Systematic review: Infliximab therapy in ulcerative colitis
J P Gisbert1, Y González-Lama, J Maté
1Gastroenterology Unit, La Princesa University Hospital, Autonomous University, Madrid, Spain. gisbert@meditex.es
Alimentary Pharmacology & Therapeutics
|January 19, 2007
Summary
Infliximab significantly improves treatment outcomes for ulcerative colitis (UC) patients, demonstrating superior efficacy compared to placebo. This therapy achieves clinical remission in 40% of patients within nine months, with a low number-needed-to-treat.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
- Evidence-Based Medicine
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Current treatments for moderate-to-severe UC have limitations.
- Infliximab is a biologic agent used for UC treatment.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy and safety of infliximab in ulcerative colitis.
- To compare infliximab versus placebo or steroid treatments in UC patients.
Main Methods:
- Systematic review and meta-analysis of randomized clinical trials.
- Electronic and manual literature searches were conducted.
- Study quality was independently assessed by two reviewers.
Main Results:
- Thirty-four studies involving 896 patients were analyzed.
- Infliximab showed significant short-term (68% response, 40% remission) and long-term (53% response, 39% remission) efficacy.
- Meta-analysis of five randomized trials confirmed infliximab's superiority over placebo (ORs 2.7-4.6, NNT 3-5).
- Adverse event rates were similar between infliximab and placebo groups (OR 1.52).
Conclusions:
- Infliximab is an effective treatment for moderate-to-severe UC, outperforming placebo.
- Achieving clinical remission in approximately 40% of patients at 9 months.
- Further research is needed to confirm long-term infliximab efficacy in UC.
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