Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jul;22(7):408-418.
doi: 10.1111/1751-2980.13026. Epub 2021 Jun 29.

Anti-TNF and immunosuppressive combination therapy is preferential to inducing clinical remission in patients with active inflammatory bowel disease: A systemic review and meta-analysis

Liang Chen #  1   2 , Chun Jin Xu #  1 , Wei Wu  2 , Bai Jing Ding  3 , Zhan Ju Liu  2
Affiliations
Meta-Analysis

Anti-TNF and immunosuppressive combination therapy is preferential to inducing clinical remission in patients with active inflammatory bowel disease: A systemic review and meta-analysis

Liang Chen et al. J Dig Dis. 2021 Jul.

Abstract

Objective: To compare the efficacy and safety of a combination therapy of biologics and immunosuppressants with biological monotherapy in inflammatory bowel disease (IBD) in a systematic review and meta-analysis.

Methods: Eligible randomized controlled trials (RCTs) on the comparison of the efficacy and safety of biologics and immunomodulators with biological monotherapy were identified from the EMBASE, PubMed and the Cochrane Library databases published up to 1 May 2020. Raw data were extracted, pooled relative risk (RR) and 95% confidence interval (CI) was calculated, the fixed-effect and inverse variance models were used. Funnel plots were performed to analyze publication bias.

Results: Twelve RCTs were eligible for analysis. Overall, there was statistically a benefit for combination treatment over biologic monotherapy (IFX/ADA) in inducing clinical remission and preventing relapse in patients with IBD (RR 0.89, 95% CI 0.80-0.98). Moreover, the combination therapy was superior to biological monotherapy for active CD (RR 0.83, 95% CI 0.73-0.94). Also, there were significant benefits for combination therapy in the subgroup treated with infliximab (IFX) (RR 0.83, 95% CI 0.70-0.97).

Conclusions: Combination therapy has slight benefits in inducing clinical remission in active CD compared with biological monotherapy. Patients with IBD who receive therapy with IFX and immunomodulator also have a mild advantage in comparison with those treated with IFX monotherapy.

Keywords: biologics; biosimilar pharmaceuticals; combination therapy; immunomodulator; inflammatory bowel diseases.

PubMed Disclaimer

References

REFERENCES

    1. Chouraki V, Savoye G, Dauchet L, et al. The changing pattern of Crohn's disease incidence in northern France: a continuing increase in the 10- to 19-year-old age bracket (1988-2007). Aliment Pharmacol Ther. 2011;33(10):1133-1142.
    1. Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142(1):46-54.e42.
    1. Walter E, Hausberger SC, Groß E, Siebert U. Health-related quality of life, work productivity and costs related to patients with inflammatory bowel disease in Austria. J Med Econ. 2020;10:1061-1071.
    1. Yamabe K, Liebert R, Flores N, Pashos CL. Health-related quality of life outcomes and economic burden of inflammatory bowel disease in Japan. Clinicoecon Outcomes Res. 2019;11:221-232.
    1. Jones JL, Nguyen GC, Benchimol EI, et al. The impact of inflammatory bowel disease in Canada 2018: quality of life. J Can Assoc Gastroenterol. 2019;2(Suppl):S42-S48.

MeSH terms

LinkOut - more resources