Systematic review with meta‐analysis: infliximab and immunosuppressant therapy vs. infliximab alone for active ulcerative colitis

• Published in: Alimentary Pharmacology & Therapeutics (Suppl) 2015-04, Vol.41 (7), p.603-612
• Main Authors: Christophorou, D., Funakoshi, N., Duny, Y., Valats, J.‐C., Bismuth, M., Pineton De Chambrun, G., Daures, J.‐P., Blanc, P.
• Format: Article
• Language: English
• Subjects: Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - therapeutic use; Clinical Trials as Topic; Colitis, Ulcerative - drug therapy; Drug Therapy, Combination; Human health and pathology; Humans; Hépatology and Gastroenterology; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - therapeutic use; Infliximab; Life Sciences; Middle Aged; Pharmaceutical sciences; Pharmacology; Time Factors
• ISSN: 0269-2813; 0953-0673; 1365-2036
• DOI: 10.1111/apt.13102

Summary Background The benefit of the combination of infliximab (IFX) and immunosuppressant (IS) therapy is debated in ulcerative colitis (UC). Aims To determine whether the combination of IFX and IS therapy is more effective than infliximab alone for active UC regardless of prior IS use. Methods We identified all controlled trials including patients with moderate‐to‐severe active UC, treated by either IFX or combined IFX‐IS therapy. The main outcome was clinical remission at 4–6 months. Two statistical methods were used, Mantel‐Haenszel and Der‐Simonian and Laird. Inter‐trial heterogeneity was taken into account and publication bias was assessed. Results Four controlled trials were analysed and included in the meta‐analysis. These four trials included 765 patients, 389 treated with IFX alone and 376 treated with IFX and IS. At 4–6 months' therapy, the clinical remission rate was significantly lower for the IFX monotherapy group OR 0.50, 95% CI [0.34–0.73], P