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Review
. 2016 Oct 1;12(5):1088-1096.
doi: 10.5114/aoms.2016.61915. Epub 2016 Aug 24.

Effectiveness and safety of vedolizumab for treatment of Crohn's disease: a systematic review and meta-analysis

Paweł Moćko  1 , Paweł Kawalec  1 , Beata Smela-Lipińska  1 , Andrzej Pilc  2
Affiliations
Review

Effectiveness and safety of vedolizumab for treatment of Crohn's disease: a systematic review and meta-analysis

Paweł Moćko et al. Arch Med Sci. .

Abstract

Introduction: The aim of this systematic review (SR) and meta-analysis was to assess the efficacy and safety of vedolizumab in the treatment of Crohn's disease (CD).

Material and methods: A systematic literature search was conducted in Medline/PubMed, Embase and Cochrane Library until 25 January, 2015. Included studies were critically appraised according to the PRISMA protocol. Assessment in specified subgroups of CD patients and meta-analysis with Revman software were performed.

Results: Two randomized controlled trial (RCTs) were included in a meta-analysis for the induction phase of therapy: GEMINI II and GEMINI III. The clinical response was significantly higher for patients who received vedolizumab compared to placebo in the general population (risk benefit (RB) = 1.48; p = 0.0006) and in both analyzed subgroups: patients with previous failure of anti-TNFs treatment (RB = 1.51; p = 0.006) and patients naive to earlier anti-TNFs (RB = 1.41; p = 0.001). The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for patients who received vedolizumab compared to placebo (RB = 1.77; p = 0.003; RB = 2.29; p = 0.0004; respectively). Meta-analysis for adverse events, serious adverse events (SAEs) and serious infections, revealed that vedolizumab was as safe as placebo in the induction phase of therapy.

Conclusions: The clinical response was significantly higher for patients who received vedolizumab in the general population and in both analyzed subgroups of patients. The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for vedolizumab, but no significant differences were revealed in the subgroup of patients with previous TNF antagonist failure.

Keywords: Crohn's disease; MLN-002; meta-analysis; systematic review; vedolizumab.

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Figures

Figure 1
Figure 1
Search flow diagram
Figure 2
Figure 2
Risk of bias summary
Figure 3
Figure 3
Forest plot of meta-analysis for vedolizumab vs. placebo of clinical remission: A – in the general population (ITT analysis) at week 6, B – in the subpopulation of patients who reported no response and/or poor tolerance of the prior treatment with TNF antagonists at week 6, and C – in the TNF antagonist-naive subgroup at week 6
Figure 4
Figure 4
Forest plot of meta-analysis for vedolizumab vs. placebo of response to treatment A) in the general population (ITT analysis) at week 6, B) in the subpopulation of patients who reported no response and/or poor tolerance of the prior treatment with TNF antagonists at week 6, and C) in the TNF antagonist-naive subgroup at week 6
Figure 5
Figure 5
Forest plot of meta-analysis of adverse events for vedolizumab vs. placebo: A – any adverse event, B – serious adverse events, C – serious infection (ITT analysis)
See this image and copyright information in PMC

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