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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Lee, Chloe Zi Ying
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Medicine & Pharmacology

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The Role of Gut Microbiota and Probiotics in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis Leong, Xue Bin; Tang, Chuan Zhe; Lee, Chloe Zi Ying; Lee, Zoe Ling Hui; Koo, Thai Hau
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 2 (2024): VOLUME 25, NUMBER 2, August, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2522024319

Abstract

Probiotics have emerged as a promising treatment for inflammatory bowel diseases (IBD). Moreover, the efficacy and safety of gut microbiota should be comprehensively studied. This systematic review and meta-analysis aim to study randomized controlled trials (RCTs) of IBD patients using probiotics, compared to conventional drugs or placebo. Eligible RCTs involving adult IBD patients were identified using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register until May 2024. Fixed-effects modeling was used to calculate risk ratio (RRs) with 95% confidence intervals (CIs) based on adverse event data due to low-moderate heterogeneity. The search yielded 2392 articles, including seven RCTs that met the criteria. On the other hand, concerning effectiveness outcomes, probiotics had an overall RR of 1.52 (95% CI: 1.08–2.13, p=0.02) compared to the controls. The comparable risk was demonstrated by the overall RR of 1.05 (95% CI: 0.59–1.86, p=0.87), which showed no apparent difference in the rate of adverse events between the groups on probiotics and the control group. Three studies were not included because their RR was non-estimable. Nevertheless, these three studies upheld the safety and tolerability of the probiotics. Though the number is small, and despite differences in types and schedules of probiotics, it can be suggested that probiotics enhance therapy responses in IBD patients. Further research with larger sample sizes and a broader range of demographics is necessary to shed more light on the effectiveness of probiotics.
Comparative Role of Anti-TNF Agents versus IL-12/23 Inhibitors in Inflammatory Bowel Disease: An Updated Review Leong, Xue Bin; Tang, Chuan Zhe; Lee, Chloe Zi Ying; Lee, Zoe Ling Hui; Koo, Thai Hau
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/253202457-61

Abstract

Treatments for Crohn's Disease (CD) and Ulcerative Colitis (UC), two conditions that fall under the umbrella of Inflammatory Bowel Disease (IBD), must be both safe and effective. This review compares the effectiveness and safety of anti-TNF agents and IL-12/23 inhibitors, specifically in the context of IBD management. Randomized controlled trials (RCTs), observational studies, and meta-analyses involving adult IBD patients were all included in the review. Anti-TNF agents (infliximab and adalimumab) were shown to significantly improve clinical remission rates and reduce complications, particularly with early intervention. However, these agents were associated with adverse effects such as infections and autoimmune reactions. IL-12/23 inhibitors, particularly risankizumab, showed superior efficacy in achieving and maintaining remission with a better safety profile. The findings prove that IL-12/23 inhibitors might be more effective for patients who are unresponsive to anti-TNF therapies. In conclusion, both anti-TNF agents and IL-12/23 inhibitors effectively manage IBD, with IL-12/23 inhibitors offering a favorable safety profile. Early intervention and personalized treatment strategies are significant for optimizing patient outcomes. It will take additional research to validate these results and improve treatment strategies. 
Co-Authors Koo, Thai Hau Lee, Zoe Ling Hui Leong, Xue Bin Tang, Chuan Zhe