Interventions for treating collagenous colitis

Chande, Nilesh; McDonald, JWD; MacDonald, JK

doi:10.1002/14651858.cd003575.pub3

Cited by 15 publications

(21 citation statements)

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“…Such findings support the conclusions of the recent Cochrane review of randomised trials in collagenous colitis, which indicated that budesonide is the only treatment for which there is strong evidence of a clinical benefit for the induction of clinical remission 14. Importantly, the present study also confirms the efficacy and favourable tolerability of budesonide for the long-term maintenance of clinical remission (which was paralleled by histological improvement), in accordance with the findings of the MIMIC study 16.…”

Section: Discussionsupporting

confidence: 92%

“…Importantly, the present study also confirms the efficacy and favourable tolerability of budesonide for the long-term maintenance of clinical remission (which was paralleled by histological improvement), in accordance with the findings of the MIMIC study 16. Taken together, such results are important given the paucity of published data on the long-term use of oral budesonide or other treatments in the setting of collagenous colitis 2 14…”

Section: Discussionsupporting

confidence: 90%

“…This was deemed important given the need to demonstrate both histological and clinical remission during treatment for collagenous colitis 14. Indeed, it was noted that the efficacy of budesonide for long-term maintenance of clinical remission was paralleled by significant histological improvement compared with placebo, although the fact that not all patients were evaluable for histology upon relapse or completion of maintenance therapy means that our findings may not be representative of the entire patient population.…”

Section: Discussionmentioning

confidence: 97%

“…The sample size estimate was based on a minimum difference between treatment groups of 50%, ie, an expected remission rate of 80% after 24 weeks of active treatment and a placebo effect of 30% 14. With a type I error risk of 5% and power of 80%, it was estimated that 18 patients would be required in each treatment arm (ie, a total of 36 patients).…”

Section: Methodsmentioning

confidence: 99%

“…Indeed, treatment with budesonide 9 mg/day for up to 8 weeks achieved clinical remission in a significantly greater proportion of patients compared with placebo. A Cochrane review revealed the number needed to treat for clinical response to be two patients 14. Long-term (maintenance) therapy with oral budesonide is well tolerated and effective for maintaining clinical remission 15.…”

mentioning

confidence: 99%

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Long-term budesonide treatment of collagenous colitis: a randomised, double-blind, placebo-controlled trial

Bonderup

Hansen

Teglbjærg

et al. 2008

Gut

152

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Long-term budesonide treatment of collagenous colitis: a randomised, double-blind, placebo-controlled trial

Bonderup

Hansen

Teglbjærg

et al. 2008

Gut

152

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Interventions for treating collagenous colitis

Kafil

Nguyen

Patton

et al. 2017

Cochrane Database of Systematic Reviews

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BackgroundCollagenous colitis is a cause of chronic diarrhea. This updated review was performed to identify therapies for collagenous colitis that have been assessed in randomized controlled trials (RCTs). ObjectivesThe primary objective was to assess the benefits and harms of treatments for collagenous colitis. Search methodsWe searched CENTRAL, the Cochrane IBD Group Specialized Register, MEDLINE and EMBASE from inception to 7 November 2016. Selection criteriaWe included RCTs comparing a therapy with placebo or active comparator for the treatment of active or quiescent collagenous colitis. Data collection and analysisData were independently extracted by two authors. The primary outcome was clinical response or maintenance of response as defined by the included studies. Secondary outcome measures included histological response, quality of life and the occurrence of adverse events. Risk ratios (RR) and 95% confidence intervals (CI) were calculated for dichotomous outcomes. The Cochrane risk of bias tool was used to assess bias. The overall quality of the evidence was assessed using the GRADE criteria. Main resultsTwelve RCTs (476 participants) were included. These studies assessed bismuth subsalicylate, Boswellia serrata extract, mesalamine, cholestyramine, probiotics, prednisolone and budesonide therapy. Four studies were low risk of bias. One study assessing mesalamine and cholestyramine was judged to be high risk of bias due to no blinding. The other studies had an unclear risk of bias for random sequence generation (five studies) allocation concealment (six studies), blinding (one study), incomplete outcome data (one study) and selective outcome reporting (one study). Clinical response occurred in 100% (4/4) of patients who received bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks) compared to 0% (0/5) of patients who received placebo (1 study; 9 participants; RR 10.80, 95% CI 0.75 to 155.93; GRADE = very low). Clinical response occurred in 44% (7/16) of patients who received Boswellia serrata extract (three 400 mg/day capsules for 8 weeks) compared to 27% (4/15) of patients who received placebo (1 study; 31 participants; RR 1.64, 1 Interventions for treating collagenous colitis (Review)

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