Abstract:
GOALS:In order to provide a comparative evaluation of available pharmacologic treatments for eosinophilic esophagitis (EoE), we conducted a network meta-analysis. BACKGROUND:A variety of pharmacologic treatments for EoE have been reported, however there exists a paucity of direct comparisons. STUDY:We searched randomized controlled trials using MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials database through December 2014. Studies were analyzed using a random-effects network meta-analysis to identify the most effective therapy. Subgroup analysis was performed among studies that excluded gastroesophageal reflux disease or proton-pump inhibitor responsive esophageal eosinophilia, and also among pediatric and adult populations. The ranking probability for the efficacy of each treatment was analyzed. Consistency of the included randomized controlled trials was checked by applying inconsistency and node-splitting models. RESULTS:Eleven studies of a total of 456 patients were identified. Six pharmacologic treatments (budesonide suspension and viscous, fluticasone, prednisone, esomeprazole, and mepolizumab) and placebo were included in our analysis. Meta-analysis showed superiority of budesonide viscous, budesonide suspension, and fluticasone over placebo. Network meta-analysis demonstrated the rank order of efficacy as budesonide viscous, esomeprazole, prednisone, budesonide suspension, fluticasone, mepolizumab, and placebo. The results were consistent from the inconsistency model analysis and node-splitting analysis. Subgroup analysis demonstrated prednisone, budesonide suspension, and esomeprazole were the most effective when network meta-analyses were performed among studies that excluded gastroesophageal reflux disease or proton-pump inhibitor responsive esophageal eosinophilia, and among pediatric and adult populations, respectively. CONCLUSIONS:On the basis of this network meta-analysis, viscous budesonide was shown to be the most effective pharmacologic therapy for EoE among the reported pharmacologic treatments.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Tomizawa Y,Melek J,Komaki Y,Kavitt RT,Sakuraba Adoi
10.1097/MCG.0000000000000878subject
Has Abstractpub_date
2018-08-01 00:00:00pages
596-606issue
7eissn
0192-0790issn
1539-2031journal_volume
52pub_type
杂志文章,meta分析abstract::A 53-year-old white woman developed diabetes mellitus, migratory erythema, and anemia, clinical features suggesting the presence of a "glucagonoma." Ten years earlier, after laparotomy and pancreatic biopsy, she had been told that she had an inoperable pancreatic carcinoma. Review of that biopsy together with current ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-197909000-00005
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:Fatigue is common in inflammatory bowel disease (IBD) patients and is associated with factors such as psychopathology, sleep quality, and disease activity. GOAL:To investigate the combined role of all the above factors in the burden of fatigue among IBD patients. STUDY:We conducted an observational study o...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000729
更新日期:2018-05-01 00:00:00
abstract::Helicobacter pylori infection may play a role in the development of gastric cancer; however, a quantitative evaluation of the density of H. pylori infection has not been reported previously in relation to the histologic stage and type of cancer. This study was designed to compare the density of H. pylori infection to ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200010000-00006
更新日期:2000-10-01 00:00:00
abstract::The recognition of Helicobacter pylori (H. pylori) as a major cause of gastroduodenal diseases has led to the use of antibiotics to treat these diseases. However, antibiotics used alone are not very effective, and adjuvant therapy is required. The most potent adjuvant therapy consists of increasing the stomach pH with...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::Two patients with similar symptoms referred for diagnosis and treatment of hepatic failure subsequently proved to have cardiomyopathy as the cause of their hepatic decompensation. Except for fatigue and edema, symptoms of congestive heart failure were absent and no history of dyspnea, orthopnea, or paroxysmal nocturna...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199006000-00015
更新日期:1990-06-01 00:00:00
abstract::Severely ill patients with ulcerative colitis are usually treated with parenteral corticoids. Those with signs of systemic toxicity usually receive antibiotics as well. However, the role of antibiotics in patients without high fever, profound leukocytosis, peritoneal signs or megacolon is not clear. Since 1985, seven ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199307000-00005
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Iron deficiency anemia (IDA) may be the sole manifestation of celiac disease. The role of routine small bowel biopsies obtained during endoscopy in the evaluation of IDA is unclear. This study assessed the usefulness of routine small bowel biopsies in patients presenting with IDA. STUDY:Evaluation of 103 co...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000139034.38568.51
更新日期:2004-10-01 00:00:00
