Defined-Formula Diets versus Steroids in the Treatment of Active Crohn's Disease A Meta-Analysis
Background: To compare the effectiveness of defined-formula diets versus steroids for the treatment of active Crohn's disease, we conducted a meta-analysis of the published clinical trials. Methods: Standard techniques for literature search were used to identify the pertinent trials. All studie...
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| Veröffentlicht in: | Scandinavian journal of gastroenterology 1996, Vol.31 (3), p.267-272 |
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| container_title | Scandinavian journal of gastroenterology |
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| creator | Messori, A. Trallori, G. D'albasio, G. Milla, M. Vannozzi, G. Pacini, F. |
| description | Background: To compare the effectiveness of defined-formula diets versus steroids for the treatment of active Crohn's disease, we conducted a meta-analysis of the published clinical trials. Methods: Standard techniques for literature search were used to identify the pertinent trials. All studies included in our meta-analysis (n = 7) were aimed at comparing defined-formula diets versus steroids, using a randomized design. The patient-specific end-point of the meta-analysis was the occurrence of a treatment failure. Results: Our meta-analysis indicated that steroids are more effective than defined-formula diets for inducing remission in active Crohn's disease. In fact, the relative risk of treatment failure (RTF) was significantly lower in the steroid group than in the diet group (risk values for patients given steroids compared with patients given diet: a) method of Mantel-Haenszel: RTF = 0.35; 95% confidence interval, 0.23-0.53; p < 0.001; b) method of Der Simonian & Laird: RTF = 0.43; 95% confidence interval, |
| doi_str_mv | 10.3109/00365529609004877 |
| format | Article |
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Methods: Standard techniques for literature search were used to identify the pertinent trials. All studies included in our meta-analysis (n = 7) were aimed at comparing defined-formula diets versus steroids, using a randomized design. The patient-specific end-point of the meta-analysis was the occurrence of a treatment failure. Results: Our meta-analysis indicated that steroids are more effective than defined-formula diets for inducing remission in active Crohn's disease. In fact, the relative risk of treatment failure (RTF) was significantly lower in the steroid group than in the diet group (risk values for patients given steroids compared with patients given diet: a) method of Mantel-Haenszel: RTF = 0.35; 95% confidence interval, 0.23-0.53; p < 0.001; b) method of Der Simonian & Laird: RTF = 0.43; 95% confidence interval, <0-0.94; p = 0.03). A separate analysis was carried out in which only the subgroup of patients who were not intolerant to diet were evaluated; this analysis also showed a superiority of steroids over diet. Conclusions: The data examined in this meta-analysis do not support the use of diets as primary treatment for acute exacerbations of Crohn's disease in adults.</description><identifier>ISSN: 0036-5521</identifier><identifier>EISSN: 1502-7708</identifier><identifier>DOI: 10.3109/00365529609004877</identifier><identifier>PMID: 8833357</identifier><identifier>CODEN: SJGRA4</identifier><language>eng</language><publisher>Copenhagen: Informa UK Ltd</publisher><subject>Adult ; Biological and medical sciences ; Crohn Disease - diet therapy ; Crohn Disease - drug therapy ; Crohn's disease ; diet ; Digestive system ; Food, Formulated ; Glucocorticoids - therapeutic use ; Humans ; Medical sciences ; meta-analysis ; Pharmacology. Drug treatments ; Prednisolone - therapeutic use ; Prednisone - therapeutic use ; Randomized Controlled Trials as Topic ; steroids ; Treatment Failure</subject><ispartof>Scandinavian journal of gastroenterology, 1996, Vol.31 (3), p.267-272</ispartof><rights>1996 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 