Efficacy And Safety Of Oral Budesonide Compared To Placebo And Mesalazine For Mild-To-Moderate Ulcerative Colitis:A Meta-Analysis

Objective:To conduct a Meta-analysis to evaluate the efficacy and safety of oral budesonide therapy for mild-to-moderate ulcerative colitis.Methods:Use Budesonide, Mild-to-Moderate Ulcerative Colitis, mesalazine as keywords, search PubMed, Cochrane Library, Embase, Tsinghua Tongfang database (CNKI), Articles Database (WANGFANG), Chinese Biomedical Literature Database (CBM), and VIP database (VIP), which were published before December 2015, were searched for randomized controlled trials (RCTs) about treatment for ulcerative colitis. The treatment was about the oral budesonide compared with the placebo group or the mesalazine group. The primary end point was clinical remission, endoscopic improvement, histological healing and adverse events were analyzed. The extracted data were analyzed with Revman 5.2.Results:A total of 5 studies involving 1732 patients were included in our Meta-analysis. The Meta analysis results showed that oral budesonide treatment study, compared with placebo, was more effective in the clinical remission (OR =1.91,95% CI (1.44,2.55), P< 0.0001), endoscopic improvement (OR=1.31, 95% CI (1.05,1.64), P=0.02), and histological healing (OR=1.62,95% CI (1.18,2.22), P=0.003). In comparison with mesalazine group, no significant difference observed in clinical remission (OR=0.90,95%CI(0.51, 1.59),P=0.71), endoscopic improvement(OR=0.96,95%CI(0.54,1.58),P=0.88). But worse in the histological healing (OR=0.59,95%CI(0.41,0.84), P=0.004). In the short-term adverse reactions, no significant difference observed in compared with the placebo group (OR=1.08,95% CI (0.87,1.34), P=0.48) and the mesalazine group (OR=1.22,95%CI(0.94,1.34),P=0.22).Conclusions:oral budesonide therapy for mild-to-moderate ulcerative colitis is effective than placebo. There is no significant difference in compared with mesalazine in clinical remission and endoscopic improvement. It is inferior to mesalazine in the histologic improvement. In the Short-term Adverse events, it is not significant difference between oral budesonide with placebo or mesalazine.