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Digestive Diseases and Sciences
Article . 2024 . Peer-reviewed
License: CC BY NC
Data sources: Crossref
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Digestive Diseases and Sciences
Article . 2024
License: CC BY
Data sources: Pure Amsterdam UMC
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Comparative Efficacy of Subcutaneous and Intravenous Infliximab and Vedolizumab for Maintenance Treatment of TNF-naive Adult Patients with Inflammatory Bowel Disease: A Systematic Literature Review and Network Meta-analysis

A Systematic Literature Review and Network Meta-analysis
Authors: L. Peyrin-Biroulet; P. Bossuyt; D. Bettenworth; E. V. Loftus; S. I. Anjie; G. D’Haens; M. Saruta; +5 Authors

Comparative Efficacy of Subcutaneous and Intravenous Infliximab and Vedolizumab for Maintenance Treatment of TNF-naive Adult Patients with Inflammatory Bowel Disease: A Systematic Literature Review and Network Meta-analysis

Abstract

Infliximab and vedolizumab are widely used to treat Crohn's disease (CD) and ulcerative colitis (UC).This systematic review and network meta-analysis evaluated comparative efficacy of various regimens for intravenous or subcutaneous infliximab and vedolizumab during maintenance treatment in CD and UC.Parallel-group randomized controlled trials (RCTs) were identified by a systematic literature review (CRD42022383401) and included if they evaluated therapeutics of interest for maintenance treatment of adults with moderate-to-severe luminal CD or UC and assessed clinical remission between Weeks 30 and 60. Clinical remission rates in CD or UC and mucosal healing rates in UC were analyzed in a Bayesian network meta-analysis model. Endoscopic outcomes in CD were synthesized by proportional meta-analysis.Overall, 13 RCTs were included in the analyses. All vedolizumab studies randomized induction responders to maintenance treatment; infliximab studies used a treat-through design. Subcutaneous infliximab 120 mg every 2 weeks had the highest odds ratio (OR) [95% credible interval] versus placebo for clinical remission during the maintenance phase (CD: 5.90 [1.90-18.2]; UC: 5.45 [1.94-15.3]), with surface under the cumulative ranking curve (SUCRA) values of 0.91 and 0.82, respectively. For mucosal healing in UC, subcutaneous infliximab 120 mg every 2 weeks showed the highest OR (4.90 [1.63-14.1]), with SUCRA value of 0.73, followed by intravenous vedolizumab 300 mg every 4 weeks (SUCRA value, 0.70). Endoscopic outcomes in CD were better with subcutaneous infliximab 120 mg every 2 weeks than intravenous infliximab 5 mg/kg every 8 weeks.Subcutaneous infliximab showed a favorable efficacy profile for achieving clinical remission and endoscopic outcomes during maintenance treatment in CD or UC.

Countries
Finland, Netherlands
Keywords

Crohn’s disease, Monoclonal antibody, Adult, Biologic, Injections, Subcutaneous, Remission Induction, Network Meta-Analysis, Antibodies, Monoclonal, Humanized, General medicine, internal medicine and other clinical medicine, Infliximab, Crohn Disease/drug therapy [MeSH] ; Maintenance Chemotherapy/methods [MeSH] ; Adult [MeSH] ; Humans [MeSH] ; Systematic review ; Treatment Outcome [MeSH] ; Infliximab/administration ; Antibodies, Monoclonal, Humanized/administration ; Monoclonal antibody ; Administration, Intravenous [MeSH] ; Injections, Subcutaneous [MeSH] ; Original Article ; Randomized Controlled Trials as Topic [MeSH] ; Colitis, Ulcerative/drug therapy [MeSH] ; Biologic ; Network meta-analysis ; Infliximab/therapeutic use [MeSH] ; Gastrointestinal Agents/therapeutic use [MeSH] ; Antibodies, Monoclonal, Humanized/therapeutic use [MeSH] ; Remission Induction [MeSH] ; Crohn’s disease ; Ulcerative colitis ; Gastrointestinal Agents/administration, Maintenance Chemotherapy, Treatment Outcome, Ulcerative colitis, Gastrointestinal Agents, Crohn Disease, Systematic review, Humans, Original Article, Colitis, Ulcerative, Administration, Intravenous, Network meta-analysis, Randomized Controlled Trials as Topic

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
11
Top 10%
Average
Top 10%
Green
hybrid
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