Systematic review with network meta-analysis: pharmacological prophylaxis against post-ERCP pancreatitis.

Abstract:

BACKGROUND:The efficacy of many pharmacological agents for preventing post-ERCP pancreatitis (PEP) has been evaluated in randomised controlled trials (RCTs), but it is unclear which agent(s) should be used in clinical practice. Network meta-analyses of RCTs are used to simultaneously compare several agents to determine their relative efficacy and identify priority agents for comparison in future RCTs. AIM:To evaluate pharmacological agents for the prevention of PEP by conducting a network meta-analysis of RCTs. METHODS:We searched MEDLINE, EMBASE and Cochrane Library databases for RCTs that evaluated the efficacy of agents for preventing PEP. RCTs were simultaneously analysed using random-effects network meta-analysis under the Bayesian framework to identify the best agents. The efficacy of agents was ordered according to the probability of being ranked as any of the top three best performing agents. RESULTS:The network meta-analysis included 99 RCTs evaluating 16 agents in 25 313 patients. Topical epinephrine (adrenaline) was the most efficacious agent with 85.9% probability of ranking among the top three agents, followed by nafamostat (51.4%), antibiotics (44.5%) and NSAIDs (42.8%). However, in a sensitivity analysis including only rectal NSAIDs, NSAIDs moved from fourth rank to second (58.1%). Patients receiving topical epinephrine, compared with placebo, had a 75% reduced risk of PEP (OR 0.25, 95% probability interval 0.06-0.66). CONCLUSIONS:Topical epinephrine and rectal NSAIDs are the most efficacious agents for preventing post-ERCP pancreatitis, based on existing RCTs. Combinations of these agents, which act on different steps in the pathogenesis of post-ERCP pancreatitis, should be evaluated in future trials.

journal_name

Aliment Pharmacol Ther

authors

Akshintala VS,Hutfless SM,Colantuoni E,Kim KJ,Khashab MA,Li T,Elmunzer BJ,Puhan MA,Sinha A,Kamal A,Lennon AM,Okolo PI,Palakurthy MK,Kalloo AN,Singh VK

doi

10.1111/apt.12534

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

1325-37

issue

11-12

eissn

0269-2813

issn

1365-2036

journal_volume

38

pub_type

杂志文章,meta分析,评审
  • Review article: reflux and its consequences--the laryngeal, pulmonary and oesophageal manifestations. Conference held in conjunction with the 9th International Symposium on Human Pepsin (ISHP) Kingston-upon-Hull, UK, 21-23 April 2010.

    abstract:BACKGROUND:Gastro-oesophageal reflux disease (GERD) is one of the commonest diseases of Western populations, affecting 20 to 30% of adults. GERD is multifaceted and the classical oesophageal symptoms such as heartburn and regurgitation often overlap with atypical symptoms that impact upon the respiratory system and air...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2036.2011.04581.x

    authors: Pearson JP,Parikh S,Orlando RC,Johnston N,Allen J,Tinling SP,Johnston N,Belafsky P,Arevalo LF,Sharma N,Castell DO,Fox M,Harding SM,Morice AH,Watson MG,Shields MD,Bateman N,McCallion WA,van Wijk MP,Wenzl TG,Karkos

    更新日期:2011-04-01 00:00:00

  • Dyspepsia workload in urban general practice and implications of the British Society of Gastroenterology Dyspepsia guidelines (1996).

    abstract:AIM:To define the characteristics of patients consulting with active dyspeptic symptoms in urban general practice, and to consider the implications of applying the British Society of Gastroenterology Dyspepsia management guidelines. DESIGN:Prospective observational study over a period of 12 months. SETTING:Two multip...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章

    doi:10.1046/j.1365-2036.2000.00728.x

    authors: Bodger K,Eastwood PG,Manning SI,Daly MJ,Heatley RV

    更新日期:2000-04-01 00:00:00

  • The prevalence of Helicobacter pylori in peptic ulcer disease.

    abstract::Both duodenal and gastric ulcer disease are closely associated with Helicobacter pylori infection. An infected individual has an estimated lifetime risk of 10-20% for the development of peptic ulcer disease, which is at least 3-4 fold higher than in non-infected subjects. H. pylori infection can be diagnosed in 90-100...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审

    doi:

    authors: Kuipers EJ,Thijs JC,Festen HP

    更新日期:1995-01-01 00:00:00

  • Double-blind comparison of 5-aminosalicylic acid and acetyl-5-aminosalicylic acid suppositories in patients with idiopathic proctitis.

