Professor Laurent Peyrin-Biroulet and colleagues from France systematically reviewed the efficacy and the effectiveness of biologic drugs in extraintestinal manifestations in inflammatory bowel disease (IBD).
The team conducted a literature search in PubMed, Embase, and Cochrane until 2015.
The researchers' main inclusion criteria were adults with IBD, use of a biologic drug, evolution of extraintestinal manifestations, interventional study, or non-interventional study.
The team included 9 interventional studies, and 13 non-interventional studies.
|Anti-TNFs were beneficial for a majority of patients with ocular manifestations|
|Clinical Gastroenterology & Hepatology|
Tumor necrosis factor (TNF) antagonists achieved complete response for pyoderma gangrenosum in 21%–25% of patients in interventional studies, and in 92%–100% patients in non-interventional studies, with similar results for other cutaneous manifestations such as erythema nodosum or stomatitis.
The team observed that adalimumab significantly reduced the prevalence of anemia vs placebo after 56 weeks in 1 randomized controlled trial.
In 2 non-interventional studies, anti-TNF therapy improved anemia in the short-term, and in the long-term.
The research team reported complete response after anti-TNF treatment in interventional studies, including arthralgia, and arthritis.
Anti-TNFs were beneficial for a majority of patients with ocular manifestations.
The team noted that infliximab was associated with improved outcomes in bone formation and bone mineral density.
Professor Peyrin-Biroulet's team concludes, "Anti-TNFs appear to be effective alternatives for certain extraintestinal manifestations associated with IBD including musculoskeletal, cutaneous, and ocular manifestations, and some beneficial effect may be obtained in metabolic bone disease and on hematologic or vascular extraintestinal manifestations."