Efficacy and safety of adalimumab in comparison to infliximab for Crohn's disease: A systematic review and meta-analysis

作者全名："Yang, Hua-Hua; Huang, Yi; Zhou, Xu-Chun; Wang, Ruo-Nan"

作者地址："[Yang, Hua-Hua; Huang, Yi; Zhou, Xu-Chun] Chongqing Med Univ, Dept Gastroenterol, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Wang, Ruo-Nan] Huazhong Univ Sci & Technol, Liyuan Hosp, Tongji Med Coll, Dept Endocrinol, Wuhan 430077, Hubei, Peoples R China"

通信作者："Zhou, XC (通讯作者)，Chongqing Med Univ, Dept Gastroenterol, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：WORLD JOURNAL OF CLINICAL CASES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000837963500015

JCR分区：Q3

影响因子：1.1

年份：2022

卷号：10

期号：18

开始页：6091

结束页：6104

文献类型：Review

关键词：Crohn disease; Adalimumab; Infliximab; Clinical efficacy; Adverse effects; Meta-analysis

摘要："BACKGROUND Adalimumab (ADA) and infliximab (IFX) are the cornerstones of the treatment of Crohn's disease (CD). It remains controversial whether there is a difference in the effectiveness and safety between IFX and ADA for CD. AIM To perform a meta-analysis to compare the effectiveness and safety of ADA and IFX in CD. METHODS PubMed, Embase, Cochrane Library, and Web of Science databases were searched. Cohort studies were considered for inclusion. The primary outcomes were induction of response and remission, maintenance of response and remission, and secondary loss of response. Adverse events were secondary outcomes. RESULTS Fourteen cohort studies were included. There was no apparent difference between the two agents in the induction response [odds ratio (OR): 1.27, 95% confidence interval (CI): 0.93-1.74, P = 0.14] and remission (OR: 1.11, 95%CI: 0.78-1.57, P = 0.57), maintenance response (OR: 1.08, 95%CI: 0.76-1.53, P = 0.67) and remission (OR: 1.26, 95%CI: 0.87-1.82, P = 0.22), and secondary loss of response (OR: 1.01, 95%CI: 0.65-1.55, P = 0.97). Subgroup analysis revealed ADA and IFX had similar rates of response, remission, and loss of response either in anti-tumor necrosis factor-alpha naive or non-naive patients. Further, there was a similar result regardless of whether CD patients were treated with optimized therapy, including dose intensification, shortening interval, and combination immunomodulators. However, ADA had a fewer overall adverse events than IFX (OR: 0.62, 95%CI: 0.42-0.91, P = 0.02). CONCLUSION ADA and IFX have similar clinical benefits for anti-tumor necrosis factor-alpha naive or non-naive CD patients. Overall adverse events rate is higher in patients in the IFX group."

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