Dr Laurent Peyrin-Biroulet and colleagues from France performed a systematic review that investigated the efficacy, and the effectiveness of biologic drugs in extraintestinal manifestations in inflammatory bowel disease (IBD).
The researchers conducted a literature search in PubMed, Embase, and Cochrane until 2015.
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, 7 open label trials, 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 research 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 team noted that complete response after anti-TNF treatment was reported in interventional studies, including arthralgia, and arthritis.
The researchers found that anti-TNFs were beneficial for a majority of patients with ocular manifestations.
Infliximab was associated with improved outcomes in bone formation and bone mineral density.
Dr Laurent 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."