Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease – a systematic review with meta-analysis
The efficacy and safety of vedolizumab in bio-naïve patients with ulcerative colitis (UC) and Crohn's disease (CD) remain unknown. To perform a meta-analysis regarding vedolizumab as first line of biological therapy for UC or CD. A systematic review of Medline, EMBASE, and Cochrane databases pe...
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| Veröffentlicht in: | Digestive and liver disease 2022-09, Vol.54 (9), p.1168-1178 |
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| container_title | Digestive and liver disease |
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| creator | Attauabi, Mohamed Madsen, Gorm Roager Bendtsen, Flemming Seidelin, Jakob Benedict Burisch, Johan |
| description | The efficacy and safety of vedolizumab in bio-naïve patients with ulcerative colitis (UC) and Crohn's disease (CD) remain unknown.
To perform a meta-analysis regarding vedolizumab as first line of biological therapy for UC or CD.
A systematic review of Medline, EMBASE, and Cochrane databases per December 2020 was undertaken. Meta-analysis was conducted using random-effects models.
This systematic review identified 79 eligible studies with 4,520 and 3,494 bio-naïve patients with UC and CD, respectively, and 8,105 and 11,140 bio-exposed patients. Among bio-naïve patients with UC, a total of 40.0% (95%CI 27.0–54.0, I2=86%) and 63.9% (95%CI 47.0–79.2, I2=36%) achieved clinical remission at weeks 14 and 52, respectively. The corresponding rates in CD were 54.0% (95%CI 42.0–66.0, I2=23%), and 61.7% (95%CI 55.2–68.1, I2=0%). Bio-naïvety 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-naïve UC patients had a lower risk of serious adverse events (RR=0.29 (95%CI 0.09–0.95)).
Vedolizumab was found to have a favorable efficacy and safety profile in bio-naïve patients with UC and CD. The findings have implications in the management of IBD. |
| doi_str_mv | 10.1016/j.dld.2021.11.014 |
| format | Article |
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To perform a meta-analysis regarding vedolizumab as first line of biological therapy for UC or CD.
A systematic review of Medline, EMBASE, and Cochrane databases per December 2020 was undertaken. Meta-analysis was conducted using random-effects models.
This systematic review identified 79 eligible studies with 4,520 and 3,494 bio-naïve patients with UC and CD, respectively, and 8,105 and 11,140 bio-exposed patients. Among bio-naïve patients with UC, a total of 40.0% (95%CI 27.0–54.0, I2=86%) and 63.9% (95%CI 47.0–79.2, I2=36%) achieved clinical remission at weeks 14 and 52, respectively. The corresponding rates in CD were 54.0% (95%CI 42.0–66.0, I2=23%), and 61.7% (95%CI 55.2–68.1, I2=0%). Bio-naïvety 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-naïve UC patients had a lower risk of serious adverse events (RR=0.29 (95%CI 0.09–0.95)).
Vedolizumab was found to have a favorable efficacy and safety profile in bio-naïve patients with UC and CD. The findings have implications in the management of IBD.</description><identifier>ISSN: 1590-8658</identifier><identifier>EISSN: 1878-3562</identifier><identifier>DOI: 10.1016/j.dld.2021.11.014</identifier><identifier>PMID: 34903497</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Antibodies, Monoclonal, Humanized ; Bio-naïve ; Biological Therapy ; Colitis, Ulcerative ; Crohn Disease ; First-line ; Gastrointestinal Agents ; Humans ; Inflammatory bowel disease ; Meta-analysis ; Remission Induction ; Systematic review ; Treatment Outcome</subject><ispartof>Digestive and liver disease, 2022-09, Vol.54 (9), p.1168-1178</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-d4d1ac25cef67032b128407db62c17d77c886e2294adff229492311f138f21113</citedby><cites>FETCH-LOGICAL-c353t-d4d1ac25cef67032b128407db62c17d77c886e2294adff229492311f138f21113</cites><orcidid>0000-0003-0323-7030</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1590865821008562$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34903497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Attauabi, Mohamed</creatorcontrib><creatorcontrib>Madsen, Gorm Roager</creatorcontrib><creatorcontrib>Bendtsen, Flemming</creatorcontrib><creatorcontrib>Seidelin, Jakob Benedict</creatorcontrib><creatorcontrib>Burisch, Johan</creatorcontrib><title>Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease – a systematic review with meta-analysis</title><title>Digestive and liver disease</title><addtitle>Dig Liver Dis</addtitle><description>The efficacy and safety of vedolizumab in bio-naïve patients with ulcerative colitis (UC) and Crohn's disease (CD) remain unknown.
To perform a meta-analysis regarding vedolizumab as first line of biological therapy for UC or CD.
A systematic review of Medline, EMBASE, and Cochrane databases per December 2020 was undertaken. Meta-analysis was conducted using random-effects models.
This systematic review identified 79 eligible studies with 4,520 and 3,494 bio-naïve patients with UC and CD, respectively, and 8,105 and 11,140 bio-exposed patients. Among bio-naïve patients with UC, a total of 40.0% (95%CI 27.0–54.0, I2=86%) and 63.9% (95%CI 47.0–79.2, I2=36%) achieved clinical remission at weeks 14 and 52, respectively. The corresponding rates in CD were 54.0% (95%CI 42.0–66.0, I2=23%), and 61.7% (95%CI 55.2–68.1, I2=0%). Bio-naïvety 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-naïve UC patients had a lower risk of serious adverse events (RR=0.29 (95%CI 0.09–0.95)).
