Remission endpoints in ulcerative colitis: A systematic review

Jitsumura, Maki; Kokelaar, Rory; Harris, Dean

doi:10.13105/wjma.v5.i4.85

Cited by 5 publications

(5 citation statements)

References 79 publications

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“…The specific influence of isoflavones that was stated for pus, with the opposite effect for mucus, may result from the role, visibility and frequency of pus and mucus in individuals with ulcerative colitis. Generally, pus is indicated as one of the descriptors of exacerbation [42], and its presence in the intestine is indicated as one of the determinants of the status of mucosa [43], and may allow the diagnosis of endoscopic exacerbation. Moreover, the presence of pus may be associated with active inflammation [44].…”

Section: Discussionmentioning

confidence: 99%

Association between Dietary Isoflavone Intake and Ulcerative Colitis Symptoms in Polish Caucasian Individuals

et al. 2019

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Currently there are contradictory observations regarding the associations between the isoflavone intake and inflammatory bowel disease in terms of its prevention and treatment, and this may be attributed to the diversity of applied doses and influence of various isoflavones. The aim of the presented cross-sectional study is to analyze the association between intake of various isoflavones (daidzein, genistein, glicytein and total isoflavones) and ulcerative colitis symptoms (fecal blood, mucus and pus) in Polish Caucasian individuals in confirmed remission. Assessment of diet was based on self-reported data obtained from patients’ three-day dietary records and their individual assessments of symptoms. A total of 56 Caucasian patients with ulcerative colitis in confirmed remission were recruited for the study (37 females and 19 males, aged 18–80). For individuals with no fecal mucus observed, higher daidzein (p = 0.035, 122 vs. 19 µg) and total isoflavone intakes (p = 0.034, 302.2 vs. 123.7 µg) were observed in comparison with individuals not declaring this symptom, while for daidzein it was confirmed for the component density of their diets. The opposite association was stated for fecal pus, as for individuals with a lack of this symptom, lower daidzein intake was stated in comparison with individuals declaring this symptom (p = 0.049, 103.3 vs. 206.7 µg), but it was not confirmed for the component density of the diets. It was stated that the high intake of isoflavones by Caucasian individuals, as in a western diet, may influence the symptoms of ulcerative colitis, with the strongest influence by daidzein. Taking this into account, isoflavones may be included into the diets of ulcerative colitis patients in remission if well-tolerated, but there is a need for further study.

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Section: Discussionmentioning

confidence: 99%

Association between Dietary Isoflavone Intake and Ulcerative Colitis Symptoms in Polish Caucasian Individuals

et al. 2019

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“…Moderate or high PGA scores were negatively associated with prescribing probiotics to patients with UC. PGA is an important component in evaluating disease activity, such as the UC disease activity index, and correlates well with disease activity [ 23 ]. Physicians may prescribe probiotics to patients with UC to relieve gastrointestinal symptoms, such as abdominal pain, hematochezia, or increased stool frequency, but not to control disease activity.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study

Kim¹,

Cheon²

2023

J Yeungnam Med Sci

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Background: Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD.Methods: This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups. Results: In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics.Conclusion: Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.

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“…In addition, a systematic review containing 153 trials, of which 116 used the UCDAI scale, evaluated the definition and evidence for remission endpoints in UC from the point of view of two particular scales (UCEIS and UCDAI), and recommended that an international consensus of remission should be sought as a matter of urgency before establishing a gold standard for outcome measurement. This would lead towards standardization of clinical trial protocols and advance in patient care [ 74 ]. Thus, presently, it is difficult to determine the best possible outcomes due to a lack of homogeneity of the clinical trial protocols.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Probiotics, Prebiotic Inulin-Type Fructans, and Synbiotics in Human Ulcerative Colitis: A Systematic Review and Meta-Analysis

et al. 2019

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Studies of probiotics, fructan-type prebiotics, and synbiotics in patients with ulcerative colitis (UC) show significant heterogeneity in methodology and results. Here, we study the efficacy of such interventions and the reasons for the heterogeneity of their results. Eligible random controlled trials were collected from the PUBMED and SCOPUS databases. A total of 18 placebo-controlled and active treatment-controlled (i.e., mesalazine) studies were selected with a Jadad score ≥ 3, including 1491 patients with UC. Data for prebiotics and synbiotics were sparse and consequently these studies were excluded from the meta-analysis. The UC remission efficacy of probiotics was measured in terms of relative risk (RR) and odds ratio (OR). Significant effects were observed in patients with active UC whenever probiotics containing bifidobacteria were used, or when adopting the US Food and Drug Administration (FDA)-recommended scales (UC Disease Activity Index and Disease Activity Index). By the FDA recommended scales, the RR was 1.55 (CI95%: 1.13–2.15, p-value = 0.007, I2 = 29%); for bifidobacteria-containing probiotics, the RR was 1.73 (CI95%: 1.23–2.43, p-value = 0.002, I2 = 35%). No significant effects were observed on the maintenance of remission for placebo-controlled or mesalazine-controlled studies. We conclude that a validated scale is necessary to determine the state of patients with UC. However, probiotics containing bifidobacteria are promising for the treatment of active UC.

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Remission endpoints in ulcerative colitis: A systematic review

Cited by 5 publications

References 79 publications

Association between Dietary Isoflavone Intake and Ulcerative Colitis Symptoms in Polish Caucasian Individuals

Association between Dietary Isoflavone Intake and Ulcerative Colitis Symptoms in Polish Caucasian Individuals

Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study

The Efficacy of Probiotics, Prebiotic Inulin-Type Fructans, and Synbiotics in Human Ulcerative Colitis: A Systematic Review and Meta-Analysis

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