Systematic review and meta-analysis of the efficacy and tolerability of nicotine preparations in active ulcerative colitis

Clin Ther. 2010 Dec;32(14):2304-15. doi: 10.1016/j.clinthera.2011.01.004.

Abstract

Background: Findings from clinical studies of the efficacy and tolerability of nicotine preparations in maintaining remission of ulcerative colitis (UC) have been inconsistent.

Objectives: This systematic review and meta-analysis aimed to assess the efficacy and tolerability of nicotine preparations in inducing remission in UC.

Methods: A literature search (1966 August 2010) of Scopus (EMBASE), PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted for clinical trials that investigated the efficacy and/or tolerability (any adverse events [AEs] and withdrawals due to AEs) of any nicotine preparation for the induction of remission in UC.

Results: The electronic searches yielded 788 items. Of these, 3 placebo-controlled trials representing 233 patients with UC and 2 randomized controlled trials that compared nicotine to corticosteroids in 81 patients with UC were included in meta-analysis. The summary relative risks (RRs) (95% CI) in comparing nicotine to placebo were 1.40 (0.63-3.12) (P = NS) for clinical remission, 1.95 (1.38-2.78) (P < 0.001) for AEs, and 3.44 (0.71-16.71) (P = NS) for withdrawal due to AEs. The summary RRs in comparing nicotine to corticosteroids (prednisolone/prednisone) were 0.74 (0.5-1.09) (P = NS) for clinical remission in 2 trials and 2.28 (0.76-6.83) (P = NS) for withdrawal due to AEs.

Conclusion: The findings from this meta-analysis do not support the efficacy or tolerability of nicotine preparations in inducing remission in UC.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Clinical Trials as Topic
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / epidemiology
  • Humans
  • Nicotine / administration & dosage
  • Nicotine / adverse effects
  • Nicotine / therapeutic use*
  • Remission Induction
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Nicotine