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중등도-중증 궤양성 대장염 환자에서 infliximab의 치료효과에 대한 메타분석

Meta-analysis of the Efficacy of Infliximab in Patients with Moderate-Severe Ulcerative Colitis

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Ulcerative colitis (UC) is characterized by a life-long chronic course with remissions and exacerbations. Use of biological therapies may reduce or delay the surgical procedures in patients with UC. The aim of this study was to determine the impact of infliximab (IFX) use on the rate of remission, surgical interventions, and the effect on quality of life in patients with moderate to severe UC. Literature was searched for studies that investigated the efficacy of IFX on the rate of remission, colectomy and quality of life (QoL) between January 1990 and June 2012 at MEDLINE, January 1988 and June 2012 at EMbase and others. Eleven trials were included in the meta-analysis; divided into placebo controlled 8 trials and intravenous corticosteroid controlled group 3 trials. In comparison to placebo control groups, patients who received IFX had an odds ratio (OR) of 3.712 (95% CI: 2.714, 5.079) for the short-term clinical remission, and 3.053(95% CI: 2.044, 4.559) for the rate of long-term remission. In colectomy rate and quality of life (QoL), odds ratio were 0.566(95% CI: 0.387, 0.827) and 0.658 (0.505, 0.811) respectively. Any adverse reactions including infections, infusion reaction, rash and arthralgia were equivalent in both groups. Compared with intravenous corticosteroid controlled group,patients who received IFX had lower remission rate with short-term odds ratio 0.227 (95% CI: 0.033, 1.556) and longterm odds ratio 1.054 (95% CI: 0.317, 3.502) respectively. However, statistical significance was not showed with both two analyses. The higher adverse drug reaction (ADR) rates were occurred in the corticosteroid controlled groups. 73.3%of patients treated corticosteroid reported Cushing-like syndrome with moon face. In conclusion, IFX does increase remission rate and decrease the rate of colectomy in patients with UC without elevating any adverse reactions significantly. IFX also improves QoL in moderate to severe UC patients. It would not exceed the efficacy of intravenous corticosteroid,whereas intravenous corticosteroid also reported high rate of adverse reactions

Abstract

Ulcerative colitis (UC) is characterized by a life-long chronic course with remissions and exacerbations. Use of biological therapies may reduce or delay the surgical procedures in patients with UC. The aim of this study was to determine the impact of infliximab (IFX) use on the rate of remission, surgical interventions, and the effect on quality of life in patients with moderate to severe UC. Literature was searched for studies that investigated the efficacy of IFX on the rate of remission, colectomy and quality of life (QoL) between January 1990 and June 2012 at MEDLINE, January 1988 and June 2012 at EMbase and others. Eleven trials were included in the meta-analysis; divided into placebo controlled 8 trials and intravenous corticosteroid controlled group 3 trials. In comparison to placebo control groups, patients who received IFX had an odds ratio (OR) of 3.712 (95% CI: 2.714, 5.079) for the short-term clinical remission, and 3.053(95% CI: 2.044, 4.559) for the rate of long-term remission. In colectomy rate and quality of life (QoL), odds ratio were 0.566(95% CI: 0.387, 0.827) and 0.658 (0.505, 0.811) respectively. Any adverse reactions including infections, infusion reaction, rash and arthralgia were equivalent in both groups. Compared with intravenous corticosteroid controlled group,patients who received IFX had lower remission rate with short-term odds ratio 0.227 (95% CI: 0.033, 1.556) and longterm odds ratio 1.054 (95% CI: 0.317, 3.502) respectively. However, statistical significance was not showed with both two analyses. The higher adverse drug reaction (ADR) rates were occurred in the corticosteroid controlled groups. 73.3%of patients treated corticosteroid reported Cushing-like syndrome with moon face. In conclusion, IFX does increase remission rate and decrease the rate of colectomy in patients with UC without elevating any adverse reactions significantly. IFX also improves QoL in moderate to severe UC patients. It would not exceed the efficacy of intravenous corticosteroid,whereas intravenous corticosteroid also reported high rate of adverse reactions

참고문헌 (52)

