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Meta-analysis of medical treatment and placebo treatment for preventing postoperative recurrence in Crohn’s disease (CD)

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Abstract

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.

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Authors and Affiliations

  1. Department of Colorectal and Anal Surgery, First Affiliated Hospital, Guangxi Medical University, Guangxi, China

    Yunfei Cao, Feng Gao, Cun Liao & Aihua Tan

  2. Department of Urology, First Affiliated Hospital, Guangxi Medical University, Guangxi, China

    Zengnan Mo

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  1. Yunfei Cao
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  2. Feng Gao
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Correspondence to Feng Gao.

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Cao, Y., Gao, F., Liao, C. et al. Meta-analysis of medical treatment and placebo treatment for preventing postoperative recurrence in Crohn’s disease (CD). Int J Colorectal Dis 24, 509–520 (2009). https://doi.org/10.1007/s00384-009-0640-3

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  • DOI: https://doi.org/10.1007/s00384-009-0640-3

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