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Crohn's Disease Forum » Parents of Kids with IBD » Risk biologics in crohns study


11-04-2016, 02:31 PM   #1
my little penguin
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Risk biologics in crohns study


Abstract

Background & Aims: Safety issues are a major concern for patients considering treatments for inflammatory bowel disease (IBD). We performed a systematic review and meta-analysis to determine whether biologic agents affect the risk of infection or malignancy in adults with IBD.

Methods: We searched PubMed, Embase, Scopus, Cochrane IBD Group Specialized Trials Register, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov through March 2016 for randomized placebo-controlled or head-to-head trials of biologic agents approved for treatment of adults with IBD (ie, adalimumab, certolizumab, golimumab, infliximab, natalizumab, or vedolizumab). Two reviewers independently extracted study data and outcomes (serious infections, opportunistic infections, tuberculosis, any infection, and malignancies) and rated each trial's risk of bias. We used conventional meta-analysis to synthesize direct evidence and a network meta-analysis for adjusted indirect treatment comparisons.


Results: We identified 49 randomized placebo-controlled studies comprising 14,590 participants. Synthesis of the evidence indicated that patients treated with biologics had a moderate increase in risk of any infection (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.10–1.29) and a significant increase in risk of opportunistic infections (OR, 1.90; 95% CI, 1.21–3.01). Risk of serious infections was not increased in patients treated with biologics (OR, 0.89; 95% CI, 0.71–1.12). On the contrary, biologics appeared to significantly reduce risk of serious infections in studies with low risk of bias (OR, 0.56; 95% CI, 0.35–0.90). We did not find an increased risk of malignancy with use of biologic agents (OR, 0.90; 95% CI, 0.54–1.50), but data were insufficient in terms of exposure and follow-up times. None of the indirect comparisons, either among the individual agents or between the anti–tumor necrosis factor and anti-integrin classes, reached significance for any of the outcomes analyzed.

Conclusions: On the basis of a systematic review and meta-analysis, biologic agents increase the risk of opportunistic infections in patients with IBD, but not the risk of serious infections. It is necessary to continue to monitor the comparative and long-term safety profiles of these drugs.

From
Biologic Therapies and Risk of Infection and Malignancy in Patients With Inflammatory Bowel Disease
A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS
Stefanos Bonovas; Gionata Fiorino; Mariangela Allocca; Theodore Lytras; Georgios K. Nikolopoulos; Laurent Peyrin-Biroulet; Silvio Danese | Disclosures
Clin Gastroenterol Hepatol. 2016;14(10):1385-1397.


Link

http://www.medscape.com/viewarticle/...l&uac=185734DZ
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11-05-2016, 10:24 PM   #2
RNGirl
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Thank you for posting this and for taking time to do the research!
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