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Cited by 323

The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.

Systematic review with meta‐analysis: the efficacy of a second anti‐TNF in patients with inflammatory bowel disease whose previous anti‐TNF treatment has failed

Open access
Gisbert, J. P., Marín, A. C., McNicholl, A. G., Chaparro, M.·2015·Alimentary Pharmacology & Therapeutics
DOI 10.1111/apt.13083
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Abstract

Summary: Background: One‐third of patients with Crohn's disease (CD) or ulcerative colitis (UC) receiving anti‐TNF s do not respond to treatment, and a relevant proportion experience loss of response or intolerance. Aim: To investigate the efficacy and safety of a second anti‐TNF agent after primary/secondary failure or intolerance to a first drug. Methods: Inclusion criteria: studies evaluating the efficacy of infliximab (IFX), adalimumab (ADA) and certolizumab‐pegol (CZP) as the second anti‐TNF in CD or UC. Search strategy: Bibliographical searches (PubMed/Embase). Data synthesis: percentage of response/remission; the meta‐analysis was performed using the inverse variance method. Results: We included 46 studies (37 CD, 8 UC, 1 pouchitis). The CD studies comprised 32 switching IFX→ADA, 4 IFX→CZP and 1 ADA→IFX. Overall, the second anti‐TNF after the failure of IFX in CD induced remission in 43% and response in 63% of patients. The remission rate was higher when the reason to withdraw the first anti‐TNF was intolerance (61%) than after secondary (45%) or primary failure (30%); response rates were, respectively, 72%, 62% and 53%. All UC studies switched IFX→ADA, six of them reporting remission rates ranging from 0% to 50%. Adverse events rate ranged from 0% to 81% in CD, most of them mild (serious adverse event 0–21%, discontinuation rate <20%). Conclusions: The efficacy of a second anti‐TNF in CD patients largely depends on the cause for switching. The remission rate is higher when the reason to withdraw the first anti‐TNF is intolerance (61%), compared with secondary (45%) or primary failure (30%). Further studies of switch ADA→IFX are needed to evaluate this strategy. PROSPERO‐registry‐number: CRD42014012943.

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Metadata

Authors
Gisbert, J. P., Marín, A. C., McNicholl, A. G., & Chaparro, M.
Venue
Alimentary Pharmacology & Therapeutics
Publisher
Wiley
Published
2015-02-04
Volume
41
Issue
7
Pages
613-623
ISSN
  • 0269-2813 (ISSN-L)
  • 1365-2036
DOI
10.1111/apt.13083
OpenAlex
W2143747121
Cited by
323
References
53
FWCI
4.62
Type
journal article
Language
en
Open access
bronze

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