Adalimumab for induction of remission in patients with Crohn's disease: a systematic review and meta-analysis

Abstract

Purpose A large number of people with Crohn's disease (CD) fail to recover from conventional therapy or biological therapy. Some studies showed that adalimumab (ADA) may be an effective alternative therapy for these patients. The aim of this study was to evaluate the efficacy and safety of ADA in inducing CD remission. Methods We performed search of Pubmed/MEDLINE, Embase, CENTRAL, the Cochrane IBD Group Specialized Register, and several other databases. Randomized controlled trials (RCTs) comparing any dose of ADA with controls (placebo or active) in participants with active CD were included. The primary outcome was the failure to achieve clinical response/remission at 4 weeks. Several subgroup and sensitivity analyses were performed. Review Manager Software v5.3 was used. Results Four RCTs were included (n = 919), in which 553 participants received ADA and 366 participants received placebo. A meta-analysis of four studies showed that at 4 weeks, there were more people in the ADA group with clinical response/remission or symptom improvement compared with the placebo group. The rates of side effects, serious side effects, and study withdrawals due to side effects were lower in ADA participants than placebo ones. Conclusion This meta-analysis shows that ADA is superior to placebo in induction of clinical response/remission of CD patients, but no firm conclusions can be drawn on the safety of ADA in CD due to the low number of events. Graphical Abstract

Efficacy and Safety of Adalimumab in Pediatric Patients With Crohn’s Disease: A Systematic Review and Meta- analysis

“…our subgroup analysis demonstrated that previous exposure to IFX have less effect on the e cacy of ADA compared with patients with IFX-naïve. This is consistent with the results of Song et al [11] However, Yin et al [12] assessed the e cacy and safety of ADA in inducing and maintaining remission of participants with CD, which included four RCTs and concluded that e cacy rates were similar between the TNF-α-naïve and TNF-α exposed subgroups. We think the possibility might be that patients with previous IFX treatment probably had more severe disease for a longer period of time, which led them to receive anti-TNF therapy.…”

“…Adalimumab(ADA), as a fully humanized TNF-α monoclonal antibody has been approved by the United States Food and Drug Administration for the treatment of moderate and severe CD in children, and recommended by the European consensus guidelines for the treatment of long-term active intestinal diseases in children [9]. Several systematic review and meta-analysis have demonstrated that ADA is safe and effective in the treatment of CD in adults [10][11][12]. However, it is unclear whether adalimumab has similar e cacy in children with CD.This systematic review aimed to examine the e cacy and safety of ADA for inducing and maintaining remission in pediatric patients with CD.…”

Comparing the Efficacy and Safety of Adalimumab and Vedolizumab in Treating Moderate to Severe Crohn’s Disease and Ulcerative Colitis

“…There are five further systematic review and meta-analysis studies that evaluated the effectiveness and security of ADA in CD patients. All of these reviews reached the same conclusion as revealed by us and showed that ADA was effective and significantly improved the life quality of CD participants [34][35][36][37][38].…”

Terapia Biológica en Pacientes con Enfermedad Inflamatoria Intestinal

“…Finamente, otro agente biológico significativo es el Adalimumab, debido a que ha demostrado ser más eficaz al momento de tratar la enfermedad de Crohn, poniendo a consideración que presenta un menor desarrollo de efectos secundarios, así como también una mejor respuesta frente al placebo aplicado, con tasas de remisión de entre el 16.5 al 18 (Kucharzik et al, 2020;Yin et al, 2022;Zaltman et al, 2019).…”