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Comparison of mesalazine and balsalazide in induction and maintenance of remission in patients with ulcerative colitis: a meta-analysis

The authors concluded that balsalazide increased remission rates in ulcerative colitis compared to mesalazine. There was no difference in relapse, adverse events or withdrawal due to adverse events. Overall, this was a well-conducted review. The authors’ conclusions appeared reliable, but the characteristics of patients to whom findings may apply to were not clear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Once-daily versus multiple-daily mesalamine for patients with ulcerative colitis: a meta-analysis

The authors concluded that the efficacy and safety of once-daily mesalamine was comparable to multiple-daily mesalamine for the maintenance treatment of ulcerative colitis and was more effective for inducing remission in active ulcerative colitis. The evidence suggests that this conclusion may be reliable where it relates to quiescent ulcerative colitis, but subject to more uncertainty for active disease.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Once-daily dosing vs. conventional dosing schedule of mesalamine and relapse of quiescent ulcerative colitis: systematic review and meta-analysis

Once-daily dosing of mesalamine was as effective as conventional dosing in preventing relapse of quiescent ulcerative colitis and there were no significant differences in compliance or adverse events. The authors' conclusions reflect the evidence presented but given the small number of variable studies with limitations in quality, they should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Efficacy of 5-aminosalicylates in Crohn's disease: systematic review and meta-analysis

OBJECTIVES: Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract. Evidence for treatment with 5-aminosalicylic acid (5-ASA) drugs is conflicting. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine this issue.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Can oral 5-aminosalicylic acid be administered once daily in the treatment of mild-to-moderate ulcerative colitis? A meta-analysis of randomized-controlled trials

OBJECTIVES: Several trials have demonstrated that oral delayed-release mesalamine might be administered once daily. We aimed to conduct a meta-analysis to investigate this.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

5-aminosalicylic acid is not protective against colorectal cancer in inflammatory bowel disease: a meta-analysis of non-referral populations

OBJECTIVES: Some studies have demonstrated that 5-aminosalicylic acid (5-ASA) is associated with a reduced risk of colorectal cancer (CRC) in inflammatory bowel disease (IBD). However, more recent population-based studies suggest no protective association. We conducted a systematic review that focused on non-referral studies to reassess the role of 5-ASA for this indication.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Treatment of diverticular disease of the colon and prevention of acute diverticulitis: a systematic review

BACKGROUND: Diverticular disease of the colon is a common disorder, characterized by recurrent symptoms and complications such as diverticulitis, requiring hospital admissions and surgery.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Efficacy of 5-aminosalicylates in ulcerative colitis: systematic review and meta-analysis

OBJECTIVES: The efficacy of 5-aminosalicylic acids (5-ASAs) in ulcerative colitis (UC) has been studied previously in meta-analyses. However, several randomized controlled trials (RCTs) have been published recently, and no previous meta-analysis has studied the effect of 5-ASA dosage used.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Golimumab (Simponi) (Subcutaneous Injection): Adult Patients with Moderately to Severely Active Ulcerative Colitis Who Have Had an Inadequate Response to, or Have Medical Contraindications for, Conventional Therapies [Internet]

Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) that leads to severe gastrointestinal symptoms, including diarrhea, pain, and bloody stools. The inflammation can eventually lead to significant mucosal damage and to life-threatening complications such as bowel perforation and sepsis. Patients with UC are also at higher risk of malignancy, most notably colon cancer. UC is a relatively common disease in Canada, with a prevalence of 104,000 patients and an incidence of 4,500 per year.

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.

Version: November 2014
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Crohn's Disease: Management in Adults, Children and Young People

This guideline intends to show the place of both new and established treatments in the wider care pathway for Crohn's disease. This will be useful for clinicians and people with Crohn's disease because new drugs have been licensed for Crohn's disease in the last decade. The guideline also deals with those medications which are unlicensed for treatment of the condition, but which have been used in this way (off-label) for many years and their role is recognised in other NICE documents as well as the British National Formulary. They include azathioprine, mercaptopurine and methotrexate. The guideline aims to help improve the care offered to people with Crohn's disease and provide information about the clinical and cost effectiveness of potential care pathways. Management of Crohn's disease in specific populations (for example, in pregnancy) may require special consideration.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: October 10, 2012
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Ulcerative Colitis: Management in Adults, Children and Young People [Internet]

Ulcerative colitis is the most common type of inflammatory disease of the bowel. It has an incidence in the UK of approximately 10 per 100,000 people annually,and a prevalence of approximately 240 per 100,000. This amounts to around 146,000 people in the UK with a diagnosis of ulcerative colitis. The cause of ulcerative colitis is unknown. It can develop at any age, but peak incidence is between the ages of 15 and 25 years, with a second, smaller peak between 55 and 65 years (although this second peak has not been universally demonstrated). The British Paediatric Surveillance Unit reported an incidence of ulcerative colitis in children aged younger than 16 years in the United Kingdom, of 1.4 per 100,000 with a greater proportion of Asian children having ulcerative colitis than other children. The median age for diagnosis of ulcerative colitis overall in this childhood cohort was 11.7 years (range 9.3 to 13.7 years).