1996</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-add7d5472105f8647e7da6f39fdd749c0087f77852ab5ee1c54675814efd03363</citedby><cites>FETCH-LOGICAL-c430t-add7d5472105f8647e7da6f39fdd749c0087f77852ab5ee1c54675814efd03363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.3109/00365529609004877$$EPDF$$P50$$Ginformaworld$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.3109/00365529609004877$$EHTML$$P50$$Ginformaworld$$H</linktohtml><link.rule.ids>314,780,784,4021,27921,27922,27923,59645,59751,60434,60540,61219,61254,61400,61435</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3091038$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8833357$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Messori, A.</creatorcontrib><creatorcontrib>Trallori, G.</creatorcontrib><creatorcontrib>D'albasio, G.</creatorcontrib><creatorcontrib>Milla, M.</creatorcontrib><creatorcontrib>Vannozzi, G.</creatorcontrib><creatorcontrib>Pacini, F.</creatorcontrib><title>Defined-Formula Diets versus Steroids in the Treatment of Active Crohn's Disease A Meta-Analysis</title><title>Scandinavian journal of gastroenterology</title><addtitle>Scand J Gastroenterol</addtitle><description>Background: To compare the effectiveness of defined-formula diets versus steroids for the treatment of active Crohn's disease, we conducted a meta-analysis of the published clinical trials. Methods: Standard techniques for literature search were used to identify the pertinent trials. All studies included in our meta-analysis (n = 7) were aimed at comparing defined-formula diets versus steroids, using a randomized design. The patient-specific end-point of the meta-analysis was the occurrence of a treatment failure. Results: Our meta-analysis indicated that steroids are more effective than defined-formula diets for inducing remission in active Crohn's disease. In fact, the relative risk of treatment failure (RTF) was significantly lower in the steroid group than in the diet group (risk values for patients given steroids compared with patients given diet: a) method of Mantel-Haenszel: RTF = 0.35; 95% confidence interval, 0.23-0.53; p < 0.001; b) method of Der Simonian & Laird: RTF = 0.43; 95% confidence interval, <0-0.94; p = 0.03). A separate analysis was carried out in which only the subgroup of patients who were not intolerant to diet were evaluated; this analysis also showed a superiority of steroids over diet. Conclusions: The data examined in this meta-analysis do not support the use of diets as primary treatment for acute exacerbations of Crohn's disease in adults.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Crohn Disease - diet therapy</subject><subject>Crohn Disease - drug therapy</subject><subject>Crohn's disease</subject><subject>diet</subject><subject>Digestive system</subject><subject>Food, Formulated</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>meta-analysis</subject><subject>Pharmacology. Drug treatments</subject><subject>Prednisolone - therapeutic use</subject><subject>Prednisone - therapeutic use</subject><subject>Randomized Controlled Trials as Topic</subject><subject>steroids</subject><subject>Treatment Failure</subject><issn>0036-5521</issn><issn>1502-7708</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu1DAQhi0EKtvCA3BA8gHBKWW8jmNH9LLathSpiEPbc3DjsdZVEhePU7Rvj6tdKiGknnz4v2_G8zP2TsCxFNB-BpCNUsu2gRagNlq_YAuhYFlpDeYlWzzmVQHEa3ZIdAcAStftATswRkqp9IL9PEUfJnTVeUzjPFh-GjATf8BEM_GrjCkGRzxMPG-QXye0ecQp8-j5qs_hAfk6xc30iYpIaAn5in_HbKvVZIctBXrDXnk7EL7dv0fs5vzsen1RXf74-m29uqz6WkKurHPaqVovBShvmlqjdrbxsvUlqNsewGivtVFLe6sQRa_qRisjavQOpGzkEfu4m3uf4q8ZKXdjoB6HwU4YZ-q0kVqUBQUUO7BPkSih7-5TGG3adgK6x1a7_1otzvv98Pl2RPdk7Gss-Yd9bqm3g0926gM9YRJaAdIU7GSHhcmXuu3vmAbXZbsdYvrryOd-8eUffYN2yJveJuzu4pxK4fTMDX8Ab6SjMA</recordid><startdate>1996</startdate><enddate>1996</enddate><creator>Messori, A.</creator><creator>Trallori, G.</creator><creator>D'albasio, G.</creator><creator>Milla, M.</creator><creator>Vannozzi, G.</creator><creator>Pacini, F.