Efficacy And Safety Of Anti-α4β7 Integrin Biologics In The Treatment Of Crohn’s Disease:A Meta-analysis

Objective:To evaluate the effectiveness and safety of anti-α4β7integrin biologics in the treatment of Crohn’s Disease(CD).Method: Databases such as Pub Med,MEDLINE,EMBASE,VIP,Wanfang,and CNKI were searched to collect anti-α4β7 integrin biologics for the treatment of Crohn’s disease in a randomized controlled trial(RCT).The main collection criteria were: Clinical response rate,clinical remission rate,and adverse events.According to the inclusion and exclusion criteria for document screening and data extraction,the quality of the literature was evaluated by using the Cochrane Handbook and the Jadad Rating Scale.Statistical analysis was performed on the study by using Stata 12.0 software.Results: A total of 6 RCTs concerning 3378 cases were included.The result of meta-analysis showed that the clinical response rate [RR=1.549,95%CI(1.316,1.822),p≤0.001],clinical remission rate [RR=1.809,95%CI(1.583,2.068),p≤0.001],anti-α4β7 integrin biologics group was significantly higher than the placebo group.Adverse events including severe adverse events[RR=0.976,95%CI(0.643,1.480),p=0.908],headache [RR=1.105,95%CI(0.867,1.407),p=0.419],abdominal pain [RR=0.895,95%CI(0.725,1.104),p=0.301],nausea [RR=1.127,95%CI(0.920,1.382),p=0.249],vomiting[RR=0.867,95%CI(0.628,1.198),p=0.388],arthralgia [RR=1.017,95%CI(0.758,1.364),p=0.911],there was no significant difference in the incidence between anti-α4β7 integrin biologics group and the placebo group.While during the nasopharyngitis [RR=1.363,95%CI(1.075,1.728),p=0.010],upper respiratory tract infection rate [RR=2.836,95%CI(1.794,4.485),p<0.001],anti-α4β7 integrin biologics group could reduce the rate than placebo group did.The CD eacerbation [RR=0.654,95%CI(0.443,0.966),p=0.033],was less in the anti-α4β7 integrin biologics groups than in the placebo group.Conclusion: Anti-α4β7 integrin biologics can achieve better clinical response and clinical remission in CD patients.CD patients have good tolerance to anti-α4β7 integrin biologics,and their serious adverse reactions are rare,but attention should be paid to the occurrence of nasopharyngitis and the risk of upper respiratory tract infection.