Abstract | BACKGROUND: AIM: To assess the efficacy and safety of anti-TNF-α agents for treatment of ulcerative colitis patients who were intolerant or refractory to conventional medical therapy. METHODS: Pubmed, Embase, and the Cochrane database were searched. Analysis was performed on randomized controlled trials that assessed anti-TNF-α therapy on ulcerative colitis patients that had previously failed therapy with corticosteroids and/or immunosuppressants. The primary outcome focused on was the frequency of patients that achieved clinical remission. Further trial outcomes of interest included rates of remission without patient use of corticosteroids during the trial, extent of mucosal healing, and the number of cases that resulted in colectomy and serious side effects. RESULTS: Eight trials from seven studies (n = 2122) met the inclusion criteria and were thus included during analysis. TNF-α blockers demonstrated clinical benefit as compared to placebo control as evidenced by an increased frequency of clinical remission (p<0.00001), steroid-free remission (p = 0.01), endoscopic remission (p<0.00001) and a decrease in frequency of colectomy (p = 0.03). No difference was found concerning serious side effects (p = 0.05). Three small trials (n = 57) comparing infliximab to corticosteroid treatment, showed no difference in frequency of clinical remission (p = 0.93), mucosal healing (p = 0.80), and requirement for a colectomy (p = 0.49). One trial compared infliximab to cyclosporine (n = 115), wherein no difference was found in terms of mucosal healing (p = 0.85), colectomy frequency (p = 0.60) and serious side effects (p = 0.23). CONCLUSION:
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Authors | Ruxi Lv, Weiguang Qiao, Zhiyong Wu, Yinjun Wang, Shixue Dai, Qiang Liu, Xuebao Zheng |
Journal | PloS one
(PLoS One)
Vol. 9
Issue 1
Pg. e86692
( 2014)
ISSN: 1932-6203 [Electronic] United States |
PMID | 24475168
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Monoclonal
- Tumor Necrosis Factor-alpha
- Infliximab
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Topics |
- Antibodies, Monoclonal
(pharmacology, therapeutic use)
- Colitis, Ulcerative
(drug therapy)
- Humans
- Infliximab
- Randomized Controlled Trials as Topic
- Remission Induction
- Treatment Outcome
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
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