Background: Ulcerative colitis (UC) is an inflammatory disease of the colon and rectum. Treatment options include biologics and tofacitinib.
Objectives: We aim to summarize the evidence on efficacy and safety of biologics and tofacitinib in moderate-to-severe UC.
Methods: PubMed, Embase, Scopus, and the Cochrane Library were systematically searched to identify meta-analyses of randomized controlled trials assessing adalimumab, golimumab, infliximab, vedolizumab, and tofacitinib in UC. Efficacy outcomes included induction and maintenance of clinical response, clinical remission and mucosal healing. Safety outcomes included adverse events and serious adverse events.
Results: The overview involved 31 meta-analyses. All four biologics and tofacitinib were superior to placebo regarding efficacy. Indirect comparisons suggested that infliximab may be better than adalimumab and golimumab to induce clinical response and mucosal healing. Safety analyses indicated no increased rates of adverse events, except for infliximab.
Conclusions: Biologics and tofacitinib are efficacious and safe for treating UC. These findings can support clinical decision-making.
Keywords: adverse effect; anti-TNF; efficacy; inflammatory bowel disease; serious adverse effect; small molecule; ulcerative colitis.
© Author(s) 2019.
Systematic Review With Network Meta-Analysis: Comparative Assessment of Tofacitinib and Biological Therapies for Moderate-To-Severe Ulcerative ColitisS Bonovas et al. Aliment Pharmacol Ther 47 (4), 454-465. PMID 29205421. - Meta-AnalysisTofacitinib and biologics are efficacious and safe for UC. Further high-quality research is warranted to establish the best therapeutic option.
Biologics or Tofacitinib for People With Rheumatoid Arthritis Naive to Methotrexate: A Systematic Review and Network Meta-AnalysisJA Singh et al. Cochrane Database Syst Rev 5 (5), CD012657. PMID 28481462. - ReviewIn MTX-naive RA participants, there was moderate-quality evidence that, compared with MTX alone, biologics with MTX was associated with absolute and relative clinically m …
Comparative of the Effectiveness and Safety of Biological Agents, Tofacitinib, and Fecal Microbiota Transplantation in Ulcerative Colitis: Systematic Review and Network Meta-AnalysisHY Zhou et al. Immunol Invest 1-15. PMID 32009472.Of the biological agents, vedolizumab and infliximab were the most effective, suggesting that biological agents are still a better choice. Nevertheless, tofacitinib and F …
Biologics or Tofacitinib for People With Rheumatoid Arthritis Unsuccessfully Treated With Biologics: A Systematic Review and Network Meta-AnalysisJA Singh et al. Cochrane Database Syst Rev 3 (3), CD012591. PMID 28282491. - ReviewBiologic (with or without MTX) or tofacitinib (with MTX) use was associated with clinically meaningful and statistically significant benefits (ACR50, HAQ, remission) comp …
The Impact of Biological Interventions for Ulcerative Colitis on Health-Related Quality of LifeK LeBlanc et al. Cochrane Database Syst Rev (9), CD008655. PMID 26393522. - ReviewThese results suggest that biologics have the potential to improve HRQL in UC patients. High quality evidence suggests that infliximab provides a clinically meaningful im …