ORIGINAL ARTICLE
Heterogeneity in protocols and outcomes to study the effect of renin-angiotensin system blockers in inflammatory bowel disease: A systematic review
Mariana Ferreira-Duarte,
Fernanda S. Tonin,
Margarida Duarte-Araújo,
Fernando Fernandez-Llimos,
Manuela Morato,
Mariana Ferreira-Duarte
Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
LAQV@REQUIMTE, University of Porto, Porto, Portugal
Search for more papers by this authorFernanda S. Tonin
ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
H&TRC-Health and Technology Research Center, Instituto Politécnico de Lisboa, Lisbon, Portugal
Search for more papers by this authorMargarida Duarte-Araújo
LAQV@REQUIMTE, University of Porto, Porto, Portugal
Department of Immuno-Physiology and Pharmacology, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
Search for more papers by this authorCorresponding Author
Fernando Fernandez-Llimos
Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
UCIBIO i4HB - Applied Molecular Biosciences Unit, Faculty of Pharmacy, University of Porto, Porto, Portugal
Correspondence
Fernando Fernandez-Llimos, UCIBIO i4HB - Applied Molecular Biosciences Unit, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal.
Email: [email protected]
Search for more papers by this authorManuela Morato
Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
LAQV@REQUIMTE, University of Porto, Porto, Portugal
Search for more papers by this authorMariana Ferreira-Duarte,
Fernanda S. Tonin,
Margarida Duarte-Araújo,
Fernando Fernandez-Llimos,
Manuela Morato,
Mariana Ferreira-Duarte
Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
LAQV@REQUIMTE, University of Porto, Porto, Portugal
Search for more papers by this authorFernanda S. Tonin
ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
H&TRC-Health and Technology Research Center, Instituto Politécnico de Lisboa, Lisbon, Portugal
Search for more papers by this authorMargarida Duarte-Araújo
LAQV@REQUIMTE, University of Porto, Porto, Portugal
Department of Immuno-Physiology and Pharmacology, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
Search for more papers by this authorCorresponding Author
Fernando Fernandez-Llimos
Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
UCIBIO i4HB - Applied Molecular Biosciences Unit, Faculty of Pharmacy, University of Porto, Porto, Portugal
Correspondence
Fernando Fernandez-Llimos, UCIBIO i4HB - Applied Molecular Biosciences Unit, Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal.
Email: [email protected]
Search for more papers by this authorManuela Morato
Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
LAQV@REQUIMTE, University of Porto, Porto, Portugal
Search for more papers by this authorFirst published: 02 July 2023
Funding information: This work was supported by Fundação para a Ciência e Tecnologia (FCT) (Partnership Agreement UIDB-50006/2020 and SFRH/D/145654/2019 to M.F.D.).
Abstract
Background
The renin-angiotensin system (RAS) has been associated with inflammatory bowel disease (IBD), supporting translational relevance of RAS blockers. Comparability of study design/outcomes is fundamental for data analysis/discussion.
Objectives
We aimed at evaluating the heterogeneity among protocols and outcomes to study the effect of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in IBD.
Methods
This study was performed and reported in accordance with the Cochrane recommendations and PRISMA (PROSPERO-CRD42022323853). Systematic searches were performed in PubMed, Scopus and Web of Science. Studies that met the inclusion criteria were selected. Quality assessment of the studies was done with the SYRCLES's risk of bias tools for animal studies.
Results
Thirty-five pre-clinical studies and six clinical studies were included. Chemical induction of colitis was the most used model, but variable doses of the induction agent were reported. All studies reported at least a disease activity index, a macroscopic score, or a histologic assessment, but these scores were methodologically heterogeneous and reported for different characteristics. Great heterogeneity was also found in drug interventions. Inflammatory markers assessed as outcomes were different across studies.
Conclusion
Lack of standardization of protocols and outcomes among studies threatens the evidence on how RAS blockers influence IBD outcomes.
CONFLICT OF INTEREST STATEMENT
The authors have no conflict of interest to declare.
Open Research
DATA AVAILABILITY STATEMENT
The data underlying this article are available in the article and in its online supplementary material.
Supporting Information
| Filename | Description |
|---|---|
| fcp12935-sup-0001-S1 - Search strategies.docxWord 2007 document , 13.4 KB |
Data S1. Supporting Information |
| fcp12935-sup-0002-S2-Detailed eligibility criteria assessment.xlsxExcel 2007 spreadsheet , 81.1 KB |
Data S2. Supporting Information |
| fcp12935-sup-0003-S3-Detailed data extraction.xlsxExcel 2007 spreadsheet , 50.9 KB |
Data S3. Supporting Information |
| fcp12935-sup-0004-S4-SYRCLEs items for assessing risk of bias.xlsxExcel 2007 spreadsheet , 13.4 KB |
Data S4. Supporting Information |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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