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Related Experiment Videos

Interventions for treating lymphocytic colitis.

N Chande1, J W D McDonald, J K Macdonald

  • 1LHSC - South Street Hospital, Mailbox 55, 375 South Street, London, Ontario, Canada, N6A 4G5. nchande2@uwo.ca

The Cochrane Database of Systematic Reviews
|April 22, 2008
PubMed
Summary
This summary is machine-generated.

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See all related articles

Budesonide shows promise for treating active lymphocytic colitis, with a number needed to treat of 3 for clinical and histological response. Further research is needed for mesalazine and bismuth subsalicylate.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Pharmacology

Background:

  • Lymphocytic colitis is a significant cause of chronic diarrhea.
  • Current treatment strategies rely on limited evidence from case series and uncontrolled trials.
  • This review focuses on identifying therapies supported by randomized controlled trials (RCTs) for lymphocytic colitis.

Purpose of the Study:

  • To systematically review and evaluate the efficacy of different therapeutic interventions for active lymphocytic colitis.
  • To identify treatments for lymphocytic colitis with robust evidence from randomized controlled trials.

Main Methods:

  • Comprehensive literature search of MEDLINE, PUBMED, EMBASE, and clinical trial registries up to December 2007.
  • Inclusion of three randomized controlled trials comparing budesonide, mesalazine (with or without cholestyramine), and bismuth subsalicylate against placebo or active comparators.

Related Experiment Videos

  • Data extraction using 2x2 tables and statistical analysis (chi-square test) to determine treatment efficacy.

    • Main Results:

    • Budesonide (9 mg/day) demonstrated significant efficacy over placebo in inducing both clinical (P = 0.004, NNT = 3) and histological responses (P = 0.04, NNT = 3).
    • Mesalazine, with or without cholestyramine, showed high response rates, but no statistically significant difference compared to the comparator (P = 0.95).
    • Bismuth subsalicylate did not show significant clinical (P=0.10) or histological (P=0.71) improvement compared to placebo.

    Conclusions:

    • Budesonide emerges as a potentially effective treatment for active lymphocytic colitis, warranting further investigation.
    • Evidence for mesalazine (with or without cholestyramine) is weaker and requires confirmation in placebo-controlled studies.
    • Bismuth subsalicylate efficacy remains undetermined; further trials are essential to establish evidence-based treatment guidelines for lymphocytic colitis.