Loss of response to scheduled infliximab therapy for Crohn's disease in adults: A systematic review and meta-analysis.

Abstract

OBJECTIVE:

To determine the potential predictors of loss of response (LOR) to infliximab (IFX) maintenance therapy for adult patients with Crohn's disease (CD).

METHODS:

We searched for English-language articles published between 1990 and March 2017 in PubMed, Embase, and the Cochrane Library. After identifying eligible studies, data extraction was performed independently by two reviewers. The potential prognostic variables were identified and dichotomized for meta-analysis. Based on the heterogeneity among study variables, random-effects models was used in our meta-analysis.

RESULTS:

Twenty-six studies met our eligibility criteria and consolidated drug response data were obtained from 3212 patients. The pooled rate of LOR to IFX maintenance therapy with a median follow-up of 1.1 years was 34%. The incidence of LOR to IFX therapy was increased in CD patients with perianal lesions (odds ratio [OR] 1.69, 95% confidence interval [CI] 1.04-2.75, P = 0.03), colon involvement (OR 2.56, 95% CI 1.20-5.50, P = 0.02) and younger age at CD onset (standardized mean difference -0.79, 95% CI -1.41 to -0.18, P = 0.01).

CONCLUSIONS:

The meta-analysis estimates the incidence of LOR among adult CD patients undergoing IFX therapy is 34%. The presence of perianal lesions, younger age at CD onset, and involvement of the colon are relative risk factors of LOR in CD patients received scheduled IFX maintenance therapy.

• Authors: Qi Wei Zhang, Jun Shen, Qing Zheng, Zhi Hua Ran
• Journal: Journal of digestive diseases (J Dig Dis) Vol. 20 Issue 2 Pg. 65-72 (Feb 2019) ISSN: 1751-2980 [Electronic] Australia
• PMID: 30582302 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Chemical References

• Gastrointestinal Agents
• Infliximab

Topics

• Adult
• Crohn Disease (drug therapy)
• Drug Administration Schedule
• Female
• Gastrointestinal Agents (therapeutic use)
• Humans
• Infliximab (therapeutic use)
• Maintenance Chemotherapy (statistics & numerical data)
• Male
• Risk Factors
• Treatment Outcome