INTRODUCTION: We performed a meta-analysis to compare the clinical and endoscopic recurrence of medical treatment and placebo treatment for preventing postoperative recurrence in Crohn's disease. MATERIALS AND METHODS: Trials were located through Medline, Embase, the Cochrane Central Register of Controlled Trials, Ovid, Sciencedirect, and Ingenta electronic databases. From 124 articles screened, 14 were identified as randomized placebo-controlled trials and were included for data extraction. Main outcome measures were clinical recurrence, endoscopic recurrence, and severe endoscopic recurrence. The meta-analysis was performed with the fixed-effects model. RESULT: Fourteen studies with 1,497 participants were analyzed. In the intention-to-treat analysis, medical treatment was associated with a significantly lower incidence of clinical recurrence (relative risk of 0.74, 95% confidence interval 0.64-0.87, P = 0.000], but there were no significant differences in endoscopic recurrence (0.94, 0.83-1.07, P = 0.353) and severe endoscopic recurrence (0.83, 0.60-1.16, P = 0.281) between the two groups. When using per-protocol analysis, the results is similar, medical treatment was associated with a significantly lower incidence of clinical recurrence (0.84, 0.72-0.97, P = 0.020), but there were no significant differences in endoscopic recurrence (0.94, 0.85-1.05, P = 0.268) or severe endoscopic recurrence (0.76, 0.55-1.04, P = 0.084) between the two groups of patients. CONCLUSIONS: Medical treatment has a sufficiently beneficial effect on decreasing the risk of clinical postoperative recurrence in patients with CD.
INTRODUCTION: We performed a meta-analysis to compare the clinical and endoscopic recurrence of medical treatment and placebo treatment for preventing postoperative recurrence in Crohn's disease. MATERIALS AND METHODS: Trials were located through Medline, Embase, the Cochrane Central Register of Controlled Trials, Ovid, Sciencedirect, and Ingenta electronic databases. From 124 articles screened, 14 were identified as randomized placebo-controlled trials and were included for data extraction. Main outcome measures were clinical recurrence, endoscopic recurrence, and severe endoscopic recurrence. The meta-analysis was performed with the fixed-effects model. RESULT: Fourteen studies with 1,497 participants were analyzed. In the intention-to-treat analysis, medical treatment was associated with a significantly lower incidence of clinical recurrence (relative risk of 0.74, 95% confidence interval 0.64-0.87, P = 0.000], but there were no significant differences in endoscopic recurrence (0.94, 0.83-1.07, P = 0.353) and severe endoscopic recurrence (0.83, 0.60-1.16, P = 0.281) between the two groups. When using per-protocol analysis, the results is similar, medical treatment was associated with a significantly lower incidence of clinical recurrence (0.84, 0.72-0.97, P = 0.020), but there were no significant differences in endoscopic recurrence (0.94, 0.85-1.05, P = 0.268) or severe endoscopic recurrence (0.76, 0.55-1.04, P = 0.084) between the two groups of patients. CONCLUSIONS: Medical treatment has a sufficiently beneficial effect on decreasing the risk of clinical postoperative recurrence in patients with CD.
Authors: C Florent; A Cortot; P Quandale; T Sahmound; R Modigliani; E Sarfaty; P Valleur; J L Dupas; M Daurat; J L Faucheron; E Lerebours; F Michot; J Belaiche; N Jacquet; J C Soulé; N Rothman; J P Gendre; M Malafosse Journal: Eur J Gastroenterol Hepatol Date: 1996-03 Impact factor: 2.566
Authors: G Hellers; A Cortot; D Jewell; C E Leijonmarck; R Löfberg; H Malchow; L G Nilsson; F Pallone; S Pena; T Persson; C Prantera; P Rutgeerts Journal: Gastroenterology Date: 1999-02 Impact factor: 22.682
Authors: Stephen B Hanauer; Burton I Korelitz; Paul Rutgeerts; Mark A Peppercorn; Ronald A Thisted; Russell D Cohen; Daniel H Present Journal: Gastroenterology Date: 2004-09 Impact factor: 22.682
Authors: C Seifarth; J P Ritz; U Pohlen; A J Kroesen; B Siegmund; B Frericks; H J Buhr Journal: Int J Colorectal Dis Date: 2014-05-04 Impact factor: 2.571