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Systematic Review with Network Meta-Analysis: Efficacy of Induction Therapy with a Second Biological Agent in Anti-TNF-Experienced Crohn’s Disease Patients
المؤلفون المشاركون
Pagnini, Cristiano
Siakavellas, Spyros I.
Bamias, Giorgos
المصدر
Gastroenterology Research and Practice
العدد
المجلد 2018، العدد 2018 (31 ديسمبر/كانون الأول 2018)، ص ص. 1-9، 9ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2018-07-17
دولة النشر
مصر
عدد الصفحات
9
التخصصات الرئيسية
الملخص EN
Background and Aim.
Crohn’s disease (CD) is a chronic inflammatory condition of the gastrointestinal tract with the potential to progress to a severe debilitating state.
Treatment with biological agents is highly efficient, improving both short-term outcomes and long-term prognosis.
Nonetheless, up to 60% of patients receiving biological therapy will exhibit nonresponse at some point.
The optimal management of such patients is not clearly defined.
Besides traditional anti-TNF agents (infliximab, adalimumab, and certolizumab), alternative biological therapies (natalizumab, vedolizumab, and ustekinumab) are currently available for the treatment of CD.
Our aim was to analyze all available evidence regarding efficacy of a second biological in “biological-treatment-experienced” patients.
Methods.
A systematic review of the literature was conducted using specific criteria for selecting relevant randomized clinical trials evaluating response to administration of secondary biological therapy in “anti-TNF-experienced” CD patients.
Data from these studies was used to perform (a) traditional meta-analysis to ascertain the effect of secondary treatment versus placebo and (b) network meta-analysis to compare indirectly the efficacy of available biological agents.
Results.
Out of initially 977 studies, only eight were included for analysis, providing a total of 1281 treated and 733 placebo-receiving CD patients.
Treatment with a second biological was found to be superior to placebo for both induction of remission (OR 2.2, 95% CI 1.7 to 3) and response (OR 1.9, 95% CI 1.5 to 2.5), with global rates of 24% and 42%, respectively (placebo rate: 11% and 27%, p<0.0001 for both).
Indirect comparisons performed with network meta-analysis suggest no specific agent is clearly superior to others, with relatively better results observed for adalimumab in inducing disease remission.
Conclusion.
In anti-TNF-experienced CD patients, secondary biological administration may be efficient, while no specific agent seems to outperform the others.
Further research is needed to identify optimal management strategies for this challenging subset of patients.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Pagnini, Cristiano& Siakavellas, Spyros I.& Bamias, Giorgos. 2018. Systematic Review with Network Meta-Analysis: Efficacy of Induction Therapy with a Second Biological Agent in Anti-TNF-Experienced Crohn’s Disease Patients. Gastroenterology Research and Practice،Vol. 2018, no. 2018, pp.1-9.
https://search.emarefa.net/detail/BIM-1165277
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Pagnini, Cristiano…[et al.]. Systematic Review with Network Meta-Analysis: Efficacy of Induction Therapy with a Second Biological Agent in Anti-TNF-Experienced Crohn’s Disease Patients. Gastroenterology Research and Practice No. 2018 (2018), pp.1-9.
https://search.emarefa.net/detail/BIM-1165277
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Pagnini, Cristiano& Siakavellas, Spyros I.& Bamias, Giorgos. Systematic Review with Network Meta-Analysis: Efficacy of Induction Therapy with a Second Biological Agent in Anti-TNF-Experienced Crohn’s Disease Patients. Gastroenterology Research and Practice. 2018. Vol. 2018, no. 2018, pp.1-9.
https://search.emarefa.net/detail/BIM-1165277
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1165277
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
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تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر
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