P0619 Comparative efficacy of all available pharmaceutical therapies for moderate to severe Crohn’s disease: a systematic review and network meta-analysis
Abstract
The therapeutic landscape for Crohn’s disease (CD) has expanded, offering patients increased treatment possibilities, but with limited comparative evidence.This study provides compare efficacy and discontinuation rates of all pharmaceutical therapies - old and new - in moderate-to-severe CD.
We conducted a systematic review (until October 2023) and network meta-analyses (NMA) of phase-III randomized controlled trials (RCTs) on the efficacy of pharmaceutical therapies for induction of clinical response, clinical remission and maintenance of clinical remission. Furthermore, drug discontinuation rates were assessed. Frequentist NMA results and SUCRA rankings were reported for biological-naive and -exposed patients.
The search resulted in 3017 references, of which 77 RCTs were included. Networks were sparse and therapies had overlapping confidence intervals. In biological-naive patients, adalimumab (high induction regimen) had the highest SUCRA ranking for induction of clinical remission, and infliximab/azathioprine combination therapy had the highest SUCRA ranking for maintenance of remission. Among immunomodulators, methotrexate had the highest ranking for induction and azathioprine for maintenance of remission. In biological-exposed patients, upadacitinib had the highest SUCRA ranking for induction and maintenance of clinical remission. Adverse event related discontinuation was numerically highest for methotrexate, azathioprine and upadacitinib.
This NMA including…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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