TY - JOUR

T1 - Efficacy of ustekinumab for active perianal fistulizing Crohn’s disease

T2 - a systematic review and meta-analysis of the current literature

AU - Attauabi, Mohamed

AU - Burisch, Johan

AU - Seidelin, Jakob Benedict

PY - 2021

Y1 - 2021

N2 - Background: Although the number of biological therapies for the treatment of Crohn’s disease (CD) is rapidly increasing, their efficacy in inducing healing of fistulas in perianal Crohn’s disease (pCD) is practically unknown, although they occur in up to 50% of patients with CD. Objective: We aimed to investigate the clinical effectiveness of ustekinumab for pCD in a systemic review and meta-analysis. Methods: Studies describing the efficacy of ustekinumab on fistulas in pCD in PubMed and EMBASE database from inception until 22 September 2020, were assessed in a systemic review and meta-analysis. The random-effect model was applied for the meta-analysis. Results: The systematic review of the current literature yielded 2,243 studies of which nine studies with a total of 396 patients were found eligible for inclusion. The pooled proportions of patients experiencing fistula response were 41.0% (95% CI 23.9–60.6%9), I 2 = 85%, 39.7% (95% CI 24.3–57.4%), I 2 = 69% and 55.9% (95% CI 40.8–69.9%, I 2 = 67% at weeks 8, 24, and 52, respectively. Regarding fistula remission, the pooled proportions were 17.1% (95% CI 8.1–32.7%), I 2 = 45%, 17.7% (95% CI 1.8–71.9%), I 2 = 68%, and 16.7% (95% CI 3.0–56.5%, I 2 = 51% at week 8, 24, and 52, respectively. Conclusion: In this systematic review with meta-analysis, we found a signal of efficacy of ustekinumab on fistulizing pCD, emphasizing that these patients might benefit from this therapy.

AB - Background: Although the number of biological therapies for the treatment of Crohn’s disease (CD) is rapidly increasing, their efficacy in inducing healing of fistulas in perianal Crohn’s disease (pCD) is practically unknown, although they occur in up to 50% of patients with CD. Objective: We aimed to investigate the clinical effectiveness of ustekinumab for pCD in a systemic review and meta-analysis. Methods: Studies describing the efficacy of ustekinumab on fistulas in pCD in PubMed and EMBASE database from inception until 22 September 2020, were assessed in a systemic review and meta-analysis. The random-effect model was applied for the meta-analysis. Results: The systematic review of the current literature yielded 2,243 studies of which nine studies with a total of 396 patients were found eligible for inclusion. The pooled proportions of patients experiencing fistula response were 41.0% (95% CI 23.9–60.6%9), I 2 = 85%, 39.7% (95% CI 24.3–57.4%), I 2 = 69% and 55.9% (95% CI 40.8–69.9%, I 2 = 67% at weeks 8, 24, and 52, respectively. Regarding fistula remission, the pooled proportions were 17.1% (95% CI 8.1–32.7%), I 2 = 45%, 17.7% (95% CI 1.8–71.9%), I 2 = 68%, and 16.7% (95% CI 3.0–56.5%, I 2 = 51% at week 8, 24, and 52, respectively. Conclusion: In this systematic review with meta-analysis, we found a signal of efficacy of ustekinumab on fistulizing pCD, emphasizing that these patients might benefit from this therapy.

KW - meta-analysis

KW - perianal fistulizing Crohn’s disease

KW - systematic review

KW - Ustekinumab

U2 - 10.1080/00365521.2020.1854848

DO - 10.1080/00365521.2020.1854848

M3 - Review

C2 - 33264569

AN - SCOPUS:85097168223

VL - 56

SP - 53

EP - 58

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

IS - 1

ER -