Journal of gastroenterology and hepatology
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J. Gastroenterol. Hepatol. · Aug 2019
Meta AnalysisVonoprazan versus proton-pump inhibitors for healing gastroesophageal reflux disease: A systematic review.
Gastroesophageal reflux disease (GERD) is a common disease caused by reflux of gastric contents to the esophagus. Proton-pump inhibitors (PPIs) are recommended as a first-line therapy to treat GERD. Recently, a new potassium-competitive acid blocker, vonoprazan, was launched in Japan. We aimed to evaluate the comparative efficacy of vonoprazan and other PPIs in healing GERD. ⋯ This analysis shows that the GERD healing effect of vonoprazan is higher than that of rabeprazole (20 mg) but not higher than other PPIs. Subgroup analysis indicated that vonoprazan is more effective than most PPIs for patients with severe erosive esophagitis.
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J. Gastroenterol. Hepatol. · Aug 2019
Randomized Controlled Trial Comparative StudyComparison of polyp detection during both insertion and withdrawal versus only withdrawal of colonoscopy: A prospective randomized trial.
Polyps seen and not removed during colonoscope insertion are sometimes unable to be found during withdrawal. We aimed to evaluate whether additional inspection and polypectomy during insertion increases adenoma detection rate (ADR) compared with inspection and polypectomy entirely during withdrawal. ⋯ Additional inspection and polypectomy during colonoscope insertion did not improve ADR compared with inspection and polypectomy entirely during withdrawal. These results do not support an additional role for routine inspection during insertion (clinical trial registration number: NCT03444090).
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J. Gastroenterol. Hepatol. · Jul 2019
Comparative StudyRegional variations in the use of biologics and immunomodulators among Korean patients with inflammatory bowel diseases.
Variation in medical care can be an obstacle to improving quality and outcome of treatment. We conducted a nationwide, population-based study to identify regional variations in medication prescription rates in Korean patients with inflammatory bowel diseases (IBDs). ⋯ Regional variation exists in medication prescription rates within a single city as well as nationwide, suggesting that standardization of IBD treatment is necessary in Korea.
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J. Gastroenterol. Hepatol. · May 2019
Meta AnalysisPeripherally acting μ-opioid antagonist for the treatment of opioid-induced constipation: Systematic review and meta-analysis.
Opioid-induced constipation (OIC) is a frequent adverse event (AE) that impairs patients' quality of life (QOL). Peripherally acting μ-opioid receptor antagonists (PAMORAs) have been recognized as a treatment option for OIC, but the effect consistent across the studies has not been evaluated. ⋯ Peripherally acting μ-opioid receptor antagonist has been shown to be effective and durable for patients with OIC and is the only drug with confirmed evidence in meta-analysis. The possibility of publication bias was the limitation of this study.