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: June 2013
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Clinical effectiveness and cost-effectiveness of elemental nutrition for the maintenance of remission in Crohn’s disease: a systematic review and meta-analysis

This systematic review aimed to assess the clinical effectiveness and cost-effectiveness of elemental nutrition for maintenance of remission in patients with Crohn’s Disease (CD). No cost-effectiveness evidence was found. Limited evidence indicates potential benefits of elemental nutrition against no intervention in the maintenance of remission and prevention of relapse in adult patients with CD. There was a lack or insufficient evidence on adverse events and complications. The findings warrant cautious interpretation given the limitations of the evidence and the risk of bias in individual studies. Future large and long-term randomised trials are warranted to draw more definitive conclusions.

Health Technology Assessment - NIHR Journals Library.

Version: March 2015
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Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262): clinical effectiveness systematic review and economic model

The study found that adult patients with ulcerative colitis receiving infliximab, adalimumab or golimumab were more likely to achieve clinical response and remission than those receiving placebo.

Health Technology Assessment - NIHR Journals Library.

Version: May 2016
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Clinical effectiveness and cost-effectiveness of use of therapeutic monitoring of tumour necrosis factor alpha (TNF-α) inhibitors [LISA-TRACKER® enzyme-linked immunosorbent assay (ELISA) kits, TNF-α-Blocker ELISA kits and Promonitor® ELISA kits] versus standard care in patients with Crohn’s disease: systematic reviews and economic modelling

This study of the use of therapeutic monitoring of tumour necrosis factor alpha (TNF-α) inhibitors in the management of Crohn’s disease concluded that more evidence is required to tell us how the tests and the treatment options determined by the test results can benefit the management of patients.

Health Technology Assessment - NIHR Journals Library.

Version: November 2016
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Meta-analysis: the efficacy of rectal beclomethasone dipropionate vs. 5-aminosalicylic acid in mild to moderate distal ulcerative colitis

The authors concluded that treatment with rectal beclomethasone dipropionate is as effective as 5-aminosalicylic acid in symptom improvement for active left-sided UC, proctosigmoiditis and proctitis. Despite potential methodological limitations amongst the included studies, the authors' conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Pregnancy outcome in women with inflammatory bowel disease following exposure to 5-aminosalicylic acid drugs: a meta-analysis

This poorly reported review assessed the risks of adverse pregnancy outcomes in women with irritable bowel disease following exposure to 5-aminosalicylic acid (5-ASA) drugs and presented point estimates for adverse outcomes. The conclusions did not seem to reflect the substantial levels of uncertainty around the results and should be treated with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

5-aminosalicylates prevent relapse of Crohn's disease after surgically induced remission: systematic review and meta-analysis

The review concluded that mesalamine was of modest benefit compared with no therapy or placebo in preventing relapse in Crohn’s disease patients in remission after surgery. The review was generally well conducted and the authors’ conclusions reflect the evidence and seem reasonable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Efficacy of topical 5-aminosalicylates in preventing relapse of quiescent ulcerative colitis: a meta-analysis

This review concluded that topical mesalazine appeared to be safe and was effective in preventing relapse of quiescent ulcerative colitis. As no trials had a low risk of bias, the authors' conclusions could be considered to be over optimistic and their reliability is uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Efficacy of oral vs topical, or combined oral and topical 5-aminosalicylates, in ulcerative colitis: systematic review and meta-analysis

The authors concluded that combined 5-aminosalicylates (5-ASAs) appeared superior to oral 5-ASAs in inducing remission of mild to moderate ulcerative colitis. Topical 5-ASAs may be superior to oral 5-ASAs in preventing relapse of quiescent ulcerative colitis. Given the small number and low quality of available studies, the authors were appropriately tentative in their conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

High mucosal healing rates in 5-ASA-treated ulcerative colitis patients: results of a meta-analysis of clinical trials

The review concluded that 5-aminosalicylate preparations achieved mucosal healing in nearly 50% of patients with ulcerative colitis with no significant differences between the various preparations. The synthesis focused on relatively few poorly reported studies of unknown size and unclear reliability. The results should be considered with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

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