Table 2.
Summary of findings: mesalazine versus control interventions by subtype of diverticular disease.
| Outcome | Subtype of diverticular disease | No. of participants (no. of studies) | Absolute effect (per 100 patients treated) | Relative effect (95% CI) | Certainty of the evidence (GRADE) | Conclusion |
|---|---|---|---|---|---|---|
| Achievement of disease remission | Symptomatic uncomplicated diverticular disease | 123 (1) | 3 more per 100 (95% CI: 14 fewer to 19 more) |
1.04 (0.81 to 1.34) | Very Low ●○○○ |
It is uncertain whether mesalazine may lead to no difference in the achievement of disease remission. |
| Acute uncomplicated diverticulitis | 81 (1) | 20 more per 100 (95% CI: 3 fewer to 38 more) |
2.67 (1.05 to 6.79) | Very Low ●○○○ |
It is uncertain whether mesalazine may lead to the achievement of disease remission. | |
| Disease recurrence | Symptomatic uncomplicated diverticular disease | 216 (2) | 13 fewer per 100 (95% CI: 23 to 2 fewer) |
0.52 (0.28 to 0.97) | Low ●●○○ |
Mesalazine may decrease disease recurrence. |
| Acute uncomplicated diverticulitis | 2196 (7) | 3 fewer per 100 (95% CI: 12 fewer to 6 more) |
0.90 (0.61 to 1.33) | Low ●●○○ |
Mesalazine may lead to no difference in disease recurrence. | |
| Acute diverticulitis onset in symptomatic uncomplicated diverticular disease | Symptomatic uncomplicated diverticular disease | 484 (3) | 3 fewer per 100 (95% CI: 7 fewer to 0) |
0.26 (0.06 to 1.20) | Low ●●○○ |
Mesalazine may lead to no difference in the development of acute diverticulitis in patients with symptomatic uncomplicated diverticular disease. |
| Need for surgery | Symptomatic uncomplicated diverticular disease | 424 (2) | No effect per 100 (95% CI: 1 fewer to 1 more) |
0.68 (0.03 to 16.39) | Very Low ●○○○ |
It is uncertain whether mesalazine may lead to no difference in the need for surgery. |
| Acute uncomplicated diverticulitis | 1263 (3) | 1 more per 100 (95% CI: 0 to 2 more) |
1.41 (0.51 to 3.90) | Low ●●○○ |
Mesalazine may lead to no difference in the need for surgery. | |
| Any adverse events | Symptomatic uncomplicated diverticular disease | 391 (2) | 1 fewer per 100 (95% CI: 5 fewer to 3 more) |
1.04 (0.55 to 1.98) | Low ●●○○ |
Mesalazine may lead to no difference in any adverse events. |
| Acute uncomplicated diverticulitis | 2196 (7) | 3 more per 100 (95% CI: 2 fewer to 7 more) |
1.03 (0.96 to 1.11) | Moderate ●●●○ |
Mesalazine probably results in no difference in any adverse events. | |
| All-cause mortality | Symptomatic uncomplicated diverticular disease | 607 (4) | No effect per 100 (95% CI: 1 fewer to 1 more) |
No event in included studies | Very Low ●○○○ |
It is uncertain whether mesalazine may lead to no difference in all-cause mortality. |
| Acute uncomplicated diverticulitis | 1512 (5) | No effect per 100 (95% CI: 1 fewer to 1 more) |
0.52 (0.05 to 5.68) | Very Low ●○○○ |
It is uncertain whether mesalazine may lead to no difference in all-cause mortality. | |
| Diverticular disease related mortality | Symptomatic uncomplicated diverticular disease | 607 (4) | No effect per 100 (95% CI: 1 fewer to 1 more) |
No event in included studies | Very Low ●○○○ |
It is uncertain whether mesalazine may lead to no difference in diverticular disease related mortality. |
| Acute uncomplicated diverticulitis | 1512 (5) | No effect per 100 (95% CI: 1 fewer to 1 more) |
No event in included studies | Very Low ●○○○ |
It is uncertain whether mesalazine may lead to no difference in diverticular disease related mortality. | |
| Global symptoms scorea | Symptomatic uncomplicated diverticular disease | 326 (2) | Standardized mean difference: 1.01 lower (95% CI: 1.51 to 0.52 lower) |
- | Low ●●○○ |
Mesalazine may improve the global symptoms score. |
| Acute uncomplicated diverticulitis | 153 (2) | Standardized mean difference: 0.56 lower (95% CI: 0.88 to 0.24 lower) |
- | Low ●●○○ |
Mesalazine may slightly improve the global symptoms score. | |
| Time to recurrence (days) | Symptomatic uncomplicated diverticular disease | - (-) | No studies | - | Absent | No studies were found that evaluated the impact of mesalazine on time to disease recurrence of disease. |
| Acute uncomplicated diverticulitis | 91 (3) | Average difference in days: 30 lower (95% CI: 55 to 5 lower) | - | Very Low ●○○○ |
It is uncertain whether mesalazine may lead to a decrease in time to disease recurrence. |