Latest meta analysis from JBM Research demonstrates that PEG is significantly more efficacious
than lactulose in adult constipation
JBM Research conducted a systematic review and meta analysis to assess efficacy of PEG versus placebo and active comparators in adults with non-organic constipation. The paper is the only quantitative statistical analysis to have been published in the field.
Twenty published randomised controlled trials, with a parallel-group or cross-over design, comparing oral PEG with placebo or a comparator laxative in adults with a history of non-organic constipation were included in the statistical analysis. Ten of the studies were PEG versus placebo (seven of which were high-quality), seven were PEG versus lactulose (four of which were high-quality) and four were versus other agents. A total of 2,240 patients from the US, UK, Spain, France, Italy, Germany, Finland and China were included.
The analysis found that PEG treatment resulted in a highly significant increase in defaecations/week over placebo, and have clearly shown PEG to be more effective than lactulose. For PEG versus placebo, the random effects pooled estimate of weighted mean difference was 1.98 stools/week when all studies were analysed. Using only the seven high-quality studies saw the result increase to 2.34 stools/week. For PEG versus lactulose, the difference was 1.01 stools/week, increasing to 1.65 stools/week in the four high-quality studies.
JBM Research's analysis provides an important insight into the comparative efficacy of PEG.
Belsey JD, Geraint M, Dixon TA. Systematic review and meta-analysis: polyethylene glycol in adults with non-organic constipation. Int J Clin Pract 2010:64;944-955.
JBM Research's paper on hypoglycaemia is most widely cited paper in Diabetic Medicine for 2008
JBM Research's paper on hypoglycaemia, published in Diabetic Medicine in 2008, became the journal's most widely cited paper of that year. In total, the journal published 294 papers in 2008 with a mean citation rate of 3.93 citations/paper, but JBM Research's paper was the most widely cited with 41 citations.
Amiel SA, Dixon T, Mann R et al. Hypoglycaemia in type 2 diabetes. Diab Med 2008;25(3):245-254. PubMed PMID: 18215172
JBM Research's systematic review shows that the impact of constipation on quality of life is
considerable and comparable to other chronic diseases
JBM Research's recent systematic review identified studies of quality of life (QOL) in constipation that used a generic QOL tool, and compared those results with QOL studies in other chronic conditions. The literature search generated 13 studies, ten in adults and three in children. Eight studies using the SF-36/12 tools were statistically pooled and revealed that in both adult and child populations, mental and physical components of QOL were consistently impaired. The effect of constipation on the mental health elements of QOL was greater than the physical effects, and the most impact on QOL was seen in secondary care studies.
The impact of constipation on QOL is significant and comparable to other chronic conditions, including allergies, musculoskeletal conditions and inflammatory bowel disease. Improving the QOL of life for patients may be achieved through improving the management of constipation.
Belsey J, Greenfield S, Candy D. Systematic review: impact of constipation on quality of life in adults and children. Aliment Pharmacol Ther 2010 Feb 20. [Epub ahead of print]. PubMed PMID: 20180788.
Previous JBM Research publication in The Times
JBM Research's previously published work looking at levels of vitamin D in patients with osteoporotic fracture has received further coverage in The Times (15th January 2010). The Times article discusses the link between low vitamin D and fracture, and reports on calls for fortification of some foods with vitamin D. The article refers to JBM Research's work carried out in Glasgow with Dr Stephen Gallacher, Consultant Physician at Southern General Hospital, Glasgow. The retrospective arm of the study found that low levels of vitamin D were almost universal in elderly patients admitted to hospital with hip fracture - 97.8% had vitamin D levels <70 nmol/l and 91.6% <50 nmol/l.
JBM Research continued to work on the project carrying out retrospective studies in five other UK centres, with the subsequent publications achieving local and national press coverage, including The Times. Read more on our Post-patent case study page.
Gallacher SJ, McQuillan C, Harkness M et al. Prevalence of vitamin D inadequacy in Scottish adults with non-vertebral fragility fractures. Curr Med Res Opin 2005;21:1355-1361. PubMed PMID:16197653.
Dixon T, Mitchell P, Berginer T et al. An overview of the prevalence of 25-hydroxy-vitamin D inadequacy amongst elderly patients with or without fragility fracture in the United Kingdom. Curr Med Res Opin 2006;22:405-415. PubMed PMID: 16466613.
JBM Communications to work with delegates from Anhui, China
JBM Communications are to provide a series of lectures on evidence-based medicine on behalf of Sino-Bridge International (SBI). SBI are a subsidiary of an independent parent organization based in Beijing, China, and have since 1997, been designated by the Chinese central and local governments as a facilitator for hundreds of training missions to the UK.
Dr Jonathan Belsey will lead the lectures for a forthcoming delegation from Anhui, China, consisting of hospital deans, senior physicians and professors.
