PMID- 21618363
OWN - NLM
STAT- MEDLINE
DCOM- 20111220
LR  - 20181201
IS  - 1536-4844 (Electronic)
IS  - 1078-0998 (Linking)
VI  - 17
IP  - 9
DP  - 2011 Sep
TI  - Unfractionated or low molecular weight heparin for induction of remission in 
      ulcerative colitis: a Cochrane inflammatory bowel disease and functional bowel 
      disorders systematic review of randomized trials.
PG  - 1979-86
LID - 10.1002/ibd.21776 [doi]
AB  - BACKGROUND: We aimed to systematically review the efficacy of unfractionated 
      heparin (UFH) or low molecular weight heparins (LMWH) for remission induction in 
      patients with ulcerative colitis (UC). METHODS: A literature search to April 2011 
      was performed to identify all randomized trials studying UFH or LMWH use in 
      patients with UC. The Cochrane Risk of Bias Tool was used to assess study 
      quality. RESULTS: LMWH administered subcutaneously showed no benefit over placebo 
      for any outcome, including clinical remission, and clinical, endoscopic, or 
      histological improvement. High-dose LMWH administered via an extended 
      colon-release tablet demonstrated benefit over placebo for clinical remission 
      (odds ratio [OR] 2.73; 95% confidence interval [CI] 1.32-5.67; P = 0.007), 
      clinical improvement (OR 2.99; 95% CI 1.30-6.87; P = 0.01), and endoscopic 
      improvement (OR 2.25; 95% CI 1.01-5.01; P = 0.05) but not endoscopic remission or 
      histologic improvement. LMWH was not beneficial when added to standard therapy 
      for clinical remission, clinical improvement, endoscopic remission, or endoscopic 
      improvement. One study examining UFH versus corticosteroids for the treatment of 
      severe UC demonstrated the inferiority of UFH for clinical improvement. More 
      patients assigned to UFH had rectal hemorrhage as an adverse event. CONCLUSIONS: 
      LMWH administered by extended colon-release tablets may be effective for the 
      treatment of active UC. This benefit needs to be confirmed by further randomized 
      controlled studies. The same benefits were not seen when LMWH was administered 
      subcutaneously at lower doses. There is no evidence to support the use of UFH for 
      the treatment of active UC.
CI  - Copyright (c) 2011 Crohn's & Colitis Foundation of America, Inc.
FAU - Chande, Nilesh
AU  - Chande N
AD  - Gastroenterology, University of Western Ontario, London, Ontario, Canada. 
      Nilesh.Chande@lhsc.on.ca
FAU - MacDonald, John K
AU  - MacDonald JK
FAU - Wang, Josh J
AU  - Wang JJ
FAU - McDonald, John W D
AU  - McDonald JW
LA  - eng
GR  - Canadian Institutes of Health Research/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20110525
PL  - England
TA  - Inflamm Bowel Dis
JT  - Inflammatory bowel diseases
JID - 9508162
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/*therapeutic use
MH  - Colitis, Ulcerative/*drug therapy
MH  - Heparin/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Inflammatory Bowel Diseases/*drug therapy
MH  - Prognosis
MH  - Randomized Controlled Trials as Topic
MH  - Remission Induction
EDAT- 2011/05/28 06:00
MHDA- 2011/12/21 06:00
CRDT- 2011/05/28 06:00
PHST- 2011/04/17 00:00 [received]
PHST- 2011/04/19 00:00 [accepted]
PHST- 2011/05/28 06:00 [entrez]
PHST- 2011/05/28 06:00 [pubmed]
PHST- 2011/12/21 06:00 [medline]
AID - 10.1002/ibd.21776 [doi]
PST - ppublish
SO  - Inflamm Bowel Dis. 2011 Sep;17(9):1979-86. doi: 10.1002/ibd.21776. Epub 2011 May 
      25.