Meta analysis on comparison of accelerated and standard infliximab induction in acute severe ulcerative colitis
10.3760/cma.j.cn101480-20220622-00094
- VernacularTitle:急性重度溃疡性结肠炎使用英夫利西单克隆抗体加速治疗与标准治疗比较的Meta分析
- Author:
Xinyu LIU
1
;
Bowen TIAN
;
Yujie SHI
;
Hui XU
;
Bei TAN
;
Yue LI
;
Jiaming QIAN
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院消化内科，北京 100730
- Publication Type:Journal Article
- Keywords:
Ulcerative colitis, acute severe;
Infliximab;
Accelerated induction;
Meta-analysis
- From:
Chinese Journal of Inflammatory Bowel Diseases
2023;07(2):135-143
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the difference of colectomy rate of acute severe ulcerative colitis (ASUC) treated with accelerated and standard infliximab (IFX) induction as salvage therapy.Methods:Relevant studies comparing accelerated and standard IFX induction in ASUC were systematically searched in PubMed, MEDLINE, EMBASE, Cochrane Library, Scopus from the establishment of the databases to Feb 7th, 2022. Two researchers screened the studies according to the established inclusion and exclusion criteria, evaluated the quality of included studies, and extracted the data. Meta-analysis was performed using R 4.0.3.Results:Ten studies were finally included, including 716 patients. The results of meta-analysis showed that there were no significant difference in colectomy rate of in-hospital ( OR = 0.56, 95% CI: 0.13 - 2.45, P = 0.446) , 3 months ( OR = 1.14, 95% CI: 0.54 - 2.42, P = 0.724) , 1 year ( OR = 0.85, 95% CI: 0.51 - 1.41, P = 0.528) , and 2 years ( OR = 1.01, 95% CI: 0.59 - 1.74, P = 0.962) between accelerated and standard IFX induction in ASUC patients, but there was significant heterogeneity among different studies. Covariate analysis revealed that baseline albumin ( MD = -1.27, 95% CI: -2.31 - -0.23, P = 0.017) and hemoglobin ( MD = -0.60, 95% CI: -1.01 - -0.20, P = 0.004) levels were significantly lower in the accelerated treatment group than those in the standard treatment group. Conclusions:There are no significant difference in short-term and long-term colectomy rates between ASUC patients treated with accelerated and standard infliximab induction, but there is significant difference in baseline disease severity between the two groups. Patients with severe disease activity should be treated with more aggressive accelerated IFX induction.