    abstract::Suppositories containing 300 mg 5-aminosalicylic acid (1.96 mmol) or 425 mg acetyl-5-aminosalicylic acid (1.96 mmol) were used in 40 patients with idiopathic proctitis to determine the efficacy of acetyl-5-aminosalicylic acid in treating this bowel inflammation. Each patient was treated with 5-aminosalicylic acid or a...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2036.1988.tb00668.x

    authors: van Hogezand RA,van Hees PA,van Gorp JP,van Lier HJ,Bakker JH,Wesseling P,van Haelst UJ,van Tongeren JH

    更新日期:1988-02-01 00:00:00

  • Changing patterns of sedation use for routine out-patient diagnostic gastroscopy between 1989 and 1998.

    abstract:BACKGROUND:Knowledge of sedation trends for upper gastrointestinal endoscopy is important for health service planning, particularly in view of rapidly increasing demands on endoscopy services. However, no data are available on sedation trends in Britain over the past 10 years. AIM:To determine sedation use for routine...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章

    doi:10.1046/j.1365-2036.2001.00912.x

    authors: Mulcahy HE,Hennessy E,Connor P,Rhodes B,Patchett SE,Farthing MJ,Fairclough PD

    更新日期:2001-02-01 00:00:00

  • Review article: 'true' re-infection of Helicobacter pylori after successful eradication--worldwide annual rates, risk factors and clinical implications.

    abstract:BACKGROUND:The incidence of 'true' re-infection with Helicobacter pylori after successful eradication remains uncertain. AIM:To determine the worldwide rates, risk factors and clinical implications of 'true' re-infection of Helicobacter pylori. 'True' re-infection of H. pylori is defined as the situation where tests f...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2036.2008.03873.x

    authors: Zhang YY,Xia HH,Zhuang ZH,Zhong J

    更新日期:2009-01-01 00:00:00

  • Prospective, randomized, parallel-group trial to evaluate the effects of lactulose and polyethylene glycol-4000 on colonic flora in chronic idiopathic constipation.

    abstract:BACKGROUND:Although lactulose and polyethylene glycol are osmotic laxatives widely used in the treatment of chronic constipation, no study has been conducted to compare their actions on the colonic bacterial ecosystem, which has an important influence on host health. AIM:To assess the effects of lactulose and polyethy...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1111/j.1365-2036.2004.01918.x

    authors: Bouhnik Y,Neut C,Raskine L,Michel C,Riottot M,Andrieux C,Guillemot F,Dyard F,Flourié B

    更新日期:2004-04-15 00:00:00

  • Cost-effectiveness analysis of sofosbuvir plus peginterferon/ribavirin in the treatment of chronic hepatitis C virus genotype 1 infection.

    abstract:BACKGROUND:Sofosbuvir, an oral NS5B nucleotide polymerase inhibitor, is indicated for the treatment of patients infected with hepatitis C virus (HCV). AIM:To evaluate the long-term health economic outcomes of sofosbuvir + pegylated interferon alfa/ribavirin (pegIFN/RBV) compared with current treatments in patients inf...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章

    doi:10.1111/apt.12871

    authors: Saab S,Gordon SC,Park H,Sulkowski M,Ahmed A,Younossi Z

    更新日期:2014-09-01 00:00:00

  • Histamine receptor antagonists and incident colorectal adenomas.

    abstract:BACKGROUND:Prior studies suggest that histamines may modulate the development of colorectal neoplasia. AIM:To assess whether histamine receptor antagonist use was associated with adenoma formation. METHODS:Patients (n = 2366) were drawn from three adenoma chemoprevention trials. All underwent baseline colonoscopy wit...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,meta分析

    doi:10.1111/j.1365-2036.2005.02529.x

    authors: Robertson DJ,Burke CA,Schwender BJ,Wargovich MJ,Greenberg ER,Sandler RS,Ahnen DJ,Rothstein R,Mott LA,Baron JA

    更新日期:2005-07-15 00:00:00

  • The safety of pegylated interferon alpha-2b in the treatment of chronic hepatitis B: predictive factors for dose reduction and treatment discontinuation.

    abstract:BACKGROUND:Treatment with interferon-alpha has been shown to be effective in one-third of hepatitis B e antigen-positive chronic hepatitis B patients, but is clinically associated with relevant adverse events. AIM:To investigate the safety of pegylated interferon alpha-2b in 300 hepatitis B e antigen-positive patients...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1111/j.1365-2036.2005.02453.x

    authors: van Zonneveld M,Flink HJ,Verhey E,Senturk H,Zeuzem S,Akarca US,Cakaloglu Y,Simon C,So TM,Gerken G,de Man RA,Hansen BE,Schalm SW,Janssen HL,HBV 99-01 Study Group.

