A meta-analysis of the therapeutic effects of tumor necrosis factor-α blockers on ulcerative colitis
European Journal of Clinical Pharmacology, 07/12/2011
Evidence Based Medicine
Huang X et al. – TNF–α blockers have better therapeutic effects on moderate or severe ulcerative colitis(UC), which shows little response to conventional therapy. TNF–α blockers can induce short–term response, maintain long–term clinical response and clinical relief, and decrease the colectomy rate and the severe adverse reaction rate, but they fail to improve quality of life and mucosal healing.Methods
- Randomized controlled trials (RCTs) of TNF–α blockers for treatment of UC were retrieved from databases.
- Heterogeneity test was performed on all data to select effects models.
- Finally, sensitivity analysis was carried out, and a funnel plot was drawn to evaluate publication bias.
- Total of 9 RCTs conformed to the inclusion criteria.
- Of 1,226 patients with UC, 806 were given a TNF–α blocker, and 420 were given placebo or other drugs as control.
- Infliximab was used in eight papers and adalimumab in one paper.
- Placebo was used in seven papers and hormones in two papers.
- Short–term response, short–term relief, long–term response, and long–term relief were better in the TNF–α blocker group than in the control group (P<0.05).
- TNF–α blockers decreased the colectomy rate (P<0.05).
- There were no significant differences in mucosal healing and quality of life between the two groups (P>0.05).
- Rates of adverse reactions were similar in the two groups (P>0.05), but the rate of severe adverse reactions was significantly lower in the TNF–α blocker group than in the control group (P<0.05).
- Funnel plot of each parameter was symmetrical with the lower part broader than the upper.