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Effectiveness and safety of vedolizumab for treatment of Crohn's disease: a systematic review and meta-analysis

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The aim of this systematic review (SR) and meta-analysis was to assess the efficacy and safety of vedolizumab in the treatment of Crohn's disease (CD).

Material and methods: A systematic literature search was conducted in Medline/PubMed, Embase and Cochrane Library until 25 January, 2015. Included studies were critically appraised according to the PRISMA protocol. Assessment in specified subgroups of CD patients and meta-analysis with Revman software were performed.

Results: Two randomized controlled trial (RCTs) were included in a meta-analysis for the induction phase of therapy: GEMINI II and GEMINI III. The clinical response was significantly higher for patients who received vedolizumab compared to placebo in the general population (risk benefit (RB) = 1.48; p = 0.0006) and in both analyzed subgroups: patients with previous failure of anti-TNFs treatment (RB = 1.51; p = 0.006) and patients naive to earlier anti-TNFs (RB = 1.41; p = 0.001). The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for patients who received vedolizumab compared to placebo (RB = 1.77; p = 0.003; RB = 2.29; p = 0.0004; respectively). Meta-analysis for adverse events, serious adverse events (SAEs) and serious infections, revealed that vedolizumab was as safe as placebo in the induction phase of therapy.

Conclusions: The clinical response was significantly higher for patients who received vedolizumab in the general population and in both analyzed subgroups of patients. The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for vedolizumab, but no significant differences were revealed in the subgroup of patients with previous TNF antagonist failure.

No MeSH data available.


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Forest plot of meta-analysis of adverse events for vedolizumab vs. placebo: A – any adverse event, B – serious adverse events, C – serious infection (ITT analysis)
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Figure 0005: Forest plot of meta-analysis of adverse events for vedolizumab vs. placebo: A – any adverse event, B – serious adverse events, C – serious infection (ITT analysis)

Mentions: A statistical analysis was performed for AEs, SAEs and serious infections occurring during the induction phase of treatment of CD with vedolizumab compared with placebo. In the intervention groups, the frequency of any AEs was similar to the control groups (Figure 5). There was no evidence of significant heterogeneity when data from the studies were pooled; therefore a fixed-effect model was used for analysis of the AEs. The meta-analysis revealed that risk of AEs was not significantly different for patients who received vedolizumab as compared with control patients (Figure 5 A). In the case of SAEs and serious infections, the results of the meta-analysis showed no significant differences between the groups (Figures 5 B and C).


Effectiveness and safety of vedolizumab for treatment of Crohn's disease: a systematic review and meta-analysis
Forest plot of meta-analysis of adverse events for vedolizumab vs. placebo: A – any adverse event, B – serious adverse events, C – serious infection (ITT analysis)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016590&req=5

Figure 0005: Forest plot of meta-analysis of adverse events for vedolizumab vs. placebo: A – any adverse event, B – serious adverse events, C – serious infection (ITT analysis)
Mentions: A statistical analysis was performed for AEs, SAEs and serious infections occurring during the induction phase of treatment of CD with vedolizumab compared with placebo. In the intervention groups, the frequency of any AEs was similar to the control groups (Figure 5). There was no evidence of significant heterogeneity when data from the studies were pooled; therefore a fixed-effect model was used for analysis of the AEs. The meta-analysis revealed that risk of AEs was not significantly different for patients who received vedolizumab as compared with control patients (Figure 5 A). In the case of SAEs and serious infections, the results of the meta-analysis showed no significant differences between the groups (Figures 5 B and C).

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The aim of this systematic review (SR) and meta-analysis was to assess the efficacy and safety of vedolizumab in the treatment of Crohn's disease (CD).

Material and methods: A systematic literature search was conducted in Medline/PubMed, Embase and Cochrane Library until 25 January, 2015. Included studies were critically appraised according to the PRISMA protocol. Assessment in specified subgroups of CD patients and meta-analysis with Revman software were performed.

Results: Two randomized controlled trial (RCTs) were included in a meta-analysis for the induction phase of therapy: GEMINI II and GEMINI III. The clinical response was significantly higher for patients who received vedolizumab compared to placebo in the general population (risk benefit (RB) = 1.48; p = 0.0006) and in both analyzed subgroups: patients with previous failure of anti-TNFs treatment (RB = 1.51; p = 0.006) and patients naive to earlier anti-TNFs (RB = 1.41; p = 0.001). The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for patients who received vedolizumab compared to placebo (RB = 1.77; p = 0.003; RB = 2.29; p = 0.0004; respectively). Meta-analysis for adverse events, serious adverse events (SAEs) and serious infections, revealed that vedolizumab was as safe as placebo in the induction phase of therapy.

Conclusions: The clinical response was significantly higher for patients who received vedolizumab in the general population and in both analyzed subgroups of patients. The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for vedolizumab, but no significant differences were revealed in the subgroup of patients with previous TNF antagonist failure.

No MeSH data available.


Related in: MedlinePlus