A systematic review and meta-analysis of anti-adhesion molecule therapy in patients with active Crohn's disease

Objective. Due to the crucial role played by adhesion molecules in the pathogenesis of Crohn's disease (CD), targeting of these molecules has recently been proposed as a new direction for the development of anti-inflammatory strategies for CD. The aim of this study was to provide up-to-date evidence on the effectiveness and safety of anti-adhesion molecule therapy in treating active CD. Material and methods. We studied articles retrieved by PubMed, EMBASE, the Cochrane Library and the Science Citation Index for randomized controlled trials (RCTs) relevant to CD and anti-adhesion molecule therapy. Results. Seven RCTs comparing anti-adhesion molecule therapy with placebo were included in a meta-analysis to evaluate the efficacy and safety of anti-adhesion molecule strategies in active CD. On the basis of pooled results of the seven RCTs (n = 2228), we found a significant difference in clinical remission rates between groups [relative risk (RR) 1.31, 95% confidence interval (CI) 1.12-1.52, fixed-effect model]. Five RCTs (n = 2178) compared the response rates of anti-adhesion molecule therapy and placebo; in overall analysis, anti-adhesion molecule therapy was effective for active CD (RR 1.28, 95% CI 1.161.42, random-effect model). In five studies enrolling 1867 individuals, anti-adhesion molecule therapy did not increase adverse events (RR 1.03, 95% CI 0.98-1.08, fixed-effect model). Conclusions. Anti-adhesion molecule therapy, which could prevent leukocyte recruitment, was effective and safe for treating active CD. Because of the small number of studies included in this meta-analysis, the results should be interpreted with caution.