abstract::Various esophageal functional abnormalities have been described in patients with Barrett's esophagus (BE). A significantly higher esophageal acid exposure especially in the supine position has been documented in BE, as compared with the other gastroesophageal reflux disease phenotypes. In addition, weakly acidic reflu...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001358
更新日期:2020-07-01 00:00:00
abstract::Hepatic iron deposition is common in patients with chronic hepatitis C (HCV) and may play a role in progression of liver disease. This pilot study examines the relationship between hepatic iron concentration (HIC) and histologic progression over time in patients with HCV. HIC was retrospectively measured in 14 patient...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200311000-00012
更新日期:2003-11-01 00:00:00
abstract::Microbial signals stimulate development and maintenance of the neonatal immune system. The process begins in utero, with limited exposure to microbes in the intrauterine environment, as well as maternal immune signals priming the developing immune system. After birth and initial colonization, the immune system must be...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0000000000000355
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Deep biliary cannulation (DBC) is a prerequisite to most endoscopic retrograde cholangiopancreatographies (ERCPs). Numerous techniques have been described to maximize success and minimize ERCP-related complications, most notably post-ERCP pancreatitis. Dye-free cannulation by using guidewires with hydrophili...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181aacbd1
更新日期:2010-03-01 00:00:00
abstract::Duodenal neoplasms are a rare and not often considered cause of massive upper gastrointestinal bleeding. During a 4-year period, 859 endoscopies in patients with upper gastrointestinal bleeding revealed a duodenal tumor to be the cause of bleeding in eight patients. Three patients had a primary duodenal neoplasm, two ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198202000-00006
更新日期:1982-02-01 00:00:00
abstract::In this manuscript, a short review is provided of the basic principles of screening, emphasizing some of the methodologic problems attendant on any screening test, in short, a "screening primer." My analysis of the "core" data supporting efforts to screen for colorectal cancer leads to the conclusion that the utility ...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:
更新日期:1983-06-01 00:00:00
abstract::The epithelial cells of the stomach and duodenum are normally protected from the damaging effects of acid and pepsin by a balancing mechanism of mucosal resistance. If an imbalance occurs, peptic ulcer may result. Traditional teaching has emphasized the importance of acid (and pepsin) as the cause of this imbalance; h...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199000000-00002
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Celiac disease (CeD) is a systemic disease with manifestations not limited to small intestine. The data on association between CeD and infertility is contradictory. There are no recommendations for the screening of female patients with infertility for CeD. AIM:We conducted a meta-analysis to find out whethe...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,meta分析
doi:10.1097/MCG.0000000000000285
更新日期:2016-01-01 00:00:00
abstract::Endoscopic placement of nasoenteric feeding tubes is a common technique used in clinical practice. However, use of the endoscopic "drag and pull" method to pull the tube into position by grasping the feeding tube with a biopsy forceps requires considerable skill. In this paper, we describe a modified suture, which mar...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::In four of five patients with gastric cancer who also had a chronic duodenal ulcer, the histologic type was "early gastric cancer," which offers a better prognosis than the more common type. Patients with duodenal ulcer who develop gastric cancer may have a better prognosis than patients with gastric cancer without du...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198702000-00009
更新日期:1987-02-01 00:00:00
abstract::A 24-year-old man with addisonian pernicious anemia, adult celiac disease and selective IgA deficiency is presented to emphasize the differential diagnosis of vitamin B12 deficient megaloblastic anemia in association with small intestinal mucosal abnormalities and the relationships between immunoglobulin deficiency, p...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198606000-00016
更新日期:1986-06-01 00:00:00
abstract::Liver transplantation (LT) for alcoholic cirrhosis remains controversial. This controversy surrounding LT in alcoholics focuses on the risk of alcohol recidivism and on potential noncompliance with the immunosuppressive regimen, both of which result in graft failure. Our study examined alcohol recidivism after LT by m...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199804000-00011
更新日期:1998-04-01 00:00:00
abstract::The methods used to discern the structure (anatomy) and function (physiology) of the indigenous microbiota can be divided according to which aspect of the microbiota they can interrogate and are positioned accordingly. At the most basic level, methods can simply describe the community structure of the microbiota, that...