Vedolizumab was found to have a favorable efficacy and safety profile in bio-naïve patients with UC and CD. The findings have implications in the management of IBD.</description><subject>Antibodies, Monoclonal, Humanized</subject><subject>Bio-naïve</subject><subject>Biological Therapy</subject><subject>Colitis, Ulcerative</subject><subject>Crohn Disease</subject><subject>First-line</subject><subject>Gastrointestinal Agents</subject><subject>Humans</subject><subject>Inflammatory bowel disease</subject><subject>Meta-analysis</subject><subject>Remission Induction</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><issn>1590-8658</issn><issn>1878-3562</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kLtuFDEUhkcIRELgAWiQO2hm4uO5iwqtuEmR0gCt5bGPWa8848XHk2ip6PIAeUOeBK82UFJYx5a__5fOVxQvgVfAobvcVcabSnABFUDFoXlUnMPQD2XdduJxvrcjL4euHc6KZ0Q7nsGu5U-Ls7oZeT79eXH3DU3w7uc6q4kpYmmLzLpIiXm3IAuWTS748N3p41dU-wOzIbLV6_xI7gaZzvHkiKnFsE0M2-U1MeMIFSH7_eueKUYHSjhnWrOINw5v2a1LWzZjUqValD-Qo-fFE6s84YuHeVF8_fD-y-ZTeXX98fPm3VWp67ZOpWkMKC1ajbbreS0mEEPDezN1QkNv-l4PQ4dCjI0y1h7nKGoAC_VgBQDUF8WbU-8-hh8rUpKzI43eqwXDSlJ0wHk_trzLKJxQHQNRRCv30c0qHiRwefQvdzL7l0f_EkBm_znz6qF-nWY0_xJ_hWfg7QnAvGR2ESVph4tG4yLqJE1w_6n_A24ll84</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Attauabi, Mohamed</creator><creator>Madsen, Gorm Roager</creator><creator>Bendtsen, Flemming</creator><creator>Seidelin, Jakob Benedict</creator><creator>Burisch, Johan</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0323-7030</orcidid></search><sort><creationdate>20220901</creationdate><title>Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease – a systematic review with meta-analysis</title><author>Attauabi, Mohamed ; Madsen, Gorm Roager ; Bendtsen, Flemming ; Seidelin, Jakob Benedict ; Burisch, Johan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-d4d1ac25cef67032b128407db62c17d77c886e2294adff229492311f138f21113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antibodies, Monoclonal, Humanized</topic><topic>Bio-naïve</topic><topic>Biological Therapy</topic><topic>Colitis, Ulcerative</topic><topic>Crohn Disease</topic><topic>First-line</topic><topic>Gastrointestinal Agents</topic><topic>Humans</topic><topic>Inflammatory bowel disease</topic><topic>Meta-analysis</topic><topic>Remission Induction</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Attauabi, Mohamed</creatorcontrib><creatorcontrib>Madsen, Gorm Roager</creatorcontrib><creatorcontrib>Bendtsen, Flemming</creatorcontrib><creatorcontrib>Seidelin, Jakob Benedict</creatorcontrib><creatorcontrib>Burisch, Johan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive and liver disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Attauabi, Mohamed</au><au>Madsen, Gorm Roager</au><au>Bendtsen, Flemming</au><au>Seidelin, Jakob Benedict</au><au>Burisch, Johan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease – a systematic review with meta-analysis</atitle><jtitle>Digestive and liver disease</jtitle><addtitle>Dig Liver Dis</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>54</volume><issue>9</issue><spage>1168</spage><epage>1178</epage><pages>1168-1178</pages><issn>1590-8658</issn><eissn>1878-3562</eissn><abstract>The efficacy and safety of vedolizumab in bio-naïve patients with ulcerative colitis (UC) and Crohn's disease (CD) remain unknown.
To perform a meta-analysis regarding vedolizumab as first line of biological therapy for UC or CD.
A systematic review of Medline, EMBASE, and Cochrane databases per December 2020 was undertaken. Meta-analysis was conducted using random-effects models.
This systematic review identified 79 eligible studies with 4,520 and 3,494 bio-naïve patients with UC and CD, respectively, and 8,105 and 11,140 bio-exposed patients. Among bio-naïve patients with UC, a total of 40.0% (95%CI 27.0–54.0, I2=86%) and 63.9% (95%CI 47.0–79.2, I2=36%) achieved clinical remission at weeks 14 and 52, respectively. The corresponding rates in CD were 54.0% (95%CI 42.0–66.0, I2=23%), and 61.7% (95%CI 55.2–68.1, I2=0%). Bio-naïvety 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-naïve UC patients had a lower risk of serious adverse events (RR=0.29 (95%CI 0.09–0.95)).
Vedolizumab was found to have a favorable efficacy and safety profile in bio-naïve patients with UC and CD. The findings have implications in the management of IBD.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>34903497</pmid><doi>10.1016/j.dld.2021.11.014</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-0323-7030</orcidid></addata></record> |
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| subjects | Antibodies, Monoclonal, Humanized Bio-naïve Biological Therapy Colitis, Ulcerative Crohn Disease First-line Gastrointestinal Agents Humans Inflammatory bowel disease Meta-analysis Remission Induction Systematic review Treatment Outcome |
| title | Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease – a systematic review with meta-analysis |
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