PDF(Pubmed)
Abstract：
Ulcerative colitis (UC) is an inflammatory disorder affecting the colon, and typically, during the disease course, the condition may exacerbate, relapse, and remit. One of the most successful lines for inducing and maintaining clinical remission in subjects with UC is biological therapy with anti-tumor necrosis factor α (anti-TNF) agents, including adalimumab (ADA) and infliximab (IFX). This meta-analysis is an attempt to obtain complementary information driven by real-world experience (RWE) concerning the efficacy and safety of two of the most popular anti-TNFs in treating UC. This is a systematic review and meta-analysis of RWE studies comparing ADA and IFX as naïve anti-TNF agents for the treatment of subjects with UC. Studies were obtained by searching Scopus, Google Scholar, the Cochrane Central Register of Controlled Trials, Embase, and the PubMed Central databases. Patients treated with IFX showed significantly higher induction responses. No statistically significant difference was found in the comparison of response in the maintenance treatment period. Higher overall adverse events were related to IFX treatment, with serious adverse events that were nonsignificantly higher in the ADA-treated group. In conclusion, IFX demonstrated significantly higher induction responses compared to ADA in patients with moderate-to-severe UC. IFX was associated with higher overall adverse events, whereas serious adverse events were non-significantly higher in the ADA-treated group. IFX may be favored as a first-line agent for its induction efficacy, and the choice between IFX and ADA should be individualized based on comprehensive clinical evaluation.
摘要：
溃疡性结肠炎（UC）是一种影响结肠的炎症性疾病，通常，在疾病过程中，病情可能会加剧,复发,和汇款。在UC患者中诱导和维持临床缓解的最成功的路线之一是使用抗肿瘤坏死因子α（anti-TNF）药物的生物治疗。包括阿达木单抗（ADA）和英夫利昔单抗（IFX）。这种荟萃分析是一种尝试，旨在获得由现实世界经验（RWE）驱动的有关两种最流行的抗TNF治疗UC的有效性和安全性的补充信息。这是比较ADA和IFX作为初始抗TNF药物用于治疗UC受试者的RWE研究的系统评价和荟萃分析。研究是通过搜索Scopus获得的，谷歌学者，Cochrane中央受控试验登记册,Embase,和PubMedCentral数据库。用IFX治疗的患者显示出显著更高的诱导反应。在维持治疗期间的反应比较中没有发现统计学上的显着差异。较高的总体不良事件与IFX治疗有关，严重不良事件在ADA治疗组中无显著增加.总之,与ADA相比，IFX在中度至重度UC患者中表现出明显更高的诱导反应。IFX与较高的总体不良事件相关，而ADA治疗组的严重不良事件无显著增加.IFX可能因其诱导功效而被青睐为一线药物，IFX和ADA的选择应在综合临床评估的基础上进行个体化。
