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Oshitani, Nobuhide; Matsumoto, Takayuki; Jinno, Yoshio; Sawa, Yoshinori; Hara, Junichi; Nakamura, Shirô; Arakawa, Tetsuo; Kitano, Atsuo; Kuroki, Tetsuo

doi:10.1023/a:1005589428082

Cited by 27 publications

(6 citation statements)

References 18 publications

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“…Oshitani et al [4 ]indicate that while the clinical efficacy of pulse steroid therapy and conventional steroid therapy are equivalent, cases of more active UC react more quickly and without any side effects to pulse steroid therapy. The rate of remission in previous reports ranged from 45 to 80%, similar to the findings of our current study [4,5,11,12]. …”

Section: Discussionsupporting

confidence: 92%

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Efficacy and Safety of Pulse Steroid Therapy in Japanese Pediatric Patients with Ulcerative Colitis: A Survey of the Japanese Society for Pediatric Inflammatory Bowel Disease

Nagata

Shimizu²,

Kudo³

et al. 2010

Digestion

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Aims: We have evaluated the therapeutic efficacy and safety of pulse steroid therapy for ulcerative colitis (UC) in a Japanese pediatric population by means of a survey. Methods: A questionnaire on UC patients treated with therapy between 2002 and 2006 was sent to 37 members of the Japanese Society for Pediatric Inflammatory Bowel Disease. Results: 21 of 62 cases in 6 of 19 centers registered in this study had been treated with pulse steroid therapy. The success rate of remission induction with this treatment was 55%, and improvement was observed in all cases in which remission was not achieved. There were no reports of any obvious side effects. The most common reason for using pulse steroid therapy was for remission induction in relapsed cases. Over the course of 12 (or fewer) months, the number of cases in which remission was maintained was only 1 in 4. However, the amount of concomitant steroid use had significantly decreased after 1 year. Conclusions: This survey shows that in Japan, pulse steroid therapy is used for a relatively large number of children with UC and is as an effective method of remission induction that has few side effects.

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Section: Discussionsupporting

confidence: 92%

“…The previous studies have not offered sufficient evidence for clinicians to make a change to pulse therapy in their normal practice, but further controlled trials in pediatric UC patients are needed to make sure there are no severe side effects (e.g. femur head necrosis) before any conclusive determinations can be made [12]. …”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Pulse Steroid Therapy in Japanese Pediatric Patients with Ulcerative Colitis: A Survey of the Japanese Society for Pediatric Inflammatory Bowel Disease

Nagata

Shimizu²,

Kudo³

et al. 2010

Digestion

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“…Rates of remission, incomplete remission, and colectomy with an intensive steroid regimen for severe UC were 40–58%, 24–26%, and 18–34%, respectively, in other studies [ 65 , 75 , 76 ]. Those in our study were 76, 12, and 6%, respectively: higher remission and lower colectomy rates.…”

Section: Plant-based Diets For Ibdmentioning

confidence: 69%

Incorporation of Plant-Based Diet Surpasses Current Standards in Therapeutic Outcomes in Inflammatory Bowel Disease

Chiba

Morita²

2023

Metabolites

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There has been no study of the therapeutic effect of a plant-based diet (PBD) in inflammatory bowel disease (IBD) except for our studies in Japan. In this review, we describe the rationale for the requirement of PBD in IBD and the outcomes of our modality incorporating PBD together with a literature review. The biggest problem in current therapy for IBD is the lack of a widely appreciated ubiquitous environmental factor in IBD. Therefore, a radical strategy against IBD has not been established. Japanese data showed an increased incidence of IBD in association with dietary westernization. Current global consumption consists of an excess of unhealthy foods and a shortage of healthy foods recognized as pro-inflammatory. Patients with IBD are no exception. One of the recommended healthy reference diets is PBD recognized as anti-inflammatory. We assert that IBD occurs in susceptible individuals mainly as a result of our omnivorous (westernized) diet. Therefore, we developed and began to provide a PBD, a lacto-ovo-vegetarian diet, for IBD patients in 2003. Infliximab and PBD as first-line (IPF) therapy was administered for all patients with newly developed Crohn’s disease (CD) and for severe ulcerative colitis (UC). Our modality broke the barrier of primary nonresponders to biologics, with a remission rate of 96% in CD, and created a new relapse-free course in slightly over half of the patients (52%) with CD. Based on the rationale derived from available evidence and the clinical outcomes, PBD is highly recommended for IBD.

