Meta-analysis of the effectiveness and safety of vedolizumab for ulcerative colitis

AIM: To conduct a meta-analysis examining the effectiveness and safety of vedolizumab for the treatment of ulcerative colitis(UC).METHODS: A search was conducted of MEDLINE, Cochrane, EMBASE, and Google Scholar on July 31, 2013. Inclusion criteria were:(1) Randomized controlled trial(RCT);(2) Patients treated for UC; and(3) Intervention was vedolizumab. The following information/data were extracted from studies that met the inclusion criteria: the name of the first author, year of publication, study design, patient demographic information, response rate, remission rate, and adverse events. The primary outcome was clinical response rate, and the secondary outcomes were clinical remission rate and serious adverse events. Odds ratio(OR) with 95%CI were calculated for each outcome. RESULTS: Of 224 studies initially identified, three RCTs examining the use of vedolizumab meeting the inclusion criteria were included in the meta-analysis. All studies examined the use of vedolizumab at dosages ranging from 0.5 to 10 mg/kg body weight(one study used a standard dose of 300 mg). The follow-up periods were approximately 6 wk. The total number of patients in the intervention groups was 901, and in the control groups was 221. The mean age of the patients was approximately 41 years, and approximately half were males. The follow-up periods ranged from 43 d to 6 wk. The clinical response and remission rates were significantly higher for patients who received vedolizumab as compared to control patients(clinical response: OR = 2.69; 95%CI: 1.94-3.74, P < 0.001 and remission rate: OR = 2.72; 95%CI: 1.76-4.19, P < 0.001). Serious adverse events were not higher in patients that received vedolizumab.CONCLUSION: This analysis supports the use of vedolizumab for the treatment of UC.

Dairy product consumption and gastric cancer risk: A meta-analysis

AIM: To investigate whether dairy product consumption is a risk factor for gastric cancer. METHODS: We searched the Pub Med and Web of Science databases for English-language studies on dairy product consumption and gastric cancer risk that were published between October 1980 and September 2013. One author independently extracted data and assessed study quality. Based on the heterogeneity results, we used either the fixed effects model or the random effects model to compute the summary relative risks and 95% confidence intervals(CIs). We also analyzed subgroups according to the study design, geographic region, sex, and whether there were adjustments for confounders(smoking and drinking) with respect to the sources of heterogeneity.RESULTS:We found 39 studies that were potentiallyeligible for inclusion in this meta-analysis,including 10cohort studies and 29 case-control studies.The summary relative risk for gastric cancer,comparing the highest and lowest dairy product consumption categories,was 1.06(95%CI:0.95-1.18).Specific analyses for milk,butter,and margarine yielded similar results,but the results for cheese and yogurt were different.There was significant heterogeneity for all studies(Q=112.61;P=0.000;I2=67.1%).No publication bias was observed(Egger’s test:P=0.135;Begg’s test:P=0.365).There was a nonsignificant association between dairy product consumption and gastric cancer risk in the subgroup analysis for the study design,sex,geographic region,and whether there were adjustments for confounders(smoking and drinking).CONCLUSION:In our meta-analysis,dairy product consumption was associated with a nonsignificantly increased risk of gastric cancer.However,this result should be verified using large,well-designed prospective studies.