Efficary And Safety Of Low Molecular Weight Heparin For Mild-to-Moderate Active Ulcerative Colitis: A Meta-Analysis

Background The number of ulcerative colitis(UC) patients in China is increasing year by year.Nowadays, the traditional drugs, including aminosalicylic acid, glucocorticoids, immune mechanisms, etc, are still the cornerstone of the treatment of the majority of patients, but they have recurrent symptoms, the conventional treatment is not satisfactory. It is observed that hypercoagulable state often occurs in patients with UC in clinical trials,which increases the risk of thrombosis formation and leads to trials examining the application of low molecular weight heparin(LMWH) in patients with mild to moderate active active ulcerative colitis.Objective This study is aimed to evaluate the effectiveness and safety of low molecular weight heparin for mild-to-moderate active ulcerative colitis,and provide medical evidence for its clinical application.Methods We searched electronically the Cochrane Library(up to January 2015), Pubmed(1966 to January 2015), EMBASE(1980 to January 2015), CNKI full-text database(1994 to January 2015), Wanfang Database(1978 to January 2015) and Chinese VIP Database(1989 to January 2015) electronically or with manual retrieval.Two reviewers independently searched low molecular weight heparin treament for patients with mild to moderate active ulcerative colitis on the basis of the inclusion and exclusion criteria, assessed the methodological quality of included studies, and fetched data. After that the data analysis was performed about the total efective rate,complete remission rate and side effects by Rev Man 5.3 software.Results There are 440 related researches on low molecular weight heparin for mild-to-moderate active ulcerative colitis retrievaled. Six studies involving 447 cases of mild-to-moderate active ulcerative colitis were included, including 222 cases in low molecular weight heparin therapy group and 225 cases in control group.The result of meta-analysis indicates that the total effective rate of LMWH group is superior to control group(RR=1.18, 95%CI:1.05~1.33, P=0.005);the complete remission rate of LMWH group is superior to control group(RR=1.64,95%CI:1.32~2.04, P<0.00001), and there were significant differences.There is no significant difference in incidence of adverse reactions(RR=0.76,95%CI:0.48~1.21,P=0.25)between two groups. The adverse reactions in low molecular weight heparin therapy group are unobvious.Conclusion The results of meta-analyses indicate that low molecular weight heparin therapy group for patients with mild-to-moderate active ulcerative colitis is effective and safe. And it provides a new way for curing patients with ulcerative colitis.However,we need more high quality and multicentre randomised controlled trials to provide more evidence for the treatment.