Pooled analysis of the comparative efficacy between tacrolimus and infliximab for ulcerative colitis
| Autor: | Cheng-Dang Wang, Yijuan Liu, Hua Fan, Wei-Wei Zhen, Xing Yu, Jin-Tong Chen |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Gastroenterology Tacrolimus 03 medical and health sciences 0302 clinical medicine Gastrointestinal Agents Internal medicine medicine Humans Adverse effect Colectomy Response rate (survey) business.industry Induction Chemotherapy General Medicine Odds ratio medicine.disease Ulcerative colitis Infliximab Confidence interval Treatment Outcome 030220 oncology & carcinogenesis Colitis Ulcerative Female 030211 gastroenterology & hepatology business Immunosuppressive Agents medicine.drug |
| Zdroj: | Medicine. 97:e11440 |
| ISSN: | 0025-7974 |
| DOI: | 10.1097/md.0000000000011440 |
| Popis: | Background Acute moderate-to-severe steroid-refractory ulcerative colitis (UC) has a poor prognosis and requires optimal rescue therapy. A pooled analysis was conducted to assess tacrolimus and infliximab (IFX) as rescue agents in patients with moderate-to-severe and steroid-refractory UC. Methods A literature search identified studies that investigated tacrolimus and IFX in moderate-to-severe steroid-refractory patients with UC. The primary outcome was short-term clinical response to treatment, including the remission and response rates. Secondary outcomes included the rates of colectomy at 3 months and adverse events rate. Results A total of 6 studies comprising 438 cases were eligible for inclusion. The pooled analysis showed that the short-term clinical response rate, clinical remission rate, and 3-month colectomy rate were 72.1%, 52.4%, and 10.1%, respectively, for those receiving tacrolimus, and 76.9%, 48.8%, and 12.4%, respectively, for those receiving IFX. No significant difference was, however, seen for tacrolimus compared with IFX with regard to clinical remission rate (odds ratio [OR] =1.08, 95% confidence interval [CI] = 0.77-1.49, P = .67), clinical response rate (OR = 0.92, 95% CI = 0.63-1.34, P = .66), and 3-month colectomy rate (OR = 0.86, 95% CI = 0.39-1.93, P = .72). More adverse events were, however, observed in the Tac group (OR = 2.16, 95% CI = 1.25-3.76, P = .006). Conclusions Our meta-analysis suggested that both tacrolimus and IFX appeared to be effective and safe for the rescue therapy of moderate-to-severe active UC and steroid-refractory UC. Therefore, tacrolimus is another choice for these patients. |
| Databáze: | OpenAIRE |
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