Comparable Long-Term Outcomes of Cyclosporine and Infliximab in Patients With Steroid-Refractory Acute Severe Ulcerative Colitis A Meta-Analysis /
Background: In steroid-refractory acute severe ulcerative colitis (ASUC), cyclosporine (CYS) or infliximab (IFX) may be considered as a second-line alternative to avoid colectomy. There are short-term data reported, but until now, there is no meta-analysis regarding long-term outcomes of CYS and IFX...
Elmentve itt :
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2020
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| Sorozat: | FRONTIERS IN MEDICINE
6 |
| doi: | 10.3389/fmed.2019.00338 |
| mtmt: | 31180155 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/19643 |
| LEADER | 03176nab a2200313 i 4500 | ||
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| 024 | 7 | |a 10.3389/fmed.2019.00338 |2 doi | |
| 024 | 7 | |a 31180155 |2 mtmt | |
| 040 | |a SZTE Publicatio Repozitórium |b hun | ||
| 041 | |a zxx | ||
| 100 | 1 | |a Szemes Kata | |
| 245 | 1 | 0 | |a Comparable Long-Term Outcomes of Cyclosporine and Infliximab in Patients With Steroid-Refractory Acute Severe Ulcerative Colitis |h [elektronikus dokumentum] : |b A Meta-Analysis / |c Szemes Kata |
| 260 | |c 2020 | ||
| 300 | |a Azonosító: 338-Terjedelem: 16 p | ||
| 490 | 0 | |a FRONTIERS IN MEDICINE |v 6 | |
| 520 | 3 | |a Background: In steroid-refractory acute severe ulcerative colitis (ASUC), cyclosporine (CYS) or infliximab (IFX) may be considered as a second-line alternative to avoid colectomy. There are short-term data reported, but until now, there is no meta-analysis regarding long-term outcomes of CYS and IFX in patients with ASUC. Aim: To compare long-term efficacy and safety of CYS and IFX in a meta-analysis. Methods: Three electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials) were searched for studies which compared CYS vs. IFX in adults with ASUC. Long-term colectomy-free rate from 1 to 10 years during CYS or IFX therapy was collected, last updated up to 22nd May 2019. Primary outcome was long-term colectomy-free rate, secondary outcomes were adverse events (AE), serious adverse events (SAE), and mortality. Long-term colectomy-free survival and safety measures were pooled with the random-effect model. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Data from 1,607 patients in 15 trials were extracted. In the first 3 years, pooled OR for colectomy-free survival was higher with IFX than with CYS (OR = 1.59, 95% CI: 1.11-2.29, p = 0.012; OR = 1.57, 95% CI: 1.14-2.18, p = 0.006; and OR = 1.75, 95% CI: 1.08-2.84, p = 0.024; at 1, 2, and 3 years, respectively). However, the significant difference remained undetected from the fourth year of follow-up and in subgroup of RCTs (OR = 1.35, 95% CI: 0.90-2.01, p = 0.143; OR = 1.41, 95% CI: 0.94-2.12, p = 0.096; and OR = 1.34, 95% CI: 0.89-2.00, p = 0.157; at 1, 2, and 3 years, respectively). No significant difference was detected regarding adverse events, serious adverse events and mortality between the groups. The neutral associations proved to be underpowered with trial sequential analysis. Conclusion: However observational studies show IFX as a better choice, according to the RCTs, choosing either CYS or IFX as rescue therapy for ASUC, the long-term outcomes are not different, although further large RCTs are warranted. | |
| 700 | 0 | 1 | |a Soós Alexandra |e aut |
| 700 | 0 | 1 | |a Hegyi Péter |e aut |
| 700 | 0 | 2 | |a Borbásné Farkas Kornélia |e aut |
| 700 | 0 | 2 | |a Erős Adrienn |e aut |
| 700 | 0 | 2 | |a Erőss Bálint Mihály |e aut |
| 700 | 0 | 2 | |a Mezősi Emese |e aut |
| 700 | 0 | 2 | |a Szakács Zsolt |e aut |
| 700 | 0 | 2 | |a Márta Katalin |e aut |
| 700 | 0 | 2 | |a Sarlós Patrícia |e aut |
| 856 | 4 | 0 | |u http://publicatio.bibl.u-szeged.hu/19643/1/31180155_Szemes_fmed-06-00338.pdf |z Dokumentum-elérés |