Feng Jin-Shan, Li Jin-Yu, Chen Xiu-Yan, Yang Zheng, Li Shang-Hai
College of Pharmacy, Guangdong Medical University, Zhanjiang 524023, China.
Science Research Center (Campus Zhanjiang), Guangdong Medical University, Zhanjiang 524023, China.
Gastroenterol Res Pract. 2017;2017:7896160. doi: 10.1155/2017/7896160. Epub 2017 May 28.
To assess the benefits of different treatments that aim to prevent the endoscopic recurrence of Crohn's disease (CD) after ileal resection.
Randomized controlled trials (RCTs) were searched from MEDLINE, Embase, and the Cochrane Central Database. All the included RCTs with an endoscopic recurrence outcome which was defined as Rutgeerts' score ≥ i2 have a duration of more than 1 year. The quality of the included RCTs was assessed by the Cochrane Risk of Bias Tool. Pairwise treatment effects were estimated through a Bayesian random effects network meta-analysis by using the OpenBUGS 1.4 software and reported as odds ratios (ORs) with a 95% credible interval (CI).
Fourteen RCTs (877 participants) were included. Two strategies were superior to placebo for preventing endoscopic recurrence of CD at 1 year after surgery: infliximab (d, -5.475; 95% CI, -10.47 to -1.632) and adalimumab (d, -7.273; 95% CI, -13.84 to -2.585). Nine strategies were not effective: budesnoid, mesalazine (in both high and low dose), azathioprine, mesalazine + infliximab, ornidazole, untreated intervention, and Lactobacillus GG.
Except for infliximab and adalimumab, other strategies included in our analysis were not effective for preventing endoscopic recurrence of CD at 1 year after ileal resection.
评估旨在预防克罗恩病（CD）回肠切除术后内镜复发的不同治疗方法的疗效。
从MEDLINE、Embase和Cochrane中心数据库检索随机对照试验（RCT）。所有纳入的RCT，其内镜复发结局定义为 Rutgeerts评分≥i2，试验持续时间超过1年。采用Cochrane偏倚风险工具评估纳入RCT的质量。使用OpenBUGS 1.4软件通过贝叶斯随机效应网络荟萃分析估计成对治疗效应，并报告为具有95%可信区间（CI）的比值比（OR）。
纳入14项RCT（877名参与者）。两种策略在术后1年预防CD内镜复发方面优于安慰剂：英夫利昔单抗（d，-5.475；95%CI，-10.47至-1.632）和阿达木单抗（d，-7.273；95%CI，-13.84至-2.585）。九种策略无效：布地奈德、美沙拉嗪（高剂量和低剂量）、硫唑嘌呤、美沙拉嗪+英夫利昔单抗、奥硝唑、未治疗干预和鼠李糖乳杆菌GG。
除英夫利昔单抗和阿达木单抗外，我们分析中纳入的其他策略在回肠切除术后1年预防CD内镜复发方面无效。
