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lüll Systematic review: Infliximab therapy in ulcerative colitis Gisbert JP; Gonzalez-Lama Y; Mate JAliment Pharmacol Ther 2007[Jan]; 25 (1): 19-37AIM: To perform a systematic review and meta-analysis on the efficacy and tolerance of infliximab in ulcerative colitis. SELECTION OF STUDIES: evaluating efficacy of infliximab in ulcerative colitis. For the meta-analysis, randomized clinical trials comparing infliximab vs. placebo/steroids. SEARCH STRATEGY: electronic and manual. Study quality: independently assessed by two reviewers. DATA SYNTHESIS: meta-analysis combining the odds ratios (OR). RESULTS: Thirty-four studies (896 patients) evaluated infliximab therapy in UC, with heterogeneous results. Mean short-term (2.3 weeks) response and remission with infliximab was 68% (95% CI 65-71%) and 40% (36-44%). Mean long-term (8.9 months) response and remission was 53% (49-56%) and 39% (35-42%). Five randomized double-blind studies compared infliximab with placebo, the meta-analysis showing an advantage (P < 0.001) of infliximab in all endpoints (short-/long-term response/remission): ORs from 2.7 to 4.6, and number-needed-to-treat (NNT) from 3 to 5. Similar infliximab response was calculated independently of the indication (steroid-refractory/non-steroid-refractory) or the dose (5/10 mg/kg). Adverse effects were reported in 83% and 75% of the infliximab and placebo-treated patients (OR = 1.52; 95% CI 1.03-2.24; number-needed-to-harm (NNH) was 14). CONCLUSION: Infliximab is more effective than placebo, with an NNT from 3 to 5, for the treatment of moderate-to-severe UC, achieving clinical remission in 40% of the patients at approximately 9 months of follow-up. Further studies are necessary to confirm the long-term efficacy of infliximab in ulcerative colitis.|Adolescent[MESH]|Adult[MESH]|Antibodies, Monoclonal/*therapeutic use[MESH]|Child[MESH]|Colitis, Ulcerative/*drug therapy[MESH]|Double-Blind Method[MESH]|Gastrointestinal Agents/*therapeutic use[MESH]|Humans[MESH]|Infliximab[MESH]|Randomized Controlled Trials as Topic[MESH]|Treatment Outcome[MESH] |