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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

130
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
130
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

157
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
157
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
115
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

126
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
126
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

135
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
135
Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

157
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
157
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  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Network Meta-analysis: Comparative Onset Of Early Effect Of Biologics And Small Molecules In Moderately To Severely Active Luminal Crohn's Disease.
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Network Meta-analysis: Comparative Onset Of Early Effect Of Biologics And Small Molecules In Moderately To Severely Active Luminal Crohn's Disease.

Related Experiment Video

Multimodal Quantitative Phase Imaging with Digital Holographic Microscopy Accurately Assesses Intestinal Inflammation and Epithelial Wound Healing
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Network meta-analysis: Comparative onset of early effect of biologics and small molecules in moderately to severely active luminal Crohn's disease.

Mohamed Attauabi1,2,3,4, Casper Steenholdt1, Anja Poulsen5

  • 1Department of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.

Alimentary Pharmacology & Therapeutics
|June 12, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Infliximab demonstrates the highest probability for early Crohn's disease remission. Upadacitinib and risankizumab showed high response rates in bio-exposed patients, though infliximab was not studied in this group.

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Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • Early treatment response is crucial for managing Crohn's disease (CD).
  • Comparative data on the rapidity of advanced CD therapies is limited.
  • Network meta-analysis (NMA) can effectively compare multiple treatments.

Purpose of the Study:

  • To compare the early response rates of advanced therapies for Crohn's disease using NMA.
  • To identify therapies with the highest probability of inducing clinical remission and response within six weeks.

Main Methods:

  • Systematic literature search of randomized controlled trials (RCTs) in MEDLINE, Embase, and CENTRAL up to February 2024.
  • Bayesian random-effects NMA following PRISMA-NMA guidelines.
  • Co-primary outcomes: clinical remission (CDAI ≤150) and clinical response (≥100-point CDAI reduction) within 6 weeks.

Main Results:

  • Infliximab (with azathioprine or monotherapy) ranked highest for early remission, superior to certolizumab, ustekinumab, guselkumab, vedolizumab, and upadacitinib.
  • Infliximab showed non-significant superiority over risankizumab (600 mg) and adalimumab (160/80 mg).
  • Upadacitinib and risankizumab showed the highest clinical responses in bio-exposed patients, a population not studied with infliximab.

Conclusions:

  • Infliximab demonstrates the highest probability for early Crohn's disease remission induction.
  • Upadacitinib and risankizumab are effective for bio-exposed patients, but infliximab's role in this subgroup requires further investigation.
  • Vedolizumab, certolizumab, and ustekinumab ranked lowest in early efficacy across analyses.