Efficacy of Bile Acid Sequestrants in the Treatment of Bile Acid Diarrhea: A Meta-Analysis of Randomized Controlled Trials

被引:0
作者
Soares, Giulia Almiron R. [1 ]
Godoi, Amanda [2 ]
Marcolin, Patricia [3 ]
Piredda, Gabriel [4 ]
Laia, Estella [5 ]
Rodrigues, Airton Zogaib [6 ]
机构
[1] Univ Metropolitana Santos, Dept Med, Sao Paulo, Brazil
[2] Cardiff Univ, Sch Med, Cardiff, Wales
[3] Fed Univ Southern Border, Passo Fundo, Brazil
[4] Redentor Univ Ctr, Rio De Janeiro, Brazil
[5] Fed Univ Fluminense, Dept Med, Rio De Janeiro, Brazil
[6] Univ Metropolitana Santos, Santos, SP, Brazil
基金
美国国家卫生研究院;
关键词
bile acids and salts; cholestyramine; colesevelam hydrochloride; colestipol; diarrhea; DOUBLE-BLIND; CHOLESTYRAMINE; MALABSORPTION; COLESEVELAM;
D O I
10.1002/jcph.6154
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Bile acid sequestrants (BASs) have often been used for bile acid diarrhea (BAD) but carry a high risk of adverse events. New generations of BASs show promising results; however, their efficacy remains unclear. This systematic review and meta-analysis was conducted using PubMed, Cochrane, and Embase to assess randomized controlled trials (RCTs) published up to November 2023 to retrieve studies that measured the parameters before and after the administration of BASs. The outcomes assessed were cessation or improvement in diarrhea, fecal consistency, abdominal cramping, frequency of diarrhea, and adverse events. Risk ratios (RRs) and mean differences with 95% confidence intervals (CIs) were pooled using a random-effects model. Statistical analyses were conducted using RStudio version 4.1.2. The protocol was prospectively registered with PROSPERO (CRD42023445444). Seven RCTs with a total of 311 patients were included, of which 168 (54%) were randomized to BASs. Among BAS-treated patients, 101 (60.1%) received colesevelam, 40 (23.8%) received chenodeoxycholate, 18 (10.7%) received cholestyramine, and 9 (5.3%) received colestid. BASs were associated with a significant improvement in the cessation of diarrhea (RR 3.27; 95% CI 2.08 to 5.15; P <= .05) and liquid stool to normal fecal consistency (RR 2.69; 95% CI 1.56 to 4.65; P <= .05), as well as an increase in abdominal cramps (RR 5.27; 95% CI 1.21 to 22.93; P <= .05). There were no differences in urgency, adverse events, or nausea between groups. These findings indicate that BASs are effective in the treatment of BAD, as indicated by the improvement or cessation of diarrhea episodes.
引用
收藏
页码:478 / 485
页数:8
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