role in genetic susceptibility to IBD, because their products play a central role in the immune response. Multiple studies have reported associations between HLA-DR or -DQ phenotypes and either ulcerative colitis or Crohn’s disease, but much of the data are still controversial.AIMSTo estimate overall associations between HLA class II phenotypes and IBD, and to establish the relative risk conferred by HLA-DR and -DQ phenotypes by meta-analysis.METHODSMedline was searched for publications reporting on the relation between IBD and HLA class II phenotypes. Raw data were extracted by recalculating the number of phenotypes or the number of alleles of the main antigens. Odds ratios and confidence intervals were calculated according to the Mantel-Haenszel method.RESULTSDR2, DR9, and DRB1*0103 were positively associated with ulcerative colitis, and a negative association was found for DR4 and ulcerative colitis. For Crohn’s disease a positive association was found with DR7, DRB3*0301, and DQ4 and a negative association with DR2 and DR3.CONCLUSIONSBoth ulcerative colitis and Crohn’s disease are associated with specific HLA class II phenotypes. Further analysis of these phenotypes and subgroup analysis may elucidate how these alleles contribute to susceptibility to IBD.

scholarly journals Predefined Diets in Patients with Inflammatory Bowel Disease: Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 52
Author(s):  
José M. M. Comeche ◽  
Ana Gutierrez-Hervás ◽  
José Tuells ◽  
Cesare Altavilla ◽  
Pablo Caballero
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Activity Index ◽  
Meta Analysis ◽  
Adult Population ◽  
Qualitative Synthesis ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD) is a chronic disease mediated by the immune system and characterized by the importance of diet in pathological development. This study aims to understand how the use of predefined diets can affect the adult population diagnosed with IBD. We conducted a systematic review and meta-analysis. From the different databases (MEDLINE, Scopus, Cochrane, LILACS, CINAHL, and WOS), we found 4195 registers. After a review process, only 31 research studies were selected for qualitative synthesis and 10 were selected for meta-analysis. The variables used were Crohn’s Disease Activity Index (CDAI) for patients with Crohn’s Disease (CD) and fecal calprotectin (FC), C-Reactive Protein (CRP), and albumin (ALB) for patients with IBD. Predefined diets have been shown to have partial efficacy for the treatment of IBD and are compatible with other medical treatments. CDAI improved but with reasonable doubts due to the high heterogeneity of the data, while no differences were observed for ALB, FC, and CRP. More studies that evaluate the influence of predefined diets on IBD patients are needed due to the great variability in diets and the tools used to measure their effects.

scholarly journals Replication and Meta-Analysis of 13,000 Cases Defines the Risk for Interleukin-23 Receptor and Autophagy-Related 16-Like 1 Variants in Crohn’s Disease

2010 ◽  
Vol 24 (5) ◽  
pp. 297-302 ◽  
Author(s):  
Lynn Cotterill ◽  
Debbie Payne ◽  
Scott Levison ◽  
John McLaughlin ◽  
Emma Wesley ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Meta Analysis ◽  
European Ancestry ◽  
Published Data ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Interleukin 23

BACKGROUND/OBJECTIVE: Variants in the interleukin-23 receptor (IL23R) and the autophagy-related 16-like 1 (ATG16L1) genes have been associated with an increased risk of Crohn’s disease (CD). Both genes were identified through genome-wide association scans and subsequent studies have validated these associations. To assess the effect size of these variants, an independent case-control association study and meta-analysis were performed.METHODS: British Caucasian subjects with inflammatory bowel disease (n=500) and 877 ethnically matched controls were genotyped for the disease-associated variants inIL23RandATG16L1. In addition, meta-analyses of 12,991 patients and 14,598 controls, and 11,909 patients and 15,798 controls, were conducted on independently published data for the associations betweenIL23RandATG16L1variants and CD, respectively.RESULTS: In the present cohort, both susceptibility variants showed highly significant associations, includingIL23R(rs11209026, P=0.0006; OR 0.37; 95% CI 0.21 to 0.67) andATG16L1(rs2241880, P=0.0017; OR 1.36; 95% CI 1.12 to 1.66). The meta-analysis based on the random effects model showed similar combined effects for rs11209026 (n=26, OR 0.41; 95% CI 0.37 to 0.46) and rs2241880 (n=25, OR 1.33; 95% CI 1.28 to 1.39). There was no statistically significant gene-gene interaction between caspase recruitment domain (CARD15) variants and theIL23RorATG16L1polymorphisms (P=0.44 and P=0.24, respectively).CONCLUSION: The present cohort and meta-analysis provides strong evidence that, in addition toCARD15, polymorphisms in bothIL23RandATG16L1alter susceptibility to CD and that these effects are consistent across all populations of European ancestry; however, onlyATG16L1is relevant to inflammatory bowel disease in the Asian population.

scholarly journals Probiotics as a Coadjuvant Factor in Active or Quiescent Inflammatory Bowel Disease of Adults—A Meta-Analytical Study

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2628
Author(s):  
Manuel Pabón-Carrasco ◽  
Lucia Ramirez-Baena ◽  
Samuel Vilar-Palomo ◽  
Aurora Castro-Méndez ◽  
Raúl Martos-García ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Relative Risk ◽  
Crohn's Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Unknown Etiology ◽  
Human Beings ◽  
Inflammatory Bowel

(1) Background: Inflammatory bowel diseases are pathologies of unknown etiology and auto-immune pathogenia. The use of probiotics is studied in order to increase the arsenal of treatments. The aim was to assess the efficacy of the probiotics in these diseases in the active or quiescent phases; (2) Methods: A systematic review with meta-analysis was performed by an exhaustive bibliographic search in Medline, Cinahl, Embase, Scopus, Web of Science, and Cochrane Library. The inclusion criteria were studies of more than 10 years, English/Spanish, clinical trials, and involving human beings. Relative risk was used to compare efficacy, which was meta-analyzed using a fixed effects model. Heterogeneity was evaluated with the Higgins I2 test; (3) Results: Nineteen studies were included in the systematic review and 17 in the meta-analysis, with a total of 1537 patients (nexperimental group = 762; nplacebo group = 775). There are significant remission differences in ulcerative colitis (relative risk (RR) = 0.81; 95% CI = 0.72–0.91; I2 = 32%; p = 0.16). However, no significant differences were found in the use of probiotics for the prevention of ulcerative colitis, and for the remission of Crohn’s disease; (4) Conclusions: There are data showing an additional beneficial effect of probiotics on active ulcerative colitis. More and better studies are needed which assess its possible therapeutic efficacy for quiescent ulcerative colitis and for Crohn’s disease.

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