Date of Award

2018

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The purpose of this EBM review is to determine, “Does Mesalazine improve the symptoms of patients with irritable bowel syndrome (IBS)?”.

STUDY DESIGN: Review of three English language primary studies, published between 2011 and 2016.

DATA SOURCES: Three randomized controlled trials (RCTs) were found through the Cochrane Library, Embase, and PubMed. These studies analyzed the effectiveness of Mesalazine in treating the symptoms of patients with IBS.

OUTCOMES MEASURED: The outcomes measured included relief of abdominal pain (primary outcome) and abdominal pain intensity. The outcomes were measured by a binary scale (“yes” or “no” or relief of pain, pain severity scale rated on a scale of 1-10, and an abdominal pain score/scale of 0-10. P-values were used to assess the significance of these outcomes in two studies, and NNT (number needed to treat), RBI (relative benefit increase), and ABI (absolute benefit increase) were used to assess the significance of these outcomes in one study.

RESULTS: The results from the studies show conflicting evidence, as two studies showed no statistically significant difference in the relief of abdominal pain/pain intensity between Mesalazine and Placebo treatment. However, one study did support the question that Mesalazine had a greater effect on treating abdominal pain than the standard treatment for IBS.

CONCLUSION: Based upon the evidence and results shown in the three studies reviewed, the use of Mesalazine in treating the primary symptom of IBS, abdominal pain, cannot be justified as a statistically significant treatment. Barbara and Lam both showed that Mesalazine did not have a statistically significant effect on the relief of abdominal pain or lowered abdominal pain intensity post-treatment, while Dorofeyev did show that Mesalazine was superior to standard therapy without Mesalazine. Thus, further investigation should be carried out to determine if Mesalazine is truly effective at improving the main symptom of abdominal pain in IBS patients.

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