PMID- 33935772
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210504
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 12
DP  - 2021
TI  - Systematic Review and Network Meta-Analysis: Comparative Efficacy and Safety of 
      Biosimilars, Biologics and JAK1 Inhibitors for Active Crohn Disease.
PG  - 655865
LID - 10.3389/fphar.2021.655865 [doi]
LID - 655865
AB  - Background: Crohn disease (CD) is a chronic inflammatory disease that affects 
      quality of life. There are several drugs available for the treatment of CD, but 
      their relative efficacy is unknown due to a lack of high-quality head-to-head 
      randomized controlled trials. Aim: To perform a mixed comparison of the efficacy 
      and safety of biosimilars, biologics and JAK1 inhibitors for CD. Methods: We 
      searched PubMed, Web of Science, embase and the Cochrane Library for randomized 
      controlled trials (RCTs) up to Dec. 28, 2020. Only RCTs that compared the 
      efficacy or safety of biosimilars, biologics and JAK1 inhibitors with placebo or 
      another active agent for CD were included in the comparative analysis. Efficacy 
      outcomes were the induction of remission, maintenance of remission and 
      steroid-free remission, and safety outcomes were serious adverse events (AEs) and 
      infections. The Bayesian method was utilized to compare the treatments. The 
      registration number is CRD42020187807. Results: Twenty-eight studies and 29 RCTs 
      were identified in our systematic review. The network meta-analysis demonstrated 
      that infliximab and adalimumab were superior to certolizumab pegol (OR 2.44, 95% 
      CI 1.35-4.97; OR 2.96, 95% CI 1.57-5.40, respectively) and tofacitinib (OR 2.55, 
      95% CI 1.27-5.97; OR 3.10, 95% CI 1.47-6.52, respectively) and revealed the 
      superiority of CT-P13 compared with placebo (OR 2.90, 95% CI 1.31-7.59) for the 
      induction of remission. Infliximab (OR 7.49, 95% CI 1.85-34.77), adalimumab (OR 
      10.76, 95% CI 2.61-52.35), certolizumab pegol (OR 4.41, 95% CI 1.10-21.08), 
      vedolizumab (OR 4.99, 95% CI 1.19-25.54) and CT-P13 (OR 10.93, 95% CI 2.10-64.37) 
      were superior to filgotinib for the maintenance of remission. Moreover, 
      infliximab (OR 3.80, 95% CI 1.49-10.23), adalimumab (OR 4.86, 95% CI 1.43-16.95), 
      vedolizumab (OR 2.48, 95% CI 1.21-6.52) and CT-P13 (OR 5.15, 95% CI 1.05-27.58) 
      were superior to placebo for steroid-free remission. Among all treatments, 
      adalimumab ranked highest for the induction of remission, and CT-P13 ranked 
      highest for the maintenance of remission and steroid-free remission. Conclusion: 
      CT-P13 was more efficacious than numerous biological agents and JAK1 inhibitors 
      and should be recommended for the treatment of CD. Further head-to-head RCTs are 
      warranted to compare these drugs.
CI  - Copyright (c) 2021 Wu, Yang, Liu, Wang and Guo.
FAU - Wu, Guozhi
AU  - Wu G
AD  - The First Clinical Medical College, Lanzhou University, Lanzhou, China.
AD  - Department of Gastroenterology, The First Hospital of Lanzhou University, 
      Lanzhou, China.
AD  - Gansu Key Laboratory of Gastroenterology, Lanzhou University, Lanzhou, China.
FAU - Yang, Yuan
AU  - Yang Y
AD  - The First Clinical Medical College, Lanzhou University, Lanzhou, China.
AD  - Department of Gastroenterology, The First Hospital of Lanzhou University, 
      Lanzhou, China.
AD  - Gansu Key Laboratory of Gastroenterology, Lanzhou University, Lanzhou, China.
FAU - Liu, Min
AU  - Liu M
AD  - Department of Gastroenterology, The First Hospital of Lanzhou University, 
      Lanzhou, China.
AD  - Gansu Key Laboratory of Gastroenterology, Lanzhou University, Lanzhou, China.
FAU - Wang, Yuping
AU  - Wang Y
AD  - Department of Gastroenterology, The First Hospital of Lanzhou University, 
      Lanzhou, China.
AD  - Gansu Key Laboratory of Gastroenterology, Lanzhou University, Lanzhou, China.
FAU - Guo, Qinghong
AU  - Guo Q
AD  - Department of Gastroenterology, The First Hospital of Lanzhou University, 
      Lanzhou, China.
AD  - Gansu Key Laboratory of Gastroenterology, Lanzhou University, Lanzhou, China.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210414
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC8080031
OTO - NOTNLM
OT  - Crohn disease
OT  - JAK inhibitors
OT  - biologics
OT  - biosimilar
OT  - network meta analysis
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/05/04 06:00
MHDA- 2021/05/04 06:01
PMCR- 2021/04/14
CRDT- 2021/05/03 06:10
PHST- 2021/01/19 00:00 [received]
PHST- 2021/03/05 00:00 [accepted]
PHST- 2021/05/03 06:10 [entrez]
PHST- 2021/05/04 06:00 [pubmed]
PHST- 2021/05/04 06:01 [medline]
PHST- 2021/04/14 00:00 [pmc-release]
AID - 655865 [pii]
AID - 10.3389/fphar.2021.655865 [doi]
PST - epublish
SO  - Front Pharmacol. 2021 Apr 14;12:655865. doi: 10.3389/fphar.2021.655865. 
      eCollection 2021.