Limits...
Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.

Gong J, Zhu L, Guo Z, Li Y, Zhu W, Li N, Li J - PLoS ONE (2013)

Bottom Line: Heterogeneity of the studies was affected by the sample size (</≥ 100 cases) and whether the patients had longstanding colitis (≥ 7 years).The current meta-analysis revealed that thiopurines had a chemopreventive effect of colorectal neoplasms and a tendency of reducing advanced colorectal neoplasms in IBD.Due to the heterogeneity of included studies, these results should be interpreted with caution.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Jinling hospital, Medical School of Nanjing University, Nanjing, PR China.

ABSTRACT

Objective: Inflammatory bowel disease (IBD) is commonly treated with thiopurines such as azathioprine and mercaptopurine for the maintenance of remission. Studies examining chemopreventive of these medications on colorectal neoplasm in IBD patients have yielded conflicting results. We performed a meta-analysis to assess the role of thiopurines for this indication.

Methods: We performed a systematic search of PubMed, Web of Science, EMBASE and Cochrane to identify studies reporting colorectal neoplasm from IBD patients treated with thiopurines and conducted a meta-analysis of pooled relative risk (RR) using the random effects model.

Results: Nine case-control and ten cohort studies fulfilled the inclusion criteria. The use of thiopurines was associated with a statistically significant decreased incidence of colorectal neoplasm (summary RR=0.71, 95% CI=0.54-0.94, p=0.017), even after adjustment for duration and extent of the disease, but there was high heterogeneity among studies (I(2)=68.0%, p<0.001). The RR of advanced neoplasm (high-grade dysplasia and cancer) was 0.72 (95%CI=0.50-1.03, p=0.070) and that of cancer was 0.70 (95% CI=0.46-1.09, p=0.111) for thiopurine-treated patients. Heterogeneity of the studies was affected by the sample size (

Conclusion: The current meta-analysis revealed that thiopurines had a chemopreventive effect of colorectal neoplasms and a tendency of reducing advanced colorectal neoplasms in IBD. Due to the heterogeneity of included studies, these results should be interpreted with caution.

Show MeSH

Related in: MedlinePlus

Search and study selection process.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3842949&req=5

pone-0081487-g001: Search and study selection process.

Mentions: We identified 969 titles and abstracts from electronic databases using the search algorithm. 926 were eliminated on review of titles and abstracts. Of the remaining 43 studies, 24 were excluded because of irrelevance (n=5), lack of control group (n=9), incomplete information on colorectal neoplasm (n=3)[13-15], name of immunomodulator unclear (n=3), or abstract fully published later (n=4). Thus, 19 full text articles were reviewed for meta-analysis. The study selection process is detailed in Figure 1


Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel diseases: a meta-analysis.

Gong J, Zhu L, Guo Z, Li Y, Zhu W, Li N, Li J - PLoS ONE (2013)

Search and study selection process.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3842949&req=5

pone-0081487-g001: Search and study selection process.
Mentions: We identified 969 titles and abstracts from electronic databases using the search algorithm. 926 were eliminated on review of titles and abstracts. Of the remaining 43 studies, 24 were excluded because of irrelevance (n=5), lack of control group (n=9), incomplete information on colorectal neoplasm (n=3)[13-15], name of immunomodulator unclear (n=3), or abstract fully published later (n=4). Thus, 19 full text articles were reviewed for meta-analysis. The study selection process is detailed in Figure 1

Bottom Line: Heterogeneity of the studies was affected by the sample size (</≥ 100 cases) and whether the patients had longstanding colitis (≥ 7 years).The current meta-analysis revealed that thiopurines had a chemopreventive effect of colorectal neoplasms and a tendency of reducing advanced colorectal neoplasms in IBD.Due to the heterogeneity of included studies, these results should be interpreted with caution.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Jinling hospital, Medical School of Nanjing University, Nanjing, PR China.

ABSTRACT

Objective: Inflammatory bowel disease (IBD) is commonly treated with thiopurines such as azathioprine and mercaptopurine for the maintenance of remission. Studies examining chemopreventive of these medications on colorectal neoplasm in IBD patients have yielded conflicting results. We performed a meta-analysis to assess the role of thiopurines for this indication.

Methods: We performed a systematic search of PubMed, Web of Science, EMBASE and Cochrane to identify studies reporting colorectal neoplasm from IBD patients treated with thiopurines and conducted a meta-analysis of pooled relative risk (RR) using the random effects model.

Results: Nine case-control and ten cohort studies fulfilled the inclusion criteria. The use of thiopurines was associated with a statistically significant decreased incidence of colorectal neoplasm (summary RR=0.71, 95% CI=0.54-0.94, p=0.017), even after adjustment for duration and extent of the disease, but there was high heterogeneity among studies (I(2)=68.0%, p<0.001). The RR of advanced neoplasm (high-grade dysplasia and cancer) was 0.72 (95%CI=0.50-1.03, p=0.070) and that of cancer was 0.70 (95% CI=0.46-1.09, p=0.111) for thiopurine-treated patients. Heterogeneity of the studies was affected by the sample size (

Conclusion: The current meta-analysis revealed that thiopurines had a chemopreventive effect of colorectal neoplasms and a tendency of reducing advanced colorectal neoplasms in IBD. Due to the heterogeneity of included studies, these results should be interpreted with caution.

Show MeSH
Related in: MedlinePlus