Study and patient characteristics
Study descriptions are provided in Table 1. Study endpoint details for
each study are stated in the Supplementary Data. The quality of studies
evaluation was assessed, using version 2 of the Cochrane risk-of-bias
tool for randomised trials (RoB 2), into two categories: some concerns
and low risk of bias (Supplemental Figures 4.6, 5.6, 6.6, 7.6, 8.6 and
9.6). Seventeen RCT compared prokinetics to
placebo29–45. Seven compared peripheral µ-opioid
receptor antagonists to placebo22–28. Four compared
non-steroidal anti-inflammatory drugs to
placebo11–14. One study compared glucocorticoids
(dexamethasone) to placebo17. Two compared
erythromycin to placebo18,19. Two studies compared
gastrograffin to placebo20,21. Three compared
probiotics to placebo46–48. One study compared
colloid infusion to placebo16 and one study compared
oral carbohydrates to placebo15. Erythromycin has a
dual antibiotic and prokinetic effect, which is why this treatment is
analysed separately 49. We have classified
erythromycin in a category outside the prokinetic treatments with regard
to its reference therapeutic class. Indeed, erythromycin being a
macrolide antibiotic, it has a potential effect on the balance of the
microbiota.
The 38 included studies covered 6,371 patients: 2,091 patients for
prokinetic studies (including 860 receiving placebo), 3,118 patients for
µ-opioid receptor antagonist studies (including 1151 receiving placebo),
276 patients for non-steroidal anti-inflammatory drug studies (including
137 receiving placebo), 302 patients for glucocorticoid studies
(including 151 receiving placebo), 156 patients for erythromycin studies
(including 80 receiving placebo), 129 patients for gastrografin studies
(including 65 receiving placebo), 169 patients for probiotics studies
(including 85 receiving placebo), 80 patients for colloid infusion
studies (including 42 receiving placebo) and 50 patients for oral
carbohydrate studies (including 25 receiving placebo). Pooled baseline
characteristics are displayed in Table 2.