Comparative efficacy and safety of infliximab and vedolizumab therapy in patients with inflammatory bowel disease: a systematic review and meta-analysis - Université de Lorraine Access content directly
Journal Articles BMC Gastroenterology Year : 2022

Comparative efficacy and safety of infliximab and vedolizumab therapy in patients with inflammatory bowel disease: a systematic review and meta-analysis

Perttu Arkkila
  • Function : Author
Alessandro Armuzzi
  • Function : Author
Silvio Danese
  • Function : Author
Jordi Guardiola
  • Function : Author
Jørgen Jahnsen
  • Function : Author
Charles Lees
  • Function : Author
Edouard Louis
  • Function : Author
Milan Lukáš
  • Function : Author
Walter Reinisch
  • Function : Author
Xavier Roblin
  • Function : Author
Minyoung Jang
  • Function : Author
Han Geul Byun
  • Function : Author
Dong-Hyeon Kim
  • Function : Author
Sung Jeong Lee
  • Function : Author
Raja Atreya

Abstract

Abstract Background and aims There are limited comparative data for infliximab and vedolizumab in inflammatory bowel disease patients. Methods We conducted a systematic review and meta-analysis to compare the efficacy and safety of infliximab and vedolizumab in adult patients with moderate-to-severe Crohn’s disease or ulcerative colitis. Results We identified six eligible Crohn’s disease and seven eligible ulcerative colitis trials that randomised over 1900 participants per disease cohort to infliximab or vedolizumab. In the Crohn’s disease and ulcerative colitis cohorts, infliximab yielded better efficacy than vedolizumab for all analysed outcomes (CDAI-70, CDAI-100 responses, and clinical remission for Crohn’s disease and clinical response and clinical remission for ulcerative colitis) during the induction phase, with non-overlapping 95% confidence intervals. In the maintenance phase, similar proportions of infliximab- or vedolizumab-treated patients achieved clinical response, clinical remission, or mucosal healing in both Crohn’s disease and ulcerative colitis. For the safety outcomes, rates of adverse events, serious adverse events, and discontinuations due to adverse events were similar in infliximab- and vedolizumab-treated patients in both diseases. The infection rate was higher in infliximab for Crohn’s disease and higher in vedolizumab when treating patients with ulcerative colitis. There was no difference between the treatments in the proportions of patients who reported serious infections in both indications. Conclusions Indirect comparison of infliximab and vedolizumab trials in adult patients with moderate-to severe Crohn’s disease or ulcerative colitis demonstrated that infliximab has better efficacy in the induction phase and comparable efficacy during the maintenance phase and overall safety profile compared to vedolizumab.

Dates and versions

hal-04165922 , version 1 (19-07-2023)

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Laurent Peyrin-Biroulet, Perttu Arkkila, Alessandro Armuzzi, Silvio Danese, Jordi Guardiola, et al.. Comparative efficacy and safety of infliximab and vedolizumab therapy in patients with inflammatory bowel disease: a systematic review and meta-analysis. BMC Gastroenterology, 2022, 22 (1), pp.291. ⟨10.1186/s12876-022-02347-1⟩. ⟨hal-04165922⟩

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