PMID- 36052677
OWN - NLM
STAT- MEDLINE
DCOM- 20220908
LR  - 20220923
IS  - 1473-5687 (Electronic)
IS  - 0954-691X (Linking)
VI  - 34
IP  - 10
DP  - 2022 Oct 1
TI  - Efficacy and safety of biologic therapy in microscopic colitis: systematic review 
      and meta-analysis.
PG  - 1000-1006
LID - 10.1097/MEG.0000000000002409 [doi]
AB  - BACKGROUND: This systematic review and meta-analysis sought to evaluate the 
      effectiveness and safety of biologic therapy in the treatment of 
      steroid-refractory microscopic colitis (MC). METHODS: We searched MEDLINE, 
      Embase, Web of Science, and Cochrane Central to identify articles and abstracts 
      reporting efficacy or safety data on biologic use (infliximab, adalimumab, 
      certolizumab, golimumab, vedolizumab, ustekinumab, and tofacitinib) for induction 
      and maintenance of remission in MC. We assessed clinical remission and response 
      rates and all reported adverse events (AEs). RESULTS: A total of 376 studies were 
      screened yielding 13 articles (including four abstracts) with a combined 
      information on 78 patients for efficacy and safety outcomes. Most studies were 
      case series. Vedolizumab was used in five studies, adalimumab in three, and a 
      combination of infliximab and adalimumab in five studies. The rates of remission 
      were 66.08% (95% CI, 36.79-95.37%; I2 , 71%) at weeks 3-6 and 54.20% (95% CI, 
      39.39-69.01%; I2 , 0%) at weeks 12-16. Clinical response rates were 100% (95% CI, 
      88.04-100%; I2 , 0%) at weeks 3-6 and 67.20% (95% CI, 47.72-86.69%; I2 , 52%) at 
      weeks 12-16. Most frequent AE was medication discontinuation with a pooled 
      incidence of 16.1% (95% CI, 5.9-37.5%). No deaths attributable to biologic use 
      were reported. The overall quality of evidence was very low due to the high risk 
      of biases. CONCLUSION: Low-quality evidence supports the short-term efficacy of 
      biologics in budesonide refractory MC. While our findings represent the most 
      comprehensive evaluation of biologic therapy in severe MC, further research 
      including randomized clinical trials is needed to better define the role of 
      specific agents and long-term therapy.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Taneja, Vikas
AU  - Taneja V
AD  - Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard 
      Medical School, Boston.
FAU - El-Dallal, Mohammed
AU  - El-Dallal M
AD  - Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard 
      Medical School, Boston.
AD  - Division of Hospital Medicine, Cambridge Health Alliance and Harvard Medical 
      School, Cambridge.
FAU - Anand, Rajsavi S
AU  - Anand RS
AD  - Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical 
      School, Boston.
FAU - Haq, Zadid
AU  - Haq Z
AD  - Johns Hopkins University School of Medicine, Bayview Medical Residency, 
      Baltimore, Maryland, USA.
FAU - Mishkin, Brooke
AU  - Mishkin B
AD  - Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard 
      Medical School, Boston.
FAU - Feuerstein, Joseph D
AU  - Feuerstein JD
AD  - Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard 
      Medical School, Boston.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220719
PL  - England
TA  - Eur J Gastroenterol Hepatol
JT  - European journal of gastroenterology & hepatology
JID - 9000874
RN  - B72HH48FLU (Infliximab)
RN  - FU77B4U5Z0 (Ustekinumab)
RN  - FYS6T7F842 (Adalimumab)
SB  - IM
MH  - Adalimumab/adverse effects
MH  - Biological Therapy/adverse effects
MH  - *Colitis, Microscopic/drug therapy
MH  - Humans
MH  - Infliximab/adverse effects
MH  - *Ustekinumab
EDAT- 2022/09/03 06:00
MHDA- 2022/09/09 06:00
CRDT- 2022/09/02 05:02
PHST- 2022/09/03 06:00 [pubmed]
PHST- 2022/09/09 06:00 [medline]
PHST- 2022/09/02 05:02 [entrez]
AID - 00042737-202210000-00003 [pii]
AID - 10.1097/MEG.0000000000002409 [doi]
PST - ppublish
SO  - Eur J Gastroenterol Hepatol. 2022 Oct 1;34(10):1000-1006. doi: 
      10.1097/MEG.0000000000002409. Epub 2022 Jul 19.