As part of AP&T's peer-review process, a technical check of this meta-analysis was performed by Mr M. Siddiqui.
Meta-analysis: serological markers and the risk of acute and chronic pouchitis
Article first published online: 10 MAR 2013
© 2013 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 37, Issue 9, pages 867–875, May 2013
How to Cite
Singh, S., Sharma, P. K., Loftus, E. V. and Pardi, D. S. (2013), Meta-analysis: serological markers and the risk of acute and chronic pouchitis. Alimentary Pharmacology & Therapeutics, 37: 867–875. doi: 10.1111/apt.12274
- Issue published online: 3 APR 2013
- Article first published online: 10 MAR 2013
- Manuscript Accepted: 16 FEB 2013
- Manuscript Revised: 15 FEB 2013
- Manuscript Revised: 9 FEB 2013
- Manuscript Received: 10 JAN 2013
Serological markers such as anti-neutrophil cytoplasmic antibody (ANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) may be associated with pouchitis after ileal pouch-anal anastomosis (IPAA).
To perform a systematic review with meta-analysis of studies evaluating the association of ANCA and ASCA status with risk of acute and chronic pouchitis after IPAA.
We searched multiple databases (upto September 2012) for studies reporting ANCA and/or ASCA status along with risk of acute or chronic pouchitis after IPAA in adults with ulcerative colitis (UC). We abstracted odds ratio (OR) or raw data from the individual studies to calculate summary OR estimates with 95% CIs using random-effects model.
Eight studies reporting 184 cases of acute pouchitis and six studies reporting 151 cases of chronic pouchitis were included. The odds of chronic pouchitis were 76% higher in ANCA-positive patients than ANCA-negative (six studies; OR: 1.76; 95% CI: 1.19–2.61; P < 0.01). ASCA-positivity was not associated with the risk of chronic pouchitis (three studies; OR: 0.89; 95% CI: 0.49–1.59; P = 0.68). Neither ANCA (eight studies; OR: 1.54; 95% CI: 0.79–3.02; P = 0.21) nor ASCA-positivity (two studies; OR: 1.28; 95% CI: 0.25–6.54; P = 0.77) were associated with the risk of acute pouchitis.
The risk of chronic pouchitis after IPAA is higher in ANCA-positive patients, but the risk of acute pouchitis is unaffected by ANCA status. ASCA status was not associated with the risk of acute or chronic pouchitis. This information may be used to counsel UC patients regarding their risk of pouchitis after IPAA.