TY - JOUR
T1 - Efficacy of ustekinumab for active perianal fistulizing Crohn's disease
T2 - a systematic review and meta-analysis of the current literature
AU - Attauabi, Mohamed
AU - Burisch, Johan
AU - Seidelin, Jakob Benedict
PY - 2021/1
Y1 - 2021/1
N2 - BACKGROUND: Although the number of biological therapies for the treatment of Crohn's disease (CD) is rapidly increasing, their efficacy in inducing healing of fistulas in perianal Crohn's disease (pCD) is practically unknown, although they occur in up to 50% of patients with CD.OBJECTIVE: We aimed to investigate the clinical effectiveness of ustekinumab for pCD in a systemic review and meta-analysis.METHODS: Studies describing the efficacy of ustekinumab on fistulas in pCD in PubMed and EMBASE database from inception until 22 September 2020, were assessed in a systemic review and meta-analysis. The random-effect model was applied for the meta-analysis.RESULTS: The systematic review of the current literature yielded 2,243 studies of which nine studies with a total of 396 patients were found eligible for inclusion. The pooled proportions of patients experiencing fistula response were 41.0% (95% CI 23.9-60.6%9), I2 = 85%, 39.7% (95% CI 24.3-57.4%), I2 = 69% and 55.9% (95% CI 40.8-69.9%, I2 = 67% at weeks 8, 24, and 52, respectively. Regarding fistula remission, the pooled proportions were 17.1% (95% CI 8.1-32.7%), I2 = 45%, 17.7% (95% CI 1.8-71.9%), I2 = 68%, and 16.7% (95% CI 3.0-56.5%, I2 = 51% at week 8, 24, and 52, respectively.CONCLUSION: In this systematic review with meta-analysis, we found a signal of efficacy of ustekinumab on fistulizing pCD, emphasizing that these patients might benefit from this therapy.
AB - BACKGROUND: Although the number of biological therapies for the treatment of Crohn's disease (CD) is rapidly increasing, their efficacy in inducing healing of fistulas in perianal Crohn's disease (pCD) is practically unknown, although they occur in up to 50% of patients with CD.OBJECTIVE: We aimed to investigate the clinical effectiveness of ustekinumab for pCD in a systemic review and meta-analysis.METHODS: Studies describing the efficacy of ustekinumab on fistulas in pCD in PubMed and EMBASE database from inception until 22 September 2020, were assessed in a systemic review and meta-analysis. The random-effect model was applied for the meta-analysis.RESULTS: The systematic review of the current literature yielded 2,243 studies of which nine studies with a total of 396 patients were found eligible for inclusion. The pooled proportions of patients experiencing fistula response were 41.0% (95% CI 23.9-60.6%9), I2 = 85%, 39.7% (95% CI 24.3-57.4%), I2 = 69% and 55.9% (95% CI 40.8-69.9%, I2 = 67% at weeks 8, 24, and 52, respectively. Regarding fistula remission, the pooled proportions were 17.1% (95% CI 8.1-32.7%), I2 = 45%, 17.7% (95% CI 1.8-71.9%), I2 = 68%, and 16.7% (95% CI 3.0-56.5%, I2 = 51% at week 8, 24, and 52, respectively.CONCLUSION: In this systematic review with meta-analysis, we found a signal of efficacy of ustekinumab on fistulizing pCD, emphasizing that these patients might benefit from this therapy.
KW - Ustekinumab
KW - meta-analysis
KW - perianal fistulizing Crohn’
KW - s disease
KW - systematic review
KW - perianal fistulizing Crohn’s disease
UR - http://www.scopus.com/inward/record.url?scp=85097168223&partnerID=8YFLogxK
U2 - 10.1080/00365521.2020.1854848
DO - 10.1080/00365521.2020.1854848
M3 - Review
C2 - 33264569
SN - 0036-5521
VL - 56
SP - 53
EP - 58
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - 1
M1 - 1854848
ER -