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World J Gastroenterol ; 21(19): 6044-51, 2015 May 21.
Article de Anglais | MEDLINE | ID: mdl-26019471

RÉSUMÉ

AIM: To compare the efficacy and safety of biological agents for the treatment of active ulcerative colitis (UC). METHODS: PubMed, MEDLINE, EMBASE and the Cochrane library were searched to screen relevant articles from January 1996 to August 2014. The mixed treatment comparison meta-analysis within a Bayesian framework was performed using WinBUGS14 software. The proportions of patients reaching clinical response, clinical remission and mucosal healing in induction and maintenance phases were analyzed as efficacy indicators. Serious adverse events in maintenance phase were analyzed as safety indicators. RESULTS: The meta-analysis results showed that biological agents achieved better clinical response, clinical remission and mucosal healing than placebo. Indirect comparison indicated that in induction phase, infliximab was more effective than adalimumab in inducing clinical response (OR = 0.41, 95%CI: 0.29-0.57), clinical remission (OR = 0.33, 95%CI: 0.19-0.56) and mucosal healing (OR = 0.33, 95%CI: 0.19-0.56), and golimumab in inducing clinical response (OR = 0.66, 95%CI: 0.39-2.33) and mucosal healing (OR = 2.15, 95%CI: 1.18-4.22). No significant difference was found between placebo and biological agents regarding their safety. CONCLUSION: All biological agents were superior to placebo for UC treatment in both induction and maintenance phases with a similar safety profile, and infliximab had a better clinical effect than the other biological agents.


Sujet(s)
Produits biologiques/usage thérapeutique , Rectocolite hémorragique/traitement médicamenteux , Côlon/effets des médicaments et des substances chimiques , Immunosuppresseurs/usage thérapeutique , Infliximab/usage thérapeutique , Muqueuse intestinale/effets des médicaments et des substances chimiques , Facteur de nécrose tumorale alpha/antagonistes et inhibiteurs , Adulte , Produits biologiques/effets indésirables , Rectocolite hémorragique/diagnostic , Rectocolite hémorragique/immunologie , Côlon/immunologie , Côlon/anatomopathologie , Humains , Immunosuppresseurs/effets indésirables , Infliximab/effets indésirables , Muqueuse intestinale/immunologie , Muqueuse intestinale/anatomopathologie , Adulte d'âge moyen , Odds ratio , Induction de rémission , Facteurs de risque , Facteurs temps , Résultat thérapeutique , Cicatrisation de plaie/effets des médicaments et des substances chimiques
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