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“…In addition, there is a current consensus in the regulatory and academic environment that clinical studies in IBD need an imaging endpoint, such as mucosal healing, with or without histopathology[52]. In this systematic review, only two meta-analyses were retrieved that evaluated mucosal healing[23,26] and four individual studies[37-39,47,53], all for patients with UC. This paucity of available studies supports our claim that there is a lack of data assessing the effectiveness of conventional therapy for mucosal healing.…”

Section: Discussionmentioning

confidence: 99%

Conventional therapy for moderate to severe inflammatory bowel disease: A systematic literature review

Damião

Azevedo

Carlos

et al. 2019

WJG

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BACKGROUND Despite the advent of biological drugs, conventional therapy continues to be used in moderate to severe inflammatory bowel disease (MS-IBD). This study hypothesized that as a standard of treatment and the primary alternative to biologics, conventional therapy should present robust effectiveness results in IBD outcomes. AIM To investigate the effectiveness of conventional therapy for MS-IBD. METHODS A systematic review with no time limit was conducted in July 2017 through the Cochrane Collaboration, MEDLINE, and LILACS databases. The inclusion criteria encompassed meta-analyses, systematic reviews, randomized clinical trials, observational and case-control studies concerning conventional therapy in adult patients with MS-IBD, including Crohn’s disease (CD) and ulcerative colitis (UC). Corticosteroids (prednisone, hydrocortisone, budesonide, prednisolone, dexamethasone), 5-aminosalicylic acid (5-ASA) derivatives (mesalazine and sulfasalazine) and immunosuppressants [azathioprine (AZA), methotrexate (MTX), mycophenolate, cyclosporine, tacrolimus, 6-mercaptopurine (6-MP)] were considered conventional therapy. The exclusion criteria were sample size below 50; narrative reviews; specific subpopulations ( e.g ., pregnant women, comorbidities); studies on postoperative IBD; and languages other than English, Spanish, French or Portuguese. The primary outcome measures were clinical remission (induction or maintenance), clinical response and mucosal healing. As secondary outcomes, fecal calprotectin, hospitalization, death, and surgeries were analyzed. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS The search strategy identified 1995 citations, of which 27 were considered eligible (7 meta-analyses, 20 individual studies). For induction of clinical remission, four meta-analyses were selected (AZA and 6-MP showed no advantage over placebo, MTX or 5-ASA in CD; MTX showed no statistically significant difference versus placebo, 6-MP, or 5-ASA in UC; tacrolimus was superior to placebo for UC in two meta-analyses). Only one meta-analysis evaluated clinical remission maintenance, showing no statistically significant difference between MTX and placebo, 5-ASA, or 6-MP in UC. AZA and 6-MP had no advantage over placebo in induction of clinical response in CD. Three meta-analyses showed the superiority of tacrolimus vs placebo for induction of clinical response in UC. The clinical response rates for cyclosporine were 41.7% in randomized controlled trials (RCTs) and 55.4% in non-RCTs for UC. For induction of mucosal healing, one meta-analysis showed a favorable rate with tacrolimus versus placebo for UC. For secondary outcomes, no meta-analyses specifically evaluated fecal calprotectin, hospitalization or death. Two meta-analyses were retrieved evaluating colectomy rates for tacrolimu...

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Cited by 27 publications

References 18 publications

Efficacy and Safety of Pulse Steroid Therapy in Japanese Pediatric Patients with Ulcerative Colitis: A Survey of the Japanese Society for Pediatric Inflammatory Bowel Disease

Efficacy and Safety of Pulse Steroid Therapy in Japanese Pediatric Patients with Ulcerative Colitis: A Survey of the Japanese Society for Pediatric Inflammatory Bowel Disease

Incorporation of Plant-Based Diet Surpasses Current Standards in Therapeutic Outcomes in Inflammatory Bowel Disease

Conventional therapy for moderate to severe inflammatory bowel disease: A systematic literature review

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