  1. Lakatos PL, "Recent trends in the epidemiology of inflammatory bowel diseases: up or down?", World J Gastroenterol, 12, pp.6102~6108 (2006)
  2. Kornbluth A, "Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults (update): American College of Gastroenterology, Practice Parameters Committee", Am J Gastroenterol, 99, pp.1371~1385 (2004)
  3. Willert RP, "Use of infliximab in the prevention and delay of colectomy in severe steroid dependent and refractory ulcerative colitis", World J Gastroenterol, 14, pp.2544~2549 (2008)
  4. Järnerot G, "Intensive intravenous treatment of ulcerative colitis", Gastroenterology, 89, pp.1005~1013 (1985)
  5. Lichtiger S, "Cyclosporine in severe ulcerative colitis refractory to steroid therapy", N Engl J Med, 330, pp.1841~1851 (1994)
  6. Laharie D, "Cyclosporin versus infliximab in severe acute ulcerative colitis refractory to intravenous steroids: A randomized trial. Gastroenterology", Conference: Digestive Disease Week, DDW 2011, 140(5 SUPPL. 1), pp.S112~ (2011)
  7. Arts J, "Long-term outcome of treatment with intravenous cyclosporine in patients with severe ulcerative colitis", Inflamm Bowel Dis, 10, pp.73~78 (2004)
  8. Pham CQ, "Cyclosporine for severe ulcerative colitis", Ann Pharmacother, 40, pp.96~101 (2006)
  9. Van AG, "Treatment of severe steroid refractory ulcerative colitis", World J Gastroenterol, 14, pp.5508~5511 (2008)
  10. 김승희, "조혈모세포이식을 받은 한국 성인 백혈병환자에서 cyclosporine의 집단약동학 분석", 한국임상약학회지, 20(1), pp.9~16 (2010), 한국임상약학회
  11. Shibolet O, "Cyclosporine A for induction of remission in severe ulcerative colitis", Cochrane Database Syst Rev, pp.CD004277~ (2005)
  12. Penna C, "Pouchitis after ileal pouch-anal anastomosis for ulcerative colitis occurs with increased frequency in patients with associated primary sclerosing cholangitis", Gut, 38, pp.234~239 (1996)
  13. McIntyre PB, "Comparing functional results one year and ten years after ileal pouchanal anastomosis for chronic ulcerative colitis", Dis Colon Rectum, 37, pp.303~307 (1994)
  14. Hahnloser D, "The effect of aging on function and quality of life in ileal pouch patients: a single cohort experience of 409 patients with chronic ulcerative colitis", Ann Surg, 240, pp.615~621 (2004)
  15. Ording OK, "Ulcerative colitis: female fecundity before diagnosis, during disease, and after surgery compared with a population sample", Gastroenterology, 122, pp.15~19 (2002)
  16. 김경옥, "염증성장질환의 치료: 새로운 약제를 중심으로", 대한소화기학회지, 58(5), pp.235~244 (2011), 대한소화기학회
  17. Papadakis KA, "Tumor necrosis factor: biology and therapeutic inhibitors", Gastroenterology, 119, pp.1148~1157 (2000)
  18. Hove T, "Infliximab treatment induces apoptosis of lamina propria T lymphocytes in Crohn’s disease", Gut, 50, pp.206~211 (2002)
  19. Rutgeerts P, "Optimizing anti-TNF treatment in inflammatory bowel disease", Gastroenterology, 126, pp.1593~1610 (2004)
  20. Travassos WJ, "Infliximab: Use in Inflammatory Bowel Disease", Curr Treat Options Gastroenterol, 8, pp.187~196 (2005)
  21. Regueiro M, "Infliximab for hospitalized patients with severe ulcerative colitis", J Clin Gastroenterol, 40, pp.476~481 (2006)
  22. Yamamoto-Furusho JK, "Infliximab as a rescue therapy for hospitalized patients with severe ulcerative colitis refractory to systemic corticosteroids", Dig Surg, 25, pp.383~386 (2008)
  23. Talley NJ, "An evidence-based systematic review on medical therapies for inflammatory bowel disease", Am J Gastroenterol, 106, pp.S2~S25 (2011)
  24. Jadad AR, "Assessing the quality of reports of randomized clinical trials: is bliniding necessary?", Control Clin Trials, 17, pp.1~12 (1996)
  25. Clark HD, "Assessing the quality of randomized trials: reliability of the Jadad scale", Control Clin Trials, 20, pp.448~452 (1999)
  26. Cochran WG, "The combination of estimates from different experiments", Biometrics, 10, pp.101~129 (1954)
