Comparative efficacy and safety of infliximab and vedolizumab therapy in patients with inflammatory bowel disease: a systematic review and meta-analysis.
[en] 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.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Peyrin-Biroulet, Laurent; Centre Hospitalier Régional Universitaire de Nancy, Nancy, France.
Arkkila, Perttu; Department of Gastroenterology, Helsinki University and Helsinki University
Armuzzi, Alessandro; Humanitas Research Hospital, Milan, Rozzano, Italy.
Danese, Silvio; Gastroenterology and Endoscopy, University Vita-Salute San Raffaele, Milan,
Guardiola, Jordi; Digestive Diseases Department, Bellvitge University Hospital, Bellvitge
Jahnsen, Jørgen; Department of Gastroenterology, Institute of Clinical Medicine, Akershus
Lees, Charles; Center of Genomics and Experimental Medicine, University of Edinburgh, Edinburgh,
Louis, Edouard ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
Lukáš, Milan; ISCARE Clinical Centre, Prague, Czech Republic.
Reinisch, Walter; Medical University of Vienna, Vienna, Austria.
Roblin, Xavier; University Hospital of Saint-Etienne, Saint-Etienne, France.
Jang, Minyoung; Celltrion Healthcare, Incheon, Republic of Korea.
Byun, Han Geul; Celltrion Healthcare, Incheon, Republic of Korea.
Kim, Dong-Hyeon; Celltrion Healthcare, Incheon, Republic of Korea.
Lee, Sung Jeong; Celltrion Healthcare, Incheon, Republic of Korea.
Atreya, Raja ; Medical Department 1, University Hospital Erlangen
Comparative efficacy and safety of infliximab and vedolizumab therapy in patients with inflammatory bowel disease: a systematic review and meta-analysis.
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