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Addition of hyperbaric oxygen therapy versus usual care alone for inflammatory bowel disease: A systematic review and
Jiu-Hong You1,2,3, Jun-Liang Jiang1,2, Wen-Bo He4
1Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Insights
Hyperbaric oxygen therapy (HBOT) shows promise as an effective adjunctive treatment for inflammatory bowel disease (IBD), significantly improving clinical response and reducing recurrence rates. This therapy was also found to be safe, with no severe adverse events reported.
Area of Science:
- Gastroenterology
- Hyperbaric Medicine
- Inflammatory Bowel Disease Research
Background:
- Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is a chronic inflammatory condition.
- Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen under increased pressure.
- Existing literature suggests HBOT's potential efficacy in IBD management, yet quantitative analysis is lacking.
Purpose of the Study:
- To quantitatively assess the adjunctive role of HBOT in treating IBD.
- To evaluate the impact of HBOT on reducing IBD recurrence rates.
Main Methods:
- Systematic review and meta-analysis of relevant studies.
- Searched multiple databases including PubMed, EMBASE, Web of Science, and Chinese databases.
- Utilized Review Manager (RevMan 5.3) for meta-analyses with a random-effects model due to heterogeneity.
Main Results:
- Included 29 articles with 2151 IBD patients (2071 UC, 80 CD); no randomized CD data.
- HBOT plus usual care improved clinical response in UC patients (RR, 1.24; 95% CI, 1.17-1.31).
- HBOT significantly lowered IBD recurrence rates (RR, 0.35; 95% CI, 0.24-0.53) and reduced serum TNF levels (SMD, -2.13; 95% CI, -3.09 to -1.18).
Conclusions:
- HBOT appears to be an effective and safe adjunctive therapy for IBD.
- Further research is needed to determine the optimal HBOT protocol for IBD treatment.
Objective:
Inflammatory bowel disease (IBD) is a chronic idiopathic inflammatory disease that includes ulcerative colitis (UC) and Crohn's disease (CD). Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen in a pressurized environment. Existing literature suggests that HBOT may be an effective therapy for IBD, but a quantitative analysis is lacking. This study aims to estimate the adjunctive role of HBOT in treating IBD and lowering its recurrence rate.
Design:
Systematic review and meta-analysis.
Methods:
The Cochrane Library, EMBASE, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang databases were systematically searched by two reviewers independently. Meta-analyses were performed using Review Manager (RevMan, version 5.3). A random-effects model was applied due to the heterogeneity between studies.
Results:
Twenty-nine out of the initially identified 606 articles were covered in this review, with a total of 2151 patients (2071 for UC and 80 for CD). No randomized data of HBOT for CD were included. Among UC patients, usual care plus HBOT were more likely to achieve a clinical response than usual care alone (risk ratio [RR], 1.24; 95% confidence interval (CI), 1.17 to 1.31; P < 0.001). Subgroup analysis showed that the number of HBOT sessions had no statistically significant effect on overall efficacy (P > 0.05). The pooled data showed a lower recurrence rate in the usual care plus HBOT group (RR, 0.35; 95% CI, 0.24 to 0.53; P < 0.001). The standardized mean difference in the serum tumor necrosis factor level between HBOT and non-HBOT groups was -2.13 (95% CI, -3.09 to -1.18; P < 0.001). No severe adverse events of HBOT were observed.
Conclusions:
HBOT might be an effective and safe adjunctive treatment for IBD. Further studies are required to investigate the optimal protocol of HBOT in IBD treatment.
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