Abstract | OBJECTIVE: SEARCH STRATEGY: Studies were selected using the MEDLINE data base (1966-December 1997), abstracts from major gastrointestinal meetings, and references from published articles and reviews. SELECTION CRITERIA: Four randomized controlled trials of medical therapy in adult patients with pouchitis were identified: two placebo controlled trials in active chronic pouchitis; one maintenance of remission trial comparing two active agents in chronic pouchitis; and one placebo-controlled maintenance of remission trial for chronic pouchitis. A single patient "n-of-1" trial for active chronic pouchitis was excluded. DATA COLLECTION AND ANALYSIS: Data were extracted by three independent observers based on the intention to treat principle. Extracted data were converted to 2 x 2 tables (response versus no response and medical therapy versus placebo or medical therapy versus medical therapy) and an odds ratio with 95% confidence intervals (CI) were determined as described by Cochrane and Mantel and Haenszel. In addition, the absolute risk reduction, relative risk reduction, and number needed to treat were determined. MAIN RESULTS: The odds ratios of inducing a response using oral metronidazole or bismuth carbomer foam enemas compared with placebo in active chronic pouchitis were 12.34 (95% CI 2.34-64.95) and 1.00 (95% CI 0.29-3.42), respectively. The odds ratio of maintaining remission in chronic pouchitis for oral probiotic bacteria (VSL-3) compared with placebo was 15.33 (95% CI 4.51-52.14). There was no difference in the odds ratio of inducing symptomatic remission and then maintaining symptomatic remission after discontinuing suppressive medical therapy for chronic pouchitis with glutamine suppositories compared with butyrate suppositories, 2.75 (95% CI 0.48-15.94). CONCLUSIONS:
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Authors | W J Sandborn, R McLeod, D P Jewell |
Journal | Inflammatory bowel diseases
(Inflamm Bowel Dis)
Vol. 5
Issue 1
Pg. 33-9
(Feb 1999)
ISSN: 1078-0998 [Print] England |
PMID | 10028447
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
- Anti-Bacterial Agents
- Gastrointestinal Agents
- Suppositories
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Topics |
- Adult
- Anti-Bacterial Agents
(administration & dosage)
- Confidence Intervals
- Enema
- Female
- Gastrointestinal Agents
(therapeutic use)
- Humans
- Long-Term Care
- Male
- Odds Ratio
- Pouchitis
(drug therapy)
- Prognosis
- Randomized Controlled Trials as Topic
- Recurrence
- Remission Induction
- Suppositories
- Treatment Outcome
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