journal_title:Journal of clinical gastroenterology
pub_type:
doi:10.1097/MCG.0000000000001106
更新日期:2018-11-01 00:00:00
abstract::Lactobacillus species are part of normal gastrointestinal flora and are an uncommon cause of bacteremia. Lactobacillus casei subsp. rhamnosus was repeatedly isolated in the blood cultures of a 43-year-old woman with ulcerative colitis. Lactobacillus spp. could be considered a potential opportunistic pathogen whenever ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200109000-00019
更新日期:2001-09-01 00:00:00
abstract::Hepatocellular carcinoma (HCC) is the most common hepatic malignancy worldwide. The primary risk factor for the development of HCC is cirrhosis. Even patients without cirrhosis who develop HCC are typically found to have some underlying hepatic abnormality, such as steatohepatitis or chronic viral hepatitis. Although ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200211002-00003
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:The aims of this study were to analyze the overall survival of patients with cirrhosis and small hepatocellular carcinoma (HCC) and identify independent pretreatment predictors of survival in Brazil. METHODS:Between 1998 and 2003, 74 patients with cirrhosis and small HCC were evaluated. Predictors of surviv...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31817ff199
更新日期:2009-02-01 00:00:00
abstract::An unusual case of malignant pancreatic composite tumor with both components of acinar cell tumor (ACT) and islet cell tumor (ICT) was investigated histologically, immunohistochemically, and ultrastructurally. The pancreatic tumor with central cyst formation was found on computerized tomographic examination of a 72-ye...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200009000-00020
更新日期:2000-09-01 00:00:00
abstract::We have found 20 cases of ectopic gastric mucosa in the proximal esophagus. Five patients had symptoms, usually a burning sensation in the neck and/or dysphagia. We report the results of immunoperoxidase staining of this tissue for gastrin, somatostatin, vasoactive intestinal peptide, and bombesin. In 85% of biopsy sp...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198610000-00003
更新日期:1986-10-01 00:00:00
abstract::During a course of 10 biofeedback sessions in a single subject, the lower esophageal sphincter pressure measured with an open-tipped perfused catheter assembly showed significant and progressive increase with each session, until it reached normal levels. There was also a decrease in symptomatic reflux episodes, from t...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198306000-00008
更新日期:1983-06-01 00:00:00
abstract::Adrenal neoplasm is a rare cause of Budd-Chiari syndrome. We report a case of fulminant acute Budd-Chiari syndrome due to inferior vena cava thrombosis stemming from invasion by a clinically nonfunctioning adrenal neoplasm. We also review briefly the clinical characteristics of the seven previously reported cases. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199703000-00015
更新日期:1997-03-01 00:00:00
abstract::5-Fluorouracil (5-FU), in association with leucovorin (LV), is the most used chemotherapy agent in the treatment of colorectal cancer. Response rate, as well as side-effect incidence, increases with the dose intensity of regimens that are used. The most common dose-limiting toxicity for 5-FU/LV modulation is diarrhea....
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200103000-00010
更新日期:2001-03-01 00:00:00
abstract::A 45-year-old woman receiving continuous infusions of 5-fluoro-2'-deoxy-uridine into the hepatic artery through a surgically implanted intraarterial catheter for hepatic metastases from adenocarcinoma of the colon, developed acute epigastric pain and anemia. Endoscopy demonstrated a duodenal ulcer with a portion of th...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198808000-00016
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Endoscopic follow-up (FU) in patients treated for colorectal adenomas or cancer (CRC) is intended to reduce the incidence of CRC. In the Dutch postpolypectomy guidelines, the FU interval is solely determined by the number of previous adenomas, whereas in other countries size and histology are also taken into...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
doi:10.1097/MCG.0b013e31809e703c
更新日期:2008-05-01 00:00:00