CEMIC - CONICET 26185
CENTRO DE EDUCACION MEDICA E INVESTIGACIONES CLINICAS "NORBERTO QUIRNO"
Unidad Ejecutora - UE
artículos
Título:
Efficacy of tacrolimus for induction of remission in patients with moderate-to-severe ulcerative colitis: A systematic review and meta-analysis Eficácia do tacrolimus para indução de remissão em pacientes com colite ulcerosa moderada a grave: Uma revisão sistemática e meta-análise
Autor/es:
LASA, JUAN; OLIVERA, PABLO
Revista:
ARQUIVOS DE GASTROENTEROLOGIA
Editorial:
IBEPEGE - Inst. Bras. Estudos Pesquisas Gastroent.
Referencias:
Año: 2017 vol. 54 p. 167 - 172
ISSN:
0004-2803
Resumen:
Background ? There is evidence that shows that calcineurin inhibitors may be useful for the treatment of severe ulcerative colitis. However, evidence regarding the efficacy of tacrolimus for remission induction in this setting is scarce. Objective ? To develop a systematic review on the existing evidence regarding the clinical efficacy of tacrolimus for the induction of remission in patients with moderate-to-severe ulcerative colitis. Methods ? A literature search was undertaken from 1966 to August 2016 using MEDLINE, Embase, LILACS and the Cochrane Library. The following MeSH terms were used: ?Inflammatory Bowel Diseases? or ?Ulcerative Colitis? and ?Calcineurin Inhibitors? or ?Tacrolimus? or ?FK506?. Studies performed in adult ulcerative colitis patients that evaluated the clinical efficacy of tacrolimus for the induction of remission were considered for revision. A meta-analysis was performed with those included studies that were also placebo-controlled and randomized. Clinical response as well as clinical remission and mucosal healing were evaluated. Results ? Overall, 755 references were identified, from which 22 studies were finally included. Only two of them were randomized, placebo-controlled trials. A total of 172 patients were evaluated. A significantly lower risk of failure in clinical response was found for tacrolimus versus placebo [RR 0.58 (0.45-0.73)]; moreover, a lower risk of failure in the induction of remission was also found versus placebo [RR 0.91 (0.82-1)]. Conclusion ? Tacrolimus seems to be a valid therapeutic alternative for the induction of remission in patients with moderate-to-severe ulcerative colitis.
