Strategies for Preventing Endoscopic Recurrence of Crohn’s Disease 1 Year after Surgery: A Network Meta-Analysis

Feng, Jiexiong; Li, Jinyu; Chen, Xiu-Yan; Yang, Zuozhang; Shanghai, LI

doi:10.1155/2017/7896160

Cited by 10 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent studies suggest that submucosal lymphocytic plexitis in the proximal surgical margin is a predictor for endoscopic and clinical recurrence after ileocolonic resection, 32‐34 but more prospective research is necessary to verify this. We found that the prophylactic start of a maintenance treatment with anti‐TNF agents or thiopurines tended to decrease endoscopic recurrence after bowel resection, which is in line with a recent network meta‐analysis concluding that anti‐TNF drugs are superior to placebo or non‐biologic agents (budesonide, azathioprine or mesalazine) in preventing the endoscopic recurrence of CD, defined as Rutgeerts’ score of ≥i2, 1 year after ileal resection 35 . To date, there are not enough data on vedolizumab or ustekinumab in this context.…”

Section: Discussionsupporting

confidence: 88%

Conservative management of spontaneous intra‐abdominal abscess in Crohn's disease: Outcome and prognostic factors

Waked

Holvoet

Geldof

et al. 2021

J of Digest Diseases

View full text Add to dashboard Cite

Objective To compare the outcomes of different treatments for spontaneous intra‐abdominal abscesses (IAA) in active Crohn's disease (CD). Methods A retrospective analysis of patients with CD between January 2007 and December 2018 was performed in two Belgian inflammatory bowel disease centers. Successful conservative management was defined as complete resolution of abscesses without the need for bowel resection. The primary outcome was suboptimal evolution, defined as a composite outcome of recurrence of abscess, postoperative complications or the need for a non‐elective resection. Results Forty CD patients presenting with 43 independent episodes of spontaneous IAA development were included. One underwent immediate bowel resection. In all other 42 cases a conservative approach was taken, which led to a complete abscess resolution rate of 28.6% (12/42). The remaining abscesses required bowel resection. Anti‐tumor necrosis factor (TNF) agent use was associated with successful conservative management (odds ratio [OR] 13.36, 95% confidence interval [CI] 11.19‐15.52, P = 0.006), while the opposite trend was found for corticosteroids (OR 0.14, 95% CI 0.02‐1.26, P = 0.055). There was a trend towards suboptimal evolution in case of previous bowel resection (OR 4.77, 95% CI 0.77‐29.66, P = 0.094) or in patients aged above 50 years (OR 5.17, 95% CI 0.86‐30.91, P = 0.072). Conclusions Bowel resection appears to be inevitable in most CD patients presenting with IAA. An attempt at conservative treatment may be particularly successful with anti‐TNF agents in younger patients who have not undergone previous bowel resection. Large‐scale prospective studies are needed to confirm these findings.

show abstract

Section: Discussionsupporting

confidence: 88%

Conservative management of spontaneous intra‐abdominal abscess in Crohn's disease: Outcome and prognostic factors

Waked

Holvoet

Geldof

et al. 2021

J of Digest Diseases

View full text Add to dashboard Cite

show abstract

“…Available data suggest that certain drugs may reduce the likelihood of disease recurrence following the surgery; however, most studies discuss the risk of recurrence of endoscopic lesions rather than of clinical symptoms [ 270 ]. For example, the post-hoc analysis of the TOPPIC study revealed that 6-mercaptopurine increases the likelihood of complete mucosal remission (Rutgeerts score of i0) in smoking patients [ 271 ].…”

