Individual Patient Data Meta-Analysis of Randomized Trials Fails To Show Benefit of Chromoendoscopy in Lynch Syndrome
Douglas K. Rex, MD, MASGE, reviewing Houwen BBSL, et al. Am J Gastroenterol 2021 Feb 11.
An individual patient data meta-analysis, which was performed for this study, utilizes the individual data from separate studies rather than summary data. However, this study did not include tandem studies because of the recent suggestion that they are more likely to be biased.
In 3 randomized trials comprising 533 patients with Lynch syndrome, the adenoma detection rates (ADRs) were 28% with white-light endoscopy and 31% with chromoendoscopy (odds ratio, 1.17; 0.81-1.70). There was no increased protection with either standard equipment or high-definition colonoscopes, and the mean number of adenomas per patient with chromoendoscopy was 0.52 compared to 0.47 with white-light endoscopy (incidence rate ratio, 1.09; 0.78-1.52).
COMMENTThe total number of patients here is relatively small, but even the absolute differences in ADR and adenomas per colonoscopy between chromoendoscopy and white-light endoscopy are small, suggesting that the benefit of chromoendoscopy in patients with Lynch syndrome could be clinically unimportant.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Houwen BBSL, Mostafavi N, Vleugels JLA, et al. Dye-based chromoendoscopy in patients with Lynch syndrome: an individual patient data meta-analysis of randomized trials. Am J Gastroenterol 2021 Feb 11. (Epub ahead of print) (https://doi.org/10.14309/ajg.0000000000001138)
