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Meta-Analysis
. 2024 Mar;80(3):395-407.
doi: 10.1007/s00228-023-03613-1. Epub 2023 Dec 29.

Efficacy and safety of adalimumab in pediatric patients with Crohn's disease: A systematic review and meta-analysis

Bin Chen  1   2 , Zhuan Zou  1   2 , Xiaoyan Zhang  1   2 , Dongqiong Xiao  1   2 , Xihong Li  3   4
Affiliations
Meta-Analysis

Efficacy and safety of adalimumab in pediatric patients with Crohn's disease: A systematic review and meta-analysis

Bin Chen et al. Eur J Clin Pharmacol. 2024 Mar.

Abstract

Purpose: There is currently no curative treatment for childhood Crohn's disease (CD). This meta-analysis aimed to validate the efficacy and safety of adalimumab (ADA) in pediatric patients with CD.

Materials and methods: We searched all relevant studies in the PubMed, Web of Science, Embase, and Cochrane Library databases. The primary outcomes were induction (≤ 12 weeks) and maintenance (up to 48 weeks) of remission and response. Secondary outcomes were severe adverse events and opportunistic infections to ADA. The Cochrane bias assessment tool was used to assess the risk of bias in randomized controlled trials. The methodological quality of the single-arm studies was assessed using the methodological index for non-randomized studies tool.

Results: Ten clinical trials involving a total of 885 patients were included. Results indicated that 59% (95% confidence interval [CI] 39-80%) of the subjects treated with ADA achieved induction of remission, and 60% (95% CI 35-86%) of the subjects treated with ADA achieved induction of response, 57% (95% CI 44-70%) achieved maintenance of remission, and 63% (95% CI 26-69%) achieved maintenance of response.

Conclusion: Current evidence indicates that ADA is effective in children and adolescents with CD and that adverse events vary but are usually not severe.

Systematic review registration: https://www.crd.york.ac.uk/prospero/ , identifier CRD42023402199.

Keywords: Adalimumab; Child; Crohn’s disease; Efficacy and safety; Meta-analysis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the literature search
Fig. 2
Fig. 2
Risk of bias graph (RCTs)
Fig. 3
Fig. 3
Risk of bias summary (RCTs)
Fig. 4
Fig. 4
Forest plot of induction of remission
Fig. 5
Fig. 5
Forest plot of induction of response
Fig. 6
Fig. 6
Forest plot of maintenance of remission
Fig. 7
Fig. 7
Forest plot of maintenance of response
See this image and copyright information in PMC

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