Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease - a systematic review with meta-analysis

被引:23
作者
Attauabi, Mohamed [1 ,2 ,3 ]
Madsen, Gorm Roager [2 ,3 ]
Bendtsen, Flemming [2 ,3 ]
Seidelin, Jakob Benedict [1 ]
Burisch, Johan [2 ,3 ]
机构
[1] Univ Copenhagen, Herlev Hosp, Dept Gastroenterol & Hepatol, Borgmester Ib Juuls Vej 1, DK-2730 Herlev, Denmark
[2] Hvidovre Univ Hosp, Med Sect, Gastrounit, Kettegaard Alle 30, DK-2650 Hvidovre, Denmark
[3] Univ Copenhagen, Hvidovre Hosp, Copenhagen Ctr Inflammatory Bowel Dis Children Ad, Kettegaard Alle 30, DK-2650 Hvidovre, Denmark
关键词
Inflammatory bowel disease; Bio-naive; First-line; Systematic review; Meta-analysis; INFLAMMATORY-BOWEL-DISEASE; NECROSIS-FACTOR-ALPHA; REAL-WORLD EXPERIENCE; MAINTENANCE THERAPY; INDUCTION THERAPY; MONOCLONAL-ANTIBODY; PATIENTS NAIVE; MULTICENTER; ADALIMUMAB; INFLIXIMAB;
D O I
10.1016/j.dld.2021.11.014
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: The efficacy and safety of vedolizumab in bio-naive patients with ulcerative colitis (UC) and Crohn's disease (CD) remain unknown. Aims: To perform a meta-analysis regarding vedolizumab as first line of biological therapy for UC or CD. Methods: A systematic review of Medline, EMBASE, and Cochrane databases per December 2020 was undertaken. Meta-analysis was conducted using random-effects models. Results: This systematic review identified 79 eligible studies with 4,520 and 3,494 bio-naive patients with UC and CD, respectively, and 8,105 and 11,140 bio-exposed patients. Among bio-naive patients with UC, a total of 40.0% (95%CI 27.0-54.0, I-2 =86%) and 63.9% (95%CI 47.0-79.2, I-2 =36%) achieved clinical remission at weeks 14 and 52, respectively. The corresponding rates in CD were 54.0% (95%CI 42.0-66.0, I-2=23%), and 61.7% (95%CI 55.2-68.1, I-2 =0%). Bio-naivety was associated with a higher probability of clinical remission at week 52 in UC (relative risk (RR)=1.32 (95%CI 1.14-1.53)), while this was only apparent until week 26 in CD (RR=1.60 (95%CI 1.30-1.95)). Finally, bio-naive UC patients had a lower risk of serious adverse events (RR=0.29 (95%CI 0.09-0.95)). Conclusion: Vedolizumab was found to have a favorable efficacy and safety profile in bio-naive patients with UC and CD. The findings have implications in the management of IBD. (c) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:1168 / 1178
页数:11
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