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Biological therapy for active moderate to severe ulcerative colitis

The most recent issue of the Journal of Gastroenterology & Hepatology reviews the effectiveness of biological therapy for active moderate to severe ulcerative colitis.

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Dr Paweł Kawalec and colleagues from Poland evaluated the efficacy and safety of biological agents (vedolizumab, abatacept, visilizumab, golimumab) in patients with active moderate to severe ulcerative colitis.

The team performed a systematic literature search in PubMed, Embase, Cochrane Library, and other databases until 2013 to identify randomized controlled trials fulfilling the established inclusion criteria for this review.

The research team included 8 randomized controlled trials in the systematic review.

The team found that vedolizumab was significantly more effective compared with placebo increasing the percentage of patients with a clinical response, clinical remission and mucosal healing in the induction phase, and patients with a clinical remission and mucosal healing in the maintenance phase.

The efficacy of visilizumab or abatacept was related to the higher risk of treatment failure
Journal of Gastroenterology & Hepatology

Similarly, golimumab was significantly more effective than placebo regarding the percentage of patients with a clinical response and mucosal healing in the induction phase, and patients with a clinical response, clinical remission, and mucosal healing in the maintenance phase.

The researchers observed that the safety of these 2 biological agents was comparable with placebo during the treatment.

However, the efficacy of visilizumab or abatacept was related to the higher risk of treatment failure and a worse safety profile than placebo.

Dr Kawalec's team concludes, "The results of the systematic review demonstrated that the efficacy and safety of particular biological agents are differentiated."

"Vedolizumab and golimumab occurred more effective, and comparably as safe as placebo in patients with active moderate to severe ulcerative colitis increasing the number of available therapeutic options."

J Gastroenterol Hepatol 2014: 29(6): 1159–1170
18 June 2014

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