</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><general>Scandinavian University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1996</creationdate><title>Defined-Formula Diets versus Steroids in the Treatment of Active Crohn's Disease A Meta-Analysis</title><author>Messori, A. ; Trallori, G. ; D'albasio, G. ; Milla, M. ; Vannozzi, G. ; Pacini, F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c430t-add7d5472105f8647e7da6f39fdd749c0087f77852ab5ee1c54675814efd03363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Crohn Disease - diet therapy</topic><topic>Crohn Disease - drug therapy</topic><topic>Crohn's disease</topic><topic>diet</topic><topic>Digestive system</topic><topic>Food, Formulated</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>meta-analysis</topic><topic>Pharmacology. Drug treatments</topic><topic>Prednisolone - therapeutic use</topic><topic>Prednisone - therapeutic use</topic><topic>Randomized Controlled Trials as Topic</topic><topic>steroids</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Messori, A.</creatorcontrib><creatorcontrib>Trallori, G.</creatorcontrib><creatorcontrib>D'albasio, G.</creatorcontrib><creatorcontrib>Milla, M.</creatorcontrib><creatorcontrib>Vannozzi, G.</creatorcontrib><creatorcontrib>Pacini, F.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Scandinavian journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Messori, A.</au><au>Trallori, G.</au><au>D'albasio, G.</au><au>Milla, M.</au><au>Vannozzi, G.</au><au>Pacini, F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Defined-Formula Diets versus Steroids in the Treatment of Active Crohn's Disease A Meta-Analysis</atitle><jtitle>Scandinavian journal of gastroenterology</jtitle><addtitle>Scand J Gastroenterol</addtitle><date>1996</date><risdate>1996</risdate><volume>31</volume><issue>3</issue><spage>267</spage><epage>272</epage><pages>267-272</pages><issn>0036-5521</issn><eissn>1502-7708</eissn><coden>SJGRA4</coden><abstract>Background: To compare the effectiveness of defined-formula diets versus steroids for the treatment of active Crohn's disease, we conducted a meta-analysis of the published clinical trials. Methods: Standard techniques for literature search were used to identify the pertinent trials. All studies included in our meta-analysis (n = 7) were aimed at comparing defined-formula diets versus steroids, using a randomized design. The patient-specific end-point of the meta-analysis was the occurrence of a treatment failure. Results: Our meta-analysis indicated that steroids are more effective than defined-formula diets for inducing remission in active Crohn's disease. In fact, the relative risk of treatment failure (RTF) was significantly lower in the steroid group than in the diet group (risk values for patients given steroids compared with patients given diet: a) method of Mantel-Haenszel: RTF = 0.35; 95% confidence interval, 0.23-0.53; p < 0.001; b) method of Der Simonian & Laird: RTF = 0.43; 95% confidence interval, <0-0.94; p = 0.03). A separate analysis was carried out in which only the subgroup of patients who were not intolerant to diet were evaluated; this analysis also showed a superiority of steroids over diet. Conclusions: The data examined in this meta-analysis do not support the use of diets as primary treatment for acute exacerbations of Crohn's disease in adults.</abstract><cop>Copenhagen</cop><cop>Oslo</cop><cop>Stockholm</cop><pub>Informa UK Ltd</pub><pmid>8833357</pmid><doi>10.3109/00365529609004877</doi><tpages>6</tpages></addata></record> |
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| ispartof | Scandinavian journal of gastroenterology, 1996, Vol.31 (3), p.267-272 |
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| source | MEDLINE; Taylor & Francis:Master (3349 titles); Taylor & Francis Medical Library - CRKN |
| subjects | Adult Biological and medical sciences Crohn Disease - diet therapy Crohn Disease - drug therapy Crohn's disease diet Digestive system Food, Formulated Glucocorticoids - therapeutic use Humans Medical sciences meta-analysis Pharmacology. Drug treatments Prednisolone - therapeutic use Prednisone - therapeutic use Randomized Controlled Trials as Topic steroids Treatment Failure |
| title | Defined-Formula Diets versus Steroids in the Treatment of Active Crohn's Disease A Meta-Analysis |
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