PMID- 30982208
OWN - NLM
STAT- MEDLINE
DCOM- 20200507
LR  - 20200507
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
VI  - 64
IP  - 10
DP  - 2019 Oct
TI  - Therapeutic Efficacy and Adverse Events of Tacrolimus in Patients with Crohn's 
      Disease: Systematic Review and Meta-Analysis.
PG  - 2945-2954
LID - 10.1007/s10620-019-05619-1 [doi]
AB  - BACKGROUND: Only a few randomized controlled trials (RCTs) and some uncontrolled 
      trials have reported the efficacy and adverse events (AEs) of tacrolimus (Tac) in 
      patients with refractory Crohn's disease (CD). The aim of this study was to 
      undertake a systematic review and meta-analysis of the therapeutic efficacy and 
      AEs of Tac in patients with CD. METHODS: We investigated studies reporting the 
      therapeutic efficacy of Tac in patients with CD from 1950 until December 2017. 
      Study subjects were categorized into three groups: systemic administration of Tac 
      for patients with luminal CD (Group 1); systemic administration of Tac for 
      patients with perianal CD (Group 2); and topical administration of Tac for 
      patients with localized CD (Group 3). The primary endpoint of this study was the 
      remission rate. Secondary endpoints were partial response rate, factors related 
      to remission, and the incidence of AEs. RESULTS: The remission rate of Group 1, 
      2, and 3 was 37.1, 32.0, and 22.7%, respectively. The partial response rate of 
      those was 42.3, 42.9, and 44.3%, respectively. In addition, the incidence of AEs 
      of those was 50.9, 65.5, and 40.0%, respectively. No life-threatening AEs were 
      observed in any study. CONCLUSION: This systematic review and meta-analysis 
      demonstrated that Tac therapy was effective for subpopulation of CD patients and 
      that the incidence of AEs was tolerable. Therefore, Tac therapy should be 
      considered an option for patients with CD. However, there have been few 
      well-designed RCTs on this subject and further studies are required.
FAU - Iida, Tomoya
AU  - Iida T
AUID- ORCID: 0000-0003-2842-8052
AD  - Department of Gastroenterology and Hepatology, Sapporo Medical University School 
      of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, 
      Japan.
FAU - Nojima, Masanori
AU  - Nojima M
AD  - Center for Translational Research, The Institute of Medical Science Hospital, The 
      University of Tokyo, Tokyo, 108-8639, Japan.
FAU - Nakase, Hiroshi
AU  - Nakase H
AD  - Department of Gastroenterology and Hepatology, Sapporo Medical University School 
      of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, 
      Japan. hiropynakase@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20190413
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
RN  - 0 (Immunosuppressive Agents)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Crohn Disease/*drug therapy
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage/adverse effects
MH  - Remission Induction
MH  - *Tacrolimus/administration & dosage/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Crohn's disease
OT  - Meta-analysis
OT  - Systematic review
OT  - Tacrolimus
EDAT- 2019/04/15 06:00
MHDA- 2020/05/08 06:00
CRDT- 2019/04/15 06:00
PHST- 2018/11/05 00:00 [received]
PHST- 2019/04/08 00:00 [accepted]
PHST- 2019/04/15 06:00 [pubmed]
PHST- 2020/05/08 06:00 [medline]
PHST- 2019/04/15 06:00 [entrez]
AID - 10.1007/s10620-019-05619-1 [pii]
AID - 10.1007/s10620-019-05619-1 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2019 Oct;64(10):2945-2954. doi: 10.1007/s10620-019-05619-1. Epub 
      2019 Apr 13.