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KMID : 1146320210090010028
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Journal of Health Technology Assessment
2021 Volume.9 No. 1 p.28 ~ p.40
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Systematic Review with Meta-Analysis: Comparative Effectiveness of Infliximab versus Adalimumab in Patients with Crohn’s Disease
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Park Jae-Eun
Chung Suh-Il
Suh Jae-Kyung
Kang Hye-Young
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Abstract
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Objectives: Infliximab and adalimumab are common biologic agents to induce remission state among patients with Crohn’s disease. Although, direct head-to-head studies comparing the clinical outcomes of the two treatments are sparse, several observational trials have been conducted recently. In this study, we performed systematic literature review and meta-analysis of cohort studies to compare the effectiveness of infliximab and adalimumab.
Methods: We searched four databases, Ovid-Medline, Embase, PubMED, and Cochran Library. Observational studies comparing infliximab and adalimumab in patients with Crohn’s disease were selected. Quality of studies was assessed, and meta-analysis was conducted using a random effect model. In addition, subgroup analyses were performed based on the diagnostic criteria, biologics naive/relapse and patients’ ethnicity.
Results: Of the total 2,209 searched studies, 8 studies were included in the analysis. No significant difference in clinical remission between Infliximab and adalimumab was found [risk ratio (RR) 0.98, 95% confidence interval (CI) 0.90?1.07, heterogeneity: p=0.08, I2=45%]. In subgroup analysis, we found that the effectiveness of adalimumab was significantly better than infliximab (RR 0.77, 95% CI 0.61?0.98) in Asian population, however, due to the insufficient number of included studies for Asian population, careful interpretation is needed.
Conclusion: The effectiveness of infliximab and adalimumab is comparable in observational studies. Follow-up studies are needed to find out treatment outcomes in different ethnicity.
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KEYWORD
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Crohn’s disease, Infliximab, Adalimumab, Clinical remission
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