A review and meta-analysis, published in BMC Gastroenterology, examined real-world data (RWD) on deep remission (DR) in inflammatory bowel disease (IBD) and found higher rates of DR at 52 weeks in patients treated with an anti-tumor necrosis factor α (anti-TNF-α) inhibitor.

An estimated 45% of the cases achieved the DR target. The data from the study complements previous trials and literature reviews according to study author Omeed Alipour, MD, and his colleagues. They suggested that further research that focuses on “the outcome of deep remission with the use of other novel targeted therapeutics,” is needed.

Studies utilizing RWD—defined as data not from phase I-III randomized clinical trials—of adult patients with IBD treated with anti-TNFα agents were collected from the Medline and Embase databases through July 8, 2019 and analyzed using comprehensive meta-analysis. DR was defined by clinical and endoscopic remission at minimum, and was at assessed eight weeks, six months, one year, and two years. Risk of bias in the meta-analysis was assessed with the Newcastle Ottawa Scale.

The final meta-analysis included 15 publications, nine manuscripts and six conference abstracts, comprising 1,212 total patients. Of those, 769 patients had Crohn’s Disease (CD) and 443 patients had ulcerative colitis (UC).

The rate of DR was 36.4% (95% CI, 12.6–69.4%) at eight weeks, 39.1% (95% CI, 10.4–78%) at six months, 44.4% (95% CI, 34.6–54.6%) at one year, and 36% (95% CI, 18.7–58%) at two years. At one year, DR in the CD group was 48.6% (95% CI, 32.8–64.7%) and in the UC group was 43.6% (95% CI, 32.8–55.1%).

According to the authors, the study was limited by the number of available studies and could not directly compare differences in DR rates between CD and UC as a result. The same constraint also inhibited specific analysis of CD and UC at time points other than one year.

Ultimately, the study found similar DR rates between patients with UC and CD after treatment with an anti-TNF-α. The results provided evidence of the efficacy of anti-TNF-α inhibitors in real-world practice.


Source: BMC Gastroenterology