Systematic review and meta-analysis of the efficacy and tolerability of nicotine preparations in active ulcerative colitis.

摘要

BACKGROUND: Findings from clinical studies of the efficacy and tolerability of nicotine preparations in maintaining remission of ulcerative colitis (UC) have been inconsistent. OBJECTIVES: This systematic review and meta-analysis aimed to assess the efficacy and tolerability of nicotine preparations in inducing remission in UC. METHODS: A literature search (1966 August 2010) of Scopus (EMBASE), PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted for clinical trials that investigated the efficacy and/or tolerability (any adverse events [AEs] and withdrawals due to AEs) of any nicotine preparation for the induction of remission in UC. RESULTS: The electronic searches yielded 788 items. Of these, 3 placebo-controlled trials representing 233 patients with UC and 2 randomized controlled trials that compared nicotine to corticosteroids in 81 patients with UC were included in meta-analysis. The summary relative risks (RRs) (95% CI) in comparing nicotine to placebo were 1.40 (0.63-3.12) (P = NS) for clinical remission, 1.95 (1.38-2.78) (P < 0.001) for AEs, and 3.44 (0.71-16.71) (P = NS) for withdrawal due to AEs. The summary RRs in comparing nicotine to corticosteroids (prednisolone/prednisone) were 0.74 (0.5-1.09) (P = NS) for clinical remission in 2 trials and 2.28 (0.76-6.83) (P = NS) for withdrawal due to AEs. CONCLUSION: The findings from this meta-analysis do not support the efficacy or tolerability of nicotine preparations in inducing remission in UC.