PMID- 31980030
OWN - NLM
STAT- MEDLINE
DCOM- 20210126
LR  - 20240229
IS  - 2046-4053 (Electronic)
IS  - 2046-4053 (Linking)
VI  - 9
IP  - 1
DP  - 2020 Jan 24
TI  - Association between anthraquinone laxatives and colorectal cancer: protocol for a 
      systematic review and meta-analysis.
PG  - 19
LID - 10.1186/s13643-020-1280-5 [doi]
LID - 19
AB  - INTRODUCTION: Products containing anthraquinones (AQ) are mainly used as 
      laxatives and have several biological effects. Long-term use of AQ laxatives is 
      associated with an increased risk of serious adverse events (AEs), such as 
      colorectal cancer (CRC). We will systematically synthesize the evidence on the 
      potential association between the use of AQ laxatives and the risk of CRC. 
      METHODS AND ANALYSIS: We will search MEDLINE, Embase, Scopus, the Cochrane 
      Library, Google Scholar, and Clinicaltrials.gov. To avoid missing any relevant 
      studies, we will search the bibliographies of retrieved papers and recent reviews 
      in the field. Interventions will include products containing oral AQ laxatives, 
      in particular, those derived from rhubarb, senna, cascara, buckhorn, and aloe. 
      Two review authors will independently screen title, abstract, and full texts and 
      will independently extract data from included studies. The primary outcome is the 
      number of participants diagnosed with CRC, while the secondary outcome will be 
      cases of melanosis coli. We will also consider all other AEs reported in the 
      included studies, in particular, intestinal bleeding, alterations of 
      gastrointestinal motility, and potential for dependence. When possible and 
      appropriate, for each outcome, a meta-analysis will be performed. DISCUSSION: 
      This protocol is prepared in accordance with the Preferred Reporting Items for 
      Systematic Reviews and Meta-Analyses Protocols guidelines. The protocol gives an 
      insight into the scope and parameters for the systematic review to be carried 
      out. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019125414.
FAU - Lombardi, Niccolo
AU  - Lombardi N
AD  - Department of Neurosciences, Psychology, Drug Research and Child Health, Section 
      of Pharmacology and Toxicology, Tuscan Regional Centre of Pharmacovigilance and 
      Phytovigilance, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, 
      Italy.
FAU - Bettiol, Alessandra
AU  - Bettiol A
AD  - Department of Neurosciences, Psychology, Drug Research and Child Health, Section 
      of Pharmacology and Toxicology, Tuscan Regional Centre of Pharmacovigilance and 
      Phytovigilance, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, 
      Italy.
FAU - Crescioli, Giada
AU  - Crescioli G
AD  - Department of Neurosciences, Psychology, Drug Research and Child Health, Section 
      of Pharmacology and Toxicology, Tuscan Regional Centre of Pharmacovigilance and 
      Phytovigilance, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, 
      Italy.
FAU - Maggini, Valentina
AU  - Maggini V
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
AD  - Research and Innovation Center in Phytotherapy and Integrated Medicine CERFIT, 
      Referring Center for Phytotherapy, Tuscany Region, Careggi University Hospital, 
      Florence, Italy.
FAU - Gallo, Eugenia
AU  - Gallo E
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
AD  - Research and Innovation Center in Phytotherapy and Integrated Medicine CERFIT, 
      Referring Center for Phytotherapy, Tuscany Region, Careggi University Hospital, 
      Florence, Italy.
FAU - Sivelli, Francesco
AU  - Sivelli F
AD  - Research and Innovation Center in Phytotherapy and Integrated Medicine CERFIT, 
      Referring Center for Phytotherapy, Tuscany Region, Careggi University Hospital, 
      Florence, Italy.
FAU - Sofi, Francesco
AU  - Sofi F
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - Gensini, Gian Franco
AU  - Gensini GF
AD  - Permanent Commission for Guidelines, Tuscany Region, Florence, Italy.
FAU - Vannacci, Alfredo
AU  - Vannacci A
AUID- ORCID: 0000-0001-5259-2026
AD  - Department of Neurosciences, Psychology, Drug Research and Child Health, Section 
      of Pharmacology and Toxicology, Tuscan Regional Centre of Pharmacovigilance and 
      Phytovigilance, University of Florence, Viale G. Pieraccini, 6, 50139, Florence, 
      Italy. alfredo.vannacci@unifi.it.
FAU - Firenzuoli, Fabio
AU  - Firenzuoli F
AD  - Research and Innovation Center in Phytotherapy and Integrated Medicine CERFIT, 
      Referring Center for Phytotherapy, Tuscany Region, Careggi University Hospital, 
      Florence, Italy.
LA  - eng
PT  - Journal Article
DEP - 20200124
PL  - England
TA  - Syst Rev
JT  - Systematic reviews
JID - 101580575
RN  - 0 (Anthraquinones)
RN  - 0 (Laxatives)
SB  - IM
MH  - Humans
MH  - *Anthraquinones
MH  - *Colorectal Neoplasms/epidemiology
MH  - *Laxatives/adverse effects/therapeutic use
MH  - Meta-Analysis as Topic
MH  - Systematic Reviews as Topic
PMC - PMC6979293
COIS- The authors declare that they have no competing interests.
EDAT- 2020/01/26 06:00
MHDA- 2021/01/26 06:00
PMCR- 2020/01/24
CRDT- 2020/01/26 06:00
PHST- 2019/08/01 00:00 [received]
PHST- 2020/01/14 00:00 [accepted]
PHST- 2020/01/26 06:00 [entrez]
PHST- 2020/01/26 06:00 [pubmed]
PHST- 2021/01/26 06:00 [medline]
PHST- 2020/01/24 00:00 [pmc-release]
AID - 10.1186/s13643-020-1280-5 [pii]
AID - 1280 [pii]
AID - 10.1186/s13643-020-1280-5 [doi]
PST - epublish
SO  - Syst Rev. 2020 Jan 24;9(1):19. doi: 10.1186/s13643-020-1280-5.