Etrolizumab as an induction and maintenance therapy for ulcerative colitis: A systematic review and meta-analysis of randomized controlled trials.

Autor: Saleh O; Faculty of Medicine The Hashemite University Zarqa Jordan., Abuelazm MT; Faculty of Medicine Tanta University Tanta Egypt., Mohamed I; Department of Internal Medicine University of Missouri Kansas City Missouri USA., Ramadan A; Faculty of Medicine South Valley University Qena Egypt., Assaf M; Faculty of Medicine The Hashemite University Zarqa Jordan., Alzoubi A; Faculty of Medicine The Hashemite University Zarqa Jordan., AlBarakat MM; Faculty of Medicine Jordan University of Science and Technology Irbid Jordan., Abdelazeem B; Department of Cardiology West Virginia University Morgantown West Virginia USA.; Department of Medicine Michigan State University East Lansing Michigan USA.
Jazyk: angličtina
Zdroj: JGH open : an open access journal of gastroenterology and hepatology [JGH Open] 2024 Apr 02; Vol. 8 (4), pp. e13056. Date of Electronic Publication: 2024 Apr 02 (Print Publication: 2024).
DOI: 10.1002/jgh3.13056
Abstrakt: Background and Aim: Etrolizumab is a gut-targeted anti-β7 integrin monoclonal antibody. However, the evidence of etrolizumab efficacy and safety in ulcerative colitis remains inconclusive. Therefore, we aim to evaluate the safety and efficacy of etrolizumab as an induction and maintenance therapy for active moderate to severe ulcerative colitis.
Methods: We synthesized randomized controlled studies (RCTs) from MEDLINE, Scopus, EMBASE, PubMed, Web of Science, and Cochrane Library until April 2023. The risk ratio (RR) for dichotomous outcomes with the corresponding 95% confidence interval (CI) was used. The study protocol was registered in PROSPERO with ID: CRD42023437040.
Results: Five RCTs with 1849 participants were included. The etrolizumab group had a significant clinical response (RR: 1.28 with 95% CI [1.08, 1.51], P  = 0.005), clinical remission rates during the induction phase (RR: 2.47 with 95% CI [1.48, 4.11], P  = 0.0005), compared with the placebo group in ulcerative colitis; however, there was no statistically significant difference between the two groups, regarding the corticosteroids-free remission rate (RR: 1.92 with 95% CI [0.94, 3.92], P  = 0.07). Moreover, endoscopic improvement, endoscopic remission, and histologic remission rates were observed more in the etrolizumab group during both the induction and maintenance phases. For safety outcomes, etrolizumab was significantly safer, but any adverse event was higher in the etrolizumab group than in the placebo.
Conclusion: Etrolizumab shows its effectiveness as both an induction and maintenance therapy for moderate or severe UC. The findings demonstrate its positive impact on clinical, endoscopic, and histologic remission rates. Regarding safety, other than any side effects, etrolizumab showed a good safety than a placebo.
(© 2024 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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