Efficacy and safety of tumor necrosis factor-a blockers for ulcerative colitis: A systematic review and meta-analysis of published randomized controlled trials

Yun-Na Song ^a, Ping Zheng ^b,*

^a Department of Gastroenterology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, PR China
^b Department of Gastroenterology, Shanghai East Hospital of Tongji University, Shanghai 200120, PR China

To evaluate the efficacy and safety of TNF-a blockers for ulcerative colitis. A systematic search for randomized controlled trials ( RCTs) of TNF-a blockers for treatment of ulcerative colitis (UC) were performed in PubMed, Web of Science, Embase and cochrane clinical trial. We estimated Pooled estimates of the odds ratio (OR) and relevant 95% confidence interval (CI) using fixed effects model or random effects model as appropriate. Heterogeneity,  publication bias, and subgroup analyses were conducted. Nine randomized controlled studies met the selection criteria with a total of 2518 patients. Five studies compared Infliximab with placebo. Two studies compared Infliximab to corticosteroids. Two studies compared Adalimumab to placebo. One study compared subcutaneous Golimumab to placebo. Short-term response, short-term remission, long-term remission and mucosal healing were better in the TNF-a blocker group than in the control group (p < 0.05). TNF-a blockers decreased the colectomy rate and serious adverse reactions (p < 0.05). The TNF-a blockers were superior to controls in achieving short-term clinical response/remission, long-term remission and mucosal healing and decreased the colectomy rate and serious adverse reactions.

Keywords:
Ulcerative colitis
Tumor necrosis factor-a blocker
Meta-analysis
Efficacy and safety