Etrolizumab versus infliximab in the treatment of induction phase of ulcerative colitis: A systematic review and indirect comparison

Motaghi, Ehsan; Ghasemi-Pirbaluti, Masoumeh; Zabihi, Mohsen

doi:10.1016/j.phrs.2018.11.003

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…By indirect comparison, etrolizumab is associated with lower induction of clinical remission than the reported efficacy of infliximab (OR = 3.04, 95% CI: 1.84–5.02), similar to vedolizumab (OR = 3.10, 95% CI: 1.53–6.26), and higher than adalimumab with no significant difference in safety profile among all drugs included. This contradicts the results of a previous meta‐analysis that compared infliximab and etrolizumab using indirect comparison regarding the clinical efficacy and adverse events and reported that infliximab is similar to etrolizumab in the induction of remission and it carries a higher risk of serious adverse events to the patients 42 . The results of this previous study are unreliable because it is an indirect comparison that included only two trials on etrolizumab with a small sample size of patients in their comparison.…”

Section: Discussioncontrasting

confidence: 67%

“…This contradicts the results of a previous meta-analysis that compared infliximab and etrolizumab using indirect comparison regarding the clinical efficacy and adverse events and reported that infliximab is similar to etrolizumab in the induction of remission and it carries a higher risk of serious adverse events to the patients. 42 The results of this previous study are unreliable because it is an indirect comparison that included only two trials on etrolizumab with a small sample size of patients in their comparison. In a phase 3 trial that compared infliximab to etrolizumab, the results showed that infliximab was similar to etrolizumab in induction of clinical remission in moderate to severe UC patients with similar safety profiles in both drugs.…”

Section: Discussionmentioning

confidence: 95%

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Efficacy and safety of etrolizumab in treatment of moderate to severe ulcerative colitis: A systematic review and meta‐analysis

Motawea,

Abdelghafar,

AbdelQadir

et al. 2024

Health Science Reports

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BackgroundEtrolizumab is a promising drug for treating moderate to severe ulcerative colitis.AimThe aim of this study was to assess the efficacy and safety of etrolizumab for induction and maintenance of remission in moderate to severe ulcerative colitis.MethodsWe searched the following databases: PUBMED, Web of Science, OVID, and SCOPUS from inception to January 15. Inclusion criteria were any phase 2 and 3 clinical trials that compared etrolizumab with a placebo in treating moderate to severe ulcerative colitis, excluding case reports, animal studies, phase 1 trials, and conference abstracts due to duplication. We used RevMan software (5.4) for the meta‐analysis.ResultsFive clinical trials were included in our meta‐analysis. The total number of patients included in the study is 1248 patients, 860 patients in the etrolizumab group and 388 patients in the placebo group. In the induction phase, the pooled analyses showed a statistically significant association between etrolizumab and increased clinical remission, and endoscopic remission compared with placebo (risk ratio [RR] = 2.66, 95% confidence interval [CI] = 1.69–4.19, p < 0.0001), and (RR = 2.35, 95% CI = 1.52–3.65, p = 0.0001), respectively. In the maintenance phase, the pooled analyses showed a statistically significant association between etrolizumab and increased histologic remission and endoscopic remission (RR = 2.04, 95% CI = 1.40–2.98, p = 0.0002) and (RR = 1.92, 95% CI = 1.29–2.85, p = 0.001), respectively. No statistically significant difference was observed in adverse events between etrolizumab and placebo in the induction and maintenance phases.ConclusionOur results show that etrolizumab is an effective and safe drug for the induction and maintenance of clinical remission in moderate to severe ulcerative colitis patients, as proved by histologic and endoscopic findings. Future randomized trials are still needed to compare etrolizumab to the other agents and further establish its value for the practice.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 95%

Efficacy and safety of etrolizumab in treatment of moderate to severe ulcerative colitis: A systematic review and meta‐analysis

Motawea,

Abdelghafar,

AbdelQadir

et al. 2024

Health Science Reports

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“…The literature search yielded 766 records. In total, 31 MAs 9–39 met the eligibility criteria (Figure 1). MAs of head-to-head trials were unavailable, hence we included network MAs presenting evidence from indirect comparisons.…”

Section: Resultsmentioning

confidence: 99%

“…of heterogeneity and small-study effects. Several MAs 9,13,14,16,[18][19][20]24,25,27,29,[31][32][33][35][36][37][38][39] provided heterogeneity assessment. Most comparisons versus placebo did not show substantial heterogeneity 16,24,32,36 (Table 1A-D).…”

Section: Methodsmentioning

confidence: 99%

Efficacy and safety of biologic agents and tofacitinib in moderate‐to‐severe ulcerative colitis: A systematic overview of meta‐analyses

et al. 2019

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Background: Ulcerative colitis (UC) is an inflammatory disease of the colon and rectum. Treatment options include biologics and tofacitinib. Objectives: We aim to summarize the evidence on efficacy and safety of biologics and tofacitinib in moderate-to-severe UC. Methods: PubMed, Embase, Scopus, and the Cochrane Library were systematically searched to identify meta-analyses of randomized controlled trials assessing adalimumab, golimumab, infliximab, vedolizumab, and tofacitinib in UC. Efficacy outcomes included induction and maintenance of clinical response, clinical remission and mucosal healing. Safety outcomes included adverse events and serious adverse events. Results: The overview involved 31 meta-analyses. All four biologics and tofacitinib were superior to placebo regarding efficacy. Indirect comparisons suggested that infliximab may be better than adalimumab and golimumab to induce clinical response and mucosal healing. Safety analyses indicated no increased rates of adverse events, except for infliximab. Conclusions: Biologics and tofacitinib are efficacious and safe for treating UC. These findings can support clinical decisionmaking.

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“…In terms of comparative efficacy to anti‐TNFs, a head‐to‐head meta‐analysis was conducted, comparing etrolizumab with infliximab for the treatment of moderate to severe UC. 47 It incorporated data from seven RCTs, representing the first meta‐analysis with comparison between these two novel medications. Notably, there were no significant differences observed in terms of clinical remission and serious AEs between etrolizumab and infliximab.…”

Section: Discussionmentioning

confidence: 99%

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

Saleh,

Abuelazm,

Mohamed

et al. 2024

JGH Open

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Background and AimEtrolizumab 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.MethodsWe 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.ResultsFive 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.ConclusionEtrolizumab 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.

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Etrolizumab versus infliximab in the treatment of induction phase of ulcerative colitis: A systematic review and indirect comparison

Cited by 8 publications

References 21 publications

Efficacy and safety of etrolizumab in treatment of moderate to severe ulcerative colitis: A systematic review and meta‐analysis

Efficacy and safety of etrolizumab in treatment of moderate to severe ulcerative colitis: A systematic review and meta‐analysis

Efficacy and safety of biologic agents and tofacitinib in moderate‐to‐severe ulcerative colitis: A systematic overview of meta‐analyses

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

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