Area Editoriale
AIM: To perform a systematic review andmeta-analysis on the efficacy and tolerance of infliximab in ulcerativecolitis. METHODS: Selection of studies: evaluating efficacy of infliximab inulcerative colitis. For the meta-analysis, randomized clinical trials comparinginfliximab vs. placebo/steroids. Search strategy: electronic and manual. Studyquality: independently assessed by two reviewers. Data synthesis: meta-analysiscombining the odds ratios (OR). RESULTS: Thirty-four studies (896 patients)evaluated infliximab therapy in UC, with heterogeneous results. Mean short-term(2.3 weeks) response and remission with infliximab was 68% (95% CI 65-71%) and40% (36-44%). Mean long-term (8.9 months) response and remission was 53%(49-56%) and 39% (35-42%). Five randomized double-blind studies comparedinfliximab with placebo, the meta-analysis showing an advantage (P < 0.001)of infliximab in all endpoints (short-/long-term response/remission): ORs from2.7 to 4.6, and number-needed-to-treat (NNT) from 3 to 5. Similar infliximabresponse was calculated independently of the indication(steroid-refractory/non-steroid-refractory) or the dose (5/10 mg/kg). Adverseeffects were reported in 83% and 75% of the infliximab and placebo-treatedpatients (OR = 1.52; 95% CI 1.03-2.24; number-needed-to-harm (NNH) was 14).CONCLUSION: Infliximab is more effective than placebo, with an NNT from 3 to 5,for the treatment of moderate-to-severe UC, achieving clinical remission in 40%of the patients at approximately 9 months of follow-up. Further studies arenecessary to confirm the long-term efficacy of infliximab in ulcerativecolitis. Leggil'articolo