Beclomethasone Dipropionate Enema Versus Traditional Glucocorticoid Enema In The Treatment Of Distal Ulcerative Colitis: A Meta-analysis

Objectives: To systematically evaluate the efficacy and safety ofenema beclomethasone dipropionate (BDP) compared with enematraditional glucocorticoids（TGC） in the treatment of distal ulcerativecolitis(UC).Methods: The PubMed database, EBSCO, The Cochrane Library,Chinese Biomedical Literature Database （CBM） and China NationalKnowledge Infrastructure(CNKI) database were searched for randomizedcontrolled trials of enema BDP compared with enema TGC in patients withUC. Two reviewers assessed the quality of included literature and extracteddata independently. Statistical analysis was performed with ReviewManager5.0.Results: Six trials involving351UC patients,181treated with BDPand170with TGC were included. The result of meta-analysis showed thatthere was no significant difference between BDP and TGC in endoscopicfindings（OR=0.60,95%CI:0.17～2.17，P=0.44） and clinical symptoms （OR=1.00,95%CI:0.32～3.11，P=0.99），BDP is superior to TGC inhistopathology improvement（OR=0.33,95%CI:0.12～0.95，P=0.04），andafter treatment the fasting plasma cortisol concentrations （MD=0.28,95%CI:0.09～0.48， P=0.004） and ACTH stimulation test（MD=0.57,95%CI:0.29～0.84，P＜0.0001）were significantly different inthe two groups.Conclusions： The randomized controlled trials identified in thisreview showed that enema BDP has equal effect as TGC to improveendoscopy and control clinical symptoms and BDP is slightly precede TGCto improve histopathology in distal UC, and enema BDP did not havedistinct suppression on hypothalamus pituitary adrenal axis.