    更新日期:2005-05-01 00:00:00

  • Review article: drugs interfering with visceral sensitivity for the treatment of functional gastrointestinal disorders--the clinical evidence.

    abstract::At present, the concept of visceral hypersensitivity provides the leading hypothesis regarding the generation of symptoms in functional gastrointestinal disorders. This paper discusses the current clinical evidence for drugs that have been proposed to interfere with visceral sensitivity in functional gastrointestinal ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2036.2005.02392.x

    authors: Kuiken SD,Tytgat GN,Boeckxstaens GE

    更新日期:2005-03-15 00:00:00

  • Use of the 'nutriceutical', bovine colostrum, for the treatment of distal colitis: results from an initial study.

    abstract:BACKGROUND:Bovine colostrum is a rich source of nutrients, antibodies and growth factors. AIM:To examine the efficacy of colostrum enemas in the treatment of distal colitis using a randomized, double-blind, controlled protocol. METHODS:Fourteen patients (eight female), with a mean age of 45 years (range, 16-75 years)...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2036.2002.01354.x

    authors: Khan Z,Macdonald C,Wicks AC,Holt MP,Floyd D,Ghosh S,Wright NA,Playford RJ

    更新日期:2002-11-01 00:00:00

  • Double-blind placebo-controlled multicentre studies of rebamipide, a gastroprotective drug, in the treatment of functional dyspepsia with or without Helicobacter pylori infection.

    abstract:BACKGROUND:Functional dyspepsia is a problem that is difficult to treat in clinical practice. AIM:To evaluate the efficacy and safety of rebamipide (a cytoprotective drug) in functional dyspepsia. METHODS:Patients with functional dyspepsia (n=557) were divided a priori into two studies by Helicobacter pylori status, ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1046/j.1365-2036.2001.01074.x

    authors: Talley NJ,Riff DS,Schwartz H,Marcuard SP

    更新日期:2001-10-01 00:00:00

  • Antioxidant effects of aminosalicylates and potential new drugs for inflammatory bowel disease: assessment in cell-free systems and inflamed human colorectal biopsies.

    abstract:BACKGROUND:The therapeutic efficacy of 5-aminosalicylic acid in inflammatory bowel disease may be related to its antioxidant properties. AIM:To compare in vitro the antioxidant effects of conventional drugs (5-aminosalicylic acid, corticosteroids, metronidazole), with new aminosalicylates (4-aminosalicylic acid, balsa...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章

    doi:10.1046/j.1365-2036.1999.00484.x

    authors: Simmonds NJ,Millar AD,Blake DR,Rampton DS

    更新日期:1999-03-01 00:00:00

  • The risk of congenital abnormalities in children fathered by men treated with azathioprine or mercaptopurine before conception.

    abstract:BACKGROUND:Immunosuppressive therapy with azathioprine and mercaptopurine is commonly used in patients with various chronic diseases. The few existing data on the reproductive safety of these drugs after paternal use before conception are inconclusive. AIM:To examine the risk of congenital abnormalities in children fa...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章

    doi:10.1111/j.1365-2036.2004.01889.x

    authors: Nørgård B,Pedersen L,Jacobsen J,Rasmussen SN,Sørensen HT

    更新日期:2004-03-15 00:00:00

  • Effects on the rat oxyntic mucosa of the histamine2-antagonist loxtidine and the H+, K(+)-ATPase inhibitor omeprazole.

    abstract::The present study examined whether histamine could affect the growth of the enterochromaffin-like (ECL) cell and the parietal cell. The effects of the unsurmountable histamine H2-receptor antagonist loxtidine (80 mg/kg) and the H+, K(+)-ATPase inhibitor omeprazole (100 mumol/kg) were compared in female Sprague-Dawley ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章

    doi:10.1111/j.1365-2036.1992.tb00055.x

    authors: Brenna E,Waldum HL,Sandvik AK,Schulze Søgnen B,Kristensen A

    更新日期:1992-06-01 00:00:00

  • Symptom overlap in patients with upper gastrointestinal complaints in the Canadian confirmatory acid suppression test (CAST) study: further psychometric validation of the reflux disease questionnaire.