  27. Gustavsson A, "Clinical trial: colectomy after rescue therapy in ulcerative colitis 3-year follow-up of the Swedish-Danish controlled infliximab study", Aliment Pharmacol Ther, 32, pp.984~989 (2010)
  28. Sandborn WJ, "Colectomy rate comparison after treatment of ulcerative colitis with placebo or infliximab", Gastroenterology, 137, pp.1250~1260 (2009)
  29. Feagan BG, "The effects of infliximab therapy on health-related quality of life in ulcerative colitis patients", Am J Gastroenterol, 102, pp.794~802 (2007)
  30. Gavalas E, "Efficacy and safety of infliximab in steroid-dependent ulcerative colitis patients", Hepatogastroenterology, 54, pp.1074~1079 (2007)
  31. Jarnerot G, "Infliximab as rescue therapy in severe to moderately severe ulcerative colitis: a randomized, placebo-controlled study", Gastroenterology, 128, pp.1805~1811 (2005)
  32. Rutgeerts P, "Infliximab for induction and maintenance therapy for ulcerative colitis", N Engl J Med, 353, pp.2462~2476 (2005)
  33. Armuzzi A, "Infliximab in the treatment of steroid-dependent ulcerative colitis", Eur Rev Med Pharmacol Sci, 8, pp.231~233 (2004)
  34. Ochsenkühn T, "Infliximab for acute, not steroid-refractory ulcerative colitis: a randomized pilot study", Eur J Gastroenterol Hepatol, 16, pp.1167~1171 (2004)
  35. Probert CJ, "Infliximab in moderately severe glucocorticoid resistant ulcerative colitis: a randomised controlled trial", Gut, 52, pp.998~1002 (2003)
  36. Sands BE, "Infliximab in the treatment of severe, steroid-refractory ulcerative colitis: a pilot study", Infl amm Bowel Dis, 7, pp.83~88 (2001)
  37. Irvine EJ, "A quality-of-life index for inflammatory bowel disease", Can J Gastroenterol, 7, pp.155~159 (1993)
  38. Egger M, "Meta-analysis: potentials and premise", BMJ, 315, pp.1371~1374 (1997)
  39. 최윤영, "제 2형 당뇨 환자에서 자가혈당측정의 임상적 유용성 : 체계적문헌고찰 및 메타분석", 한국임상약학회지, 20(3), pp.183~192 (2010), 한국임상약학회
  40. Ford AC, "Efficacy of biological therapies in inflammatory bowel disease: systematic review and meta-analysis", Am J Gastroenterol, 106, pp.644~659 (2011)
  41. Huang X, "A meta-analysis of the therapeutic effects of tumor necrosis factor-α blockers on ulcerative colitis", Eur J Clin Pharmacol, 67, pp.759~766 (2011)
  42. Samsa G, "Determining clinically important differences in health status measures: a general approach with illustration to the health utilities index mark II", Pharmacoeconomics, 15, pp.141~155 (1999)
  43. Hjortswang H, "The Short Health Scale: a valid measure of subjective health in ulcerative colitis", Scand J Gastroenterol, 41, pp.1196~1203 (2006)
  44. Sullivan M, "The Swedish SF-36 Health Survey – I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden", Soc Sci Med, 41, pp.1349~1358 (1995)
  45. Taft C, "Performance of the Swedish SF-36 version 2.0", Qual Life Res, 13, pp.251~256 (2004)
  46. Irvine EJ, "Quality of life: a valid and reliable measure of therapeutic efficacy in the treatment of inflammatory bowel disease. Canadian Crohn's Relapse Prevention Trial Study Group", Gastroenterology, 106, pp.287~296 (1994)
  47. Walmsley RS, "A simple clinical colitis activity index", Gut, 43, pp.29~32 (1998)
  48. Seo M, "Correlation between endoscopic severity and the clinical activity in ulcerative colitis", Am J Gastroenterol, 93, pp.2124~2129 (1998)
  49. Higgins PD, "Is endoscopy necessary for the measurement of disease activity in ulcerative colitis?", Am J Gastroenterol, 100, pp.355~361 (2005)
  50. Williams A, "EuroQol-a new facility for the measurement of health-related quality of life", Health Policy, 16, pp.199~208 (1990)
  51. Gurwitz JH, "Glucocorticoids and the risk for initiation of hypoglycemic therapy", Arch Intern Med, 154, pp.97~101 (1994)
  52. Clowes JA, "Glucocorticoid-induced osteoporosis", Curr Opin Rheumatol, 13, pp.326~332 (2001)

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