Section: Other Recommendationsmentioning

confidence: 99%

Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology

Łodyga¹,

Eder²,

Gawron-Kiszka³

et al. 2021

View full text Add to dashboard Cite

This paper is an update of the diagnostic and therapeutic recommendations of the National Consultant for Gastroenterology and the Polish Society of Gastroenterology from 2012. It contains 46 recommendations for the diagnosis and treatment, both pharmacological and surgical, of Crohn's disease in adults. The guidelines were developed by a group of experts appointed by the Polish Society of Gastroenterology and the National Consultant in the field of Gastroenterology. The methodology related to the GRADE methodology was used to assess the quality and strength of the available recommendations. The degree of expert support for the proposed statement, assessment of the quality of evidence and the strength of the recommendation was assessed on a 6-point Likert scale. Voting results, quality and strength ratings with comments are included with each statement.

show abstract

“…A total of 11 reviews related to cancer were identified, including NMAs of interventions for gastrointestinal cancer, pancreatic cancer, acute promyelocytic leukemia non-small cell lung cancer, neurotoxicity from chemotherapy, and cancer-related fatigue [37,54,66,74,82,89,95,105,107,112,113]. Osteoarthritis (including prostatitis) was the subject of 10 reviews [28-30, 40, 42, 73, 78, 101, 103, 114], gastrointestinal infections/disorders were the subject of 6 reviews [61,64,65,67,68,115], cardiovascular disease in 4 reviews [46,69,99,102], topics related to pregnancy, childbirth and newborn health in 4 reviews [47,62,71,83], and a variety of other clinical indications were assessed in 3 or fewer reviews. The number of NMAs overall increased notably from earlier to later years.…”

Section: Patient Indications and Outcomes Studiedmentioning

confidence: 99%

A scoping review of network meta-analyses assessing the efficacy and safety of complementary and alternative medicine interventions

et al. 2020

View full text Add to dashboard Cite

Background Network meta-analysis (NMA) has rapidly grown in use during the past decade for the comparison of healthcare interventions. While its general use in the comparison of conventional medicines has been studied previously, to our awareness, its use to assess complementary and alternative medicines (CAM) has not been studied. A scoping review of the literature was performed to identify systematic reviews incorporating NMAs involving one or more CAM interventions. Methods An information specialist executed a multi-database search (e.g., MEDLINE, Embase, Cochrane), and two reviewers performed study selection and data collection. Information on publication characteristics, diseases studied, interventions compared, reporting transparency, outcomes assessed, and other parameters were extracted from each review. Results A total of 89 SR/NMAs were included. The largest number of NMAs was conducted in China (39.3%), followed by the United Kingdom (12.4%) and the United States (9.0%). Reviews were published between 2010 and 2018, with the majority published between 2015 and 2018. More than 90 different CAM therapies appeared at least once, and the median number per NMA was 2 (IQR 1–4); 20.2% of reviews consisted of only CAM therapies. Dietary supplements (51.1%) and vitamins and minerals (42.2%) were the most commonly studied therapies, followed by electrical stimulation (31.1%), herbal medicines (24.4%), and acupuncture and related treatments (22.2%). A diverse set of conditions was identified, the most common being various forms of cancer (11.1%), osteoarthritis of the hip/knee (7.8%), and depression (5.9%). Most reviews adequately addressed a majority of the PRISMA NMA extension items; however, there were limitations in indication of an existing review protocol, exploration of network geometry, and exploration of risk of bias across studies, such as publication bias. Conclusion The use of NMA to assess the effectiveness of CAM interventions is growing rapidly. Efforts to identify priority topics for future CAM-related NMAs and to enhance methods for CAM comparisons with conventional medicine are needed. Systematic review registration https://ruor.uottawa.ca/handle/10393/35658

show abstract

Strategies for Preventing Endoscopic Recurrence of Crohn’s Disease 1 Year after Surgery: A Network Meta-Analysis

Cited by 10 publications

References 29 publications

Conservative management of spontaneous intra‐abdominal abscess in Crohn's disease: Outcome and prognostic factors

Conservative management of spontaneous intra‐abdominal abscess in Crohn's disease: Outcome and prognostic factors

Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology

A scoping review of network meta-analyses assessing the efficacy and safety of complementary and alternative medicine interventions

Contact Info

Product

Resources

About