Interventions for prevention of post-operative recurrence of Crohn's disease

作者：Glen A. Doherty, Gayle Bennett, Seema A Patil, Adam S. Cheifetz, Alan C. Moss · 发表于：Cochrane Database of Systematic Reviews · 年份：2009 · DOI：10.1002/14651858.cd006873.pub2 · 被引用次数：197 · 研究领域：Inflammatory Bowel Disease、Autoimmune and Inflammatory Disorders、Gastrointestinal Bleeding Diagnosis and Treatment

BACKGROUND: Recurrence of Crohn's disease is common after intestinal resection. A number of agents have been studied in controlled trials with the goal of reducing the risk of endoscopic or clinical recurrence of Crohn's disease following surgery. OBJECTIVES: To undertake a systematic review of the use of medical therapies for the prevention of post-operative recurrence of Crohn's disease SEARCH STRATEGY: MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify relevant studies. References from selected papers and abstracts from Digestive Disease Week were also searched. SELECTION CRITERIA: Randomised controlled trials that compared medical therapy to placebo or other medical agents for the prevention of recurrence of intestinal Crohn's disease were selected for inclusion. DATA COLLECTION AND ANALYSIS: Two authors reviewed all abstracts containing search terms, and those meeting inclusion criteria were selected for full data abstraction. Dichotomous data were summarised using relative risk and 95% confidence intervals. A fixed-effects model was used, and sensitivity analysis performed. MAIN RESULTS: Twenty-three studies were identified for inclusion. Probiotics were not superior to placebo for any outcome measured. The use of nitroimidazole antibiotics appeared to reduce the risk of clinical (RR 0.23; 95%CI 0.09 to 0.57, NNT=4) and endoscopic (RR 0.44; 95%CI 0.26 to 0.74, NNT = 4) recurrence relative to placebo. However, these...