    abstract:BACKGROUND:The reflux disease questionnaire (RDQ) is a short, patient-completed instrument. AIMS:To investigate the psychometric characteristics of the RDQ in patients with heartburn-predominant (HB) and non-heartburn predominant (NHB) dyspepsia. METHODS:HB (n = 388) and NHB (n = 733) patients were randomized to esom...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2036.2007.03271.x

    authors: van Zanten SV,Armstrong D,Barkun A,Junghard O,White RJ,Wiklund IK

    更新日期:2007-05-01 00:00:00

  • What the physician needs to know for correct management of gastro-oesophageal reflux disease and dyspepsia.

    abstract::Upper gastrointestinal symptoms are highly prevalent; usually those consulting have multiple symptoms, confounding management. Here, common clinically relevant management issues are considered based on the best available evidence. Regardless of the presenting symptoms, determine if there are any alarm features; these ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2036.2004.02043.x

    authors: Talley NJ

    更新日期:2004-07-01 00:00:00

  • Review article: potential therapeutic applications and mechanisms of action of heparin in inflammatory bowel disease.

    abstract::Unfractioned heparin was recently reported to be beneficial in the treatment of inflammatory bowel disease. The available uncontrolled data show that it may be effective in steroid-resistant ulcerative colitis with a percentage of complete clinical remission of over 70% after an average of 4-6 weeks of therapy. The ad...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审

    doi:10.1046/j.1365-2036.2000.00860.x

    authors: Papa A,Danese S,Gasbarrini A,Gasbarrini G

    更新日期:2000-11-01 00:00:00

  • Short report: long-term management of peptic ulcer disease with ranitidine in Germany.

    abstract::One hundred and twenty-five patients with duodenal ulcer disease were given continuous ranitidine therapy after initial acute healing. Cumulative remission rates indicated that 95% of patients were ulcer-free after 1 year, 89% at 2 years, 81% at 3 years, 70% at 4 years and 60% at 5 and 6 years. Nine patients had a sec...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1111/j.1365-2036.1994.tb00171.x

    authors: Simon B,Schütz E,Müller P,Dixon JS

    更新日期:1994-02-01 00:00:00

  • Serotonergic reinforcement of intestinal barrier function is impaired in irritable bowel syndrome.

    abstract:BACKGROUND:Alterations in serotonergic (5-HT) metabolism and/or intestinal integrity have been associated with irritable bowel syndrome (IBS). AIMS:To assess the effects of the precursor of 5-HT, 5-hydroxytryptophan (5-HTP), on mucosal 5-HT availability and intestinal integrity, and to assess potential differences bet...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/apt.12842

    authors: Keszthelyi D,Troost FJ,Jonkers DM,van Eijk HM,Lindsey PJ,Dekker J,Buurman WA,Masclee AA

    更新日期:2014-08-01 00:00:00

  • Systematic review with meta-analysis: endoscopic and histologic placebo rates in induction and maintenance trials of ulcerative colitis.

    abstract:BACKGROUND:Regulatory requirements for claims of mucosal healing in ulcerative colitis (UC) will require demonstration of both endoscopic and histologic healing. Quantifying these rates is essential for future drug development. AIMS:To meta-analyse endoscopic and histologic placebo response and remission rates in UC r...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,meta分析

    doi:10.1111/apt.14672

    authors: Ma C,Guizzetti L,Panaccione R,Fedorak RN,Pai RK,Parker CE,Nguyen TM,Khanna R,Vande Casteele N,D'Haens G,Sandborn WJ,Feagan BG,Jairath V

    更新日期:2018-06-01 00:00:00

  • Dose-response evaluation of the antisecretory effect of continuous infusion intravenous lansoprazole regimens over 48 h.

    abstract:BACKGROUND:Attainment of intragastric pH < 6.0 may require high-dose continuously infused proton pump therapy. AIM:To assess the pharmacokinetic and pharmacodynamic dose-responses of continuous infusion regimens of lansoprazole. METHODS:Healthy adult subjects were assigned to lansoprazole 60-mg intravenous bolus, fol...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2036.2006.02849.x

    authors: Howden CW,Metz DC,Hunt B,Vakily M,Kukulka M,Amer F,Samra N

    更新日期:2006-04-01 00:00:00

  • Circadian differences in pharmacological blockade of meal-stimulated gastric acid secretion.

