Eficacia y seguridad de la terapia biológica en el tratamiento de la enfermedad de Crohn: una revisión exhaustiva de metanálisis y revisiones sistemáticas.

Abstract

Objective: To present an overview to summarize the efficacy and safety of biologics for the treatment of Crohn's disease (CD).

Methods: We gathered systematic reviews or meta-analyses on the efficacy and safety of biologic therapy for CD from the beginning to September 30, 2023, by searching the databases of the Chinese National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database, Web of Science, the Cochrane Library, PubMed, and Embase. Analysing reviews and extracting data, two researchers worked independently. Any discrepancies in the two researchers' assessments of the review process were reevaluated, and the argument was settled by consulting to other researchers. The following details was taken out of the data: author, publication year, study type, number of included studies, country of study, sample size, risk bias tools, biologic therapy, and primary outcomes. Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) and the AMSTAR-2, a critical appraisal tool for systematic reviews (2nd edition), were then utilized to assess the methodological quality and reporting quality of the evidence.

Results: There were 19 reviews in all. 1 systematic review, 5 meta-analyses, and 13 systematic reviews and meta-analyses were among the reviews that were included. 9 studies met the high quality, 5 met the moderate quality, 3 met the poor quality, and 2 met the critically low quality requirements of the AMSTAR-2 criteria.

Conclusions: The analysis of the evidence finds biologic agents for CD are effective and safe. Overall, there was moderate to high quality biologic evidence for CD, but future head-to-head controlled studies are required to better inform the relative positioning of these drugs for the management of CD.