Efficacy and Safety of Anti-Tumor Necrosis Factor- Alpha Agents for Patients with Intestinal Behcet’s Disease: A Systematic Review and Meta-Analysis
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Purpose: Intestinal Behcet’s disease (BD) is a systemic autoimmune disease for which treatment options are limited. As a prospectivetherapeutic strategy for intestinal BD, anti-tumor necrosis factor-alpha (anti-TNF-α) agents have received increasing attention. In this study, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of anti-TNF-αagents for patients with intestinal BD. Materials and Methods: We searched PubMed, Embase, and Cochrane Library databases up to July 1, 2021 and articles that metthe eligibility criteria were further assessed. Pooled rates were synthesized by a randomized effects model using Stata software. Results: Eleven clinical trials covering 671 patients with intestinal BD were included. According to compositive data, the pooledrate for remission was 39% [95% confidence interval (CI) 26–52] in patients receiving anti-TNF-α agents. Intestinal symptomswere cured in 70% (95% CI 53–84) of the patients, and the rate for endoscopic healing was 65% (95% CI 52–78). Corticosteroid discontinuationwas achieved in 43% (95% CI 28–58) of the patients, and the dose reduction of corticosteroid was 20.43 mg (95% CI13.4–27.46). There were 239 adverse events and 80 serious adverse events during follow-up. Conclusion: Our study indicated that anti-TNF-α agents may serve as an effective treatment with acceptable safety for patientswith intestinal BD. However, more robust evidence from randomized controlled trials is urgently needed to assess the long-termefficacy and safety of anti-TNF-α agents for those patients.
Abstract
Purpose: Intestinal Behcet’s disease (BD) is a systemic autoimmune disease for which treatment options are limited. As a prospectivetherapeutic strategy for intestinal BD, anti-tumor necrosis factor-alpha (anti-TNF-α) agents have received increasing attention. In this study, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of anti-TNF-αagents for patients with intestinal BD. Materials and Methods: We searched PubMed, Embase, and Cochrane Library databases up to July 1, 2021 and articles that metthe eligibility criteria were further assessed. Pooled rates were synthesized by a randomized effects model using Stata software. Results: Eleven clinical trials covering 671 patients with intestinal BD were included. According to compositive data, the pooledrate for remission was 39% [95% confidence interval (CI) 26–52] in patients receiving anti-TNF-α agents. Intestinal symptomswere cured in 70% (95% CI 53–84) of the patients, and the rate for endoscopic healing was 65% (95% CI 52–78). Corticosteroid discontinuationwas achieved in 43% (95% CI 28–58) of the patients, and the dose reduction of corticosteroid was 20.43 mg (95% CI13.4–27.46). There were 239 adverse events and 80 serious adverse events during follow-up. Conclusion: Our study indicated that anti-TNF-α agents may serve as an effective treatment with acceptable safety for patientswith intestinal BD. However, more robust evidence from randomized controlled trials is urgently needed to assess the long-termefficacy and safety of anti-TNF-α agents for those patients.
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