Effectiveness of Bile Acid Sequestrants in Microscopic Colitis and Utility of Bile Acid Testing: A Systematic Review and Meta-analysis

Author:

Tome June1ORCID,Tariq Raseen1ORCID,Chelf Cynthia J.2ORCID,Khanna Sahil1ORCID,Pardi Darrell S.1

Affiliation:

1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA;

2. Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA.

Abstract

INTRODUCTION: Bile acid sequestrants (BAS) are an option for microscopic colitis (MC) refractory or intolerant to budesonide. There are inconsistent data on the prevalence of bile acid malabsorption (BAM) and utility of bile acid testing in MC. The aim of this systematic review and meta-analysis was to evaluate these outcomes. METHODS: A systematic search of randomized control trials and observational studies of adults with MC treated with BAS was conducted using MEDLINE, Embase, Cochrane, and Scopus from inception to January 22, 2024. Data were extracted on (i) prevalence of BAM, (ii) clinical response and adverse events, and (iii) recurrence after BAS discontinuation. Data were pooled using random-effects models to determine weighted pooled estimates and 95% confidence intervals (CIs). RESULTS: We included 23 studies (1 randomized control trial, 22 observational), with 1,011 patients with MC assessed for BAM and 771 treated with BAS. The pooled prevalence of BAM was 34% (95% CI 0.26–0.42, I 2 = 81%). The pooled response rate with BAS induction for all patients with MC, irrespective of BAM, was 62% (95% CI 0.55–0.70, I 2 = 71%). There was a higher pooled response rate in patients with BAM compared with those without BAM (P < 0.0001). The pooled rate of BAS-related adverse effects was 9% (95% CI 0.05–0.14, I 2 = 58%). DISCUSSION: One-third of patients with MC had BAM, and almost two-thirds of all patients responded to BAS with limited side effects. Patients with MC and BAM were more likely to respond to therapy, supporting the value of bile acid testing.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference41 articles.

1. Incidence, prevalence, and temporal trends of microscopic colitis: A systematic review and meta-analysis;Tong;Am J Gastroenterol,2015

2. Diagnosis and management of microscopic colitis;Pardi;Am J Gastroenterol,2017

3. Effectiveness and safety profile of budesonide maintenance in microscopic colitis: A systematic review and meta-analysis;Tome;Inflamm Bowel Dis,2023

4. Oral budesonide for maintenance treatment of collagenous colitis: A randomized, double-blind, placebo-controlled trial;Miehlke;Gastroenterology,2008

5. Budesonide maintenance in microscopic colitis: Clinical outcomes and safety profile from a population-based study;Tome;Am J Gastroenterol,2022

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3