Portal de investigação
Has the therapeutical ceiling been reached in Crohn's disease randomized controlled trials? A systematic review and meta-analysis
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Moreira, PL
- Catalano, G
- Alves, C
- Roseira, J
- Estevinho, MM
- Silva, I
- Dignass, A
- Peyrin-Biroulet, L
- Danese, S
- Jairath, V
- Santiago, M
Unidades de investigação
Abstract
Background and AimsThe availability of biological agents for inflammatory bowel disease has increased over the past years. In this systematic review and meta-analysis, we aimed to explore time trends in clinical response and clinical remission rates in Crohn's disease (CD) patients treated with biologics while discussing the need for new strategies. MethodsMEDLINE, Cochrane, and ISI Web of Science databases were searched for randomized placebo-controlled trials with biological agents in moderate-to-severe CD patients. Sub-group and meta-regression analyses compared treatment and placebo by calculating the pooled odds ratios of clinical remission and clinical response, across time categories and publication year. We also estimated the proportion of patients achieving clinical remission and clinical response by comparing both groups according to the publication year. ResultsTwenty-five trials were included in the systematic review, which enrolled 8879 patients between 1997 and 2022. The clinical remission and clinical response odds, in induction and maintenance, have been constant over time, as no statistically significant differences were found between time categories (interaction p-values: clinical remission [induction, p = 0.19; maintenance, p = 0.24]; clinical response [induction, p = 0.43; maintenance, p = 0.59]). In meta-regression analyses, publication year did not influence these outcomes (clinical remission [induction, OR 1.01{95% CI 0.97-1.05}, p = 0.72; clinical response [induction, OR 1.01{95% CI 0.97-1.04]; p = 0.63; maintenance, OR 1.03{95% CI 0.98-1.07}; p = 0.21]), with the exception of clinical remission in maintenance studies, which presented a decreased effect (odds ratio 0.97{95% CI 0.94-1.00}, p = 0.03]). ConclusionsOur review highlights that the odds of clinical outcomes in CD patients receiving biological treatment relative to placebo have been stable in the last decades.
Dados da publicação
- ISSN/ISSNe:
- 2050-6406, 2050-6414
- Tipo:
- Review
- Páginas:
- 202-217
- DOI:
- 10.1002/ueg2.12366
- Link para outro recurso:
- www.scopus.com
United European Gastroenterology Journal John Wiley & Sons Inc.
Citações Recebidas na Web of Science: 1
Citações Recebidas na Scopus: 15
Documentos
- Não há documentos
Filiações
Keywords
- biologics; clinical remission; clinical response; Crohn's disease; meta-analysis; randomized controlled trial; RCT; systematic review; therapeutical ceiling; therapy
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Citar a publicação
Magro F,Moreira PL,Catalano G,Alves C,Roseira J,Estevinho MM,Silva I,Dignass A,Peyrin L,Danese S,Jairath V,Dias CC,Santiago M. Has the therapeutical ceiling been reached in Crohn's disease randomized controlled trials? A systematic review and meta-analysis. United Eur. Gastroenterol. J. 2023. 11(2):p. 202-217. IF:6,000. (1).
