Efficacy and safety of adalimumab in comparison to infliximab for Crohn's disease:A systematic review and meta-analysis  

作　　者：Hua-Hua Yang Yi Huang Xu-Chun Zhou Ruo-Nan Wang 

机构地区：[1]Department of Gastroenterology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China [2]Department of Endocrinology,Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430077,Hubei Province,China

出　　处：《World Journal of Clinical Cases》2022年第18期6091-6104,共14页世界临床病例杂志

摘　　要：BACKGROUND Adalimumab(ADA)and infliximab(IFX)are the cornerstones of the treatment of Crohn’s disease(CD).It remains controversial whether there is a difference in the effectiveness and safety between IFX and ADA for CD.AIM To perform a meta-analysis to compare the effectiveness and safety of ADA and IFX in CD.METHODS Pub Med,Embase,Cochrane Library,and Web of Science databases were searched.Cohort studies were considered for inclusion.The primary outcomes were induction of response and remission,maintenance of response and remission,and secondary loss of response.Adverse events were secondary outcomes.RESULTS Fourteen cohort studies were included.There was no apparent difference between the two agents in the induction response[odds ratio(OR):1.27,95%confidence interval(CI):0.93-1.74,P=0.14]and remission(OR:1.11,95%CI:0.78–1.57,P=0.57),maintenance response(OR:1.08,95%CI:0.76–1.53,P=0.67)and remission(OR:1.26,95%CI:0.87–1.82,P=0.22),and secondary loss of response(OR:1.01,95%CI:0.65–1.55,P=0.97).Subgroup analysis revealed ADA and IFX had similar rates of response,remission,and loss of response either in anti-tumor necrosis factor-αna?ve or non-na?ve patients.Further,there was a similar result regardless of whether CD patients were treated with optimized therapy,including dose intensification,shortening interval,and combination immunomodulators.However,ADA had a fewer overall adverse events than IFX(OR:0.62,95%CI:0.42–0.91,P=0.02).CONCLUSION ADA and IFX have similar clinical benefits for anti-tumor necrosis factor-αna?ve or non-na?ve CD patients.Overall adverse events rate is higher in patients in the IFX group.

关 键 词：Crohn disease ADALIMUMAB INFLIXIMAB Clinical efficacy Adverse effects META-ANALYSIS 

分 类 号：R574.62[医药卫生—消化系统]