    abstract::The effects of identical morning (08.05 hours) and evening (20.05 hours) meals on intragastric pH were compared in 12 healthy volunteers receiving gastric antisecretory medication. Dosing included continuous intravenous infusion ranitidine (50 mg bolus followed by 12.5 mg/h) or a matching placebo which were randomly a...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2036.1992.tb00262.x

    authors: Sanders SW,Moore JG,Day GM,Tolman KG

    更新日期:1992-04-01 00:00:00

  • Antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice: is it worth the cost?

    abstract:BACKGROUND:There are few published data concerning the economic impact of antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography in the setting of biliary obstruction. AIM:To perform decision analysis to determine the costs of prophylaxis in patients undergoing endoscopic retrograde cholangiopa...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章

    doi:10.1046/j.1365-2036.2002.01209.x

    authors: Thompson BF,Arguedas MR,Wilcox CM

    更新日期:2002-04-01 00:00:00

  • Review article: the incidence and risk factors for irritable bowel syndrome in population-based studies.

    abstract:BACKGROUND:In the absence of prior gastrointestinal infection, the risk factors for irritable bowel syndrome (IBS) are not well established. AIM:To identify the incidence and risk factors for IBS in general population samples METHODS: Narrative review of population-based studies. Electronic databases were searched usi...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审

    doi:10.1111/apt.15396

    authors: Creed F

    更新日期:2019-09-01 00:00:00

  • Systematic review: macrophage activation syndrome in inflammatory bowel disease.

    abstract:BACKGROUND:Recently, there have been increasingly frequent reports on the occurrence of macrophage activation syndrome (MAS) in patients with inflammatory bowel disease (IBD). Clinically, MAS is characterized mainly by fever, hepatosplenomegaly, cytopenia, and elevated circulating ferritin and CD25. Mortality, even if ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审

    doi:10.1111/apt.12305

    authors: Fries W,Cottone M,Cascio A

    更新日期:2013-06-01 00:00:00

  • Vedolizumab in the treatment of chronic, antibiotic-dependent or refractory pouchitis.

    abstract:BACKGROUND:The most common complication after ileal pouch anal anastomosis in up to 50% of patients is an acute pouchitis. The majority of patients respond to antibiotic treatment. However, 10%-15% develops chronic antibiotic-dependent or refractory pouchitis which is usually hard to treat. AIM:To evaluate the effecti...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,多中心研究

    doi:10.1111/apt.14479

    authors: Bär F,Kühbacher T,Dietrich NA,Krause T,Stallmach A,Teich N,Schreiber S,Walldorf J,Schmelz R,Büning C,Fellermann K,Büning J,Helwig U,German IBD Study Group.

    更新日期:2018-03-01 00:00:00

  • Comparative safety and effectiveness of vedolizumab to tumour necrosis factor antagonist therapy for Crohn's disease.

    abstract:BACKGROUND:Direct comparisons are lacking between vedolizumab and tumour necrosis factor (TNF)-antagonist therapy in Crohn's disease (CD). AIM:To compare safety and effectiveness of vedolizumab and TNF-antagonist therapy in adult CD patients. METHODS:Retrospective observational cohort (May 2014-December 2017) propens...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章

    doi:10.1111/apt.15921

    authors: Bohm M,Xu R,Zhang Y,Varma S,Fischer M,Kochhar G,Boland B,Singh S,Hirten R,Ungaro R,Shmidt E,Lasch K,Jairaith V,Hudesman D,Chang S,Lukin D,Swaminath A,Sands BE,Colombel JF,Kane S,Loftus EV Jr,Shen B,Siegel CA,

    更新日期:2020-08-01 00:00:00

  • The effects of flumazenil on alertness and hypoxia in elderly patients after ERCP.

    abstract::It is not known whether hypoxia, associated with upper gastrointestinal endoscopic procedures when midazolam sedation is used without narcotics, persists into the post-procedure recovery period. Thirty consecutive patients aged over 60 years, undergoing ERCP using midazolam sedation alone, were monitored clinically an...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2036.1992.tb00739.x

    authors: Haines DJ,Bibbey D,Green JR

    更新日期:1992-12-01 00:00:00