Efficacy And Safety Of Anti-integrin Antibodies In The Treatment Of Inflammatory Bowel Disease:A Meta-Analysis

Objective:To evaluate the efficacy and safety of anti-integrin antibodies in the treatment of patients with inflammatory bowel disease(IBD),and to provide a reference cross-section for clinical application.Methods:Relevant studies in Cochrane Library,Pub Med,Embase,Medline,Web of Science,CNKI,Wanfang and CBM databases from January 2000 to October 2021 were searched in English only,supplemented by manual retrieval.Randomized controlled trails(RCTs)that met the inclusion and exclusion criteria were determined,and screening,data extraction and quality assessment were carried out.Statistical analysis was conducted using Stata 16.0software.Results:A total of 15 randomized controlled trials were included,including 6033 IBD patients,3830 CD patients,and 2203 UC patients.The results of meta-analysis showed that: 1.Effectiveness:(1)CD induction period: clinical response rate(RR=1.33,95%CI: 1.22～1.46,P<0.001)and clinical remission rate(RR=1.46,95%CI: 1.27～1.68,P<0.001)of antiintegrin antibody therapy for CD were better than placebo group,and the clinical remission rate of CD after failure of previous TNF-α antagonist treatment by anti-integrin antibody was better than placebo group.(2)CD maintenance period: The sustained clinical response rate(RR=2.19,95%CI: 1.22～3.95,P=0.009)and clinical remission rate(RR=1.64,95%CI:1.24～2.16,P=0.001)of anti-integrin antibody treatment of CD were better than those of placebo group.(3)UC induction period: clinical response rate(RR=1.61,95%CI: 1.38～1.87,P<0.001),clinical remission rate(RR=2.55,95%CI: 1.80～3.62,P<0.001)and mucosal healing rate(RR=1.49,95%CI: 1.22～1.82,P<0.001)of anti-integrin antibody therapy for UC were better than placebo group,and the clinical remission rate of UC after failure of previous TNF-α antagonist was better than placebo group.(4)UC maintenance period: longterm clinical response rate(RR=2.16,95%CI: 1.64～2.84,P<0.001),clinical remission rate(RR=2.43,95%CI: 1.73～3.41,P<0.001)and mucosal healing rate(RR=2.47,95%CI:1.83～3.34,P<0.001)of anti-integrin antibody therapy for UC were better than placebo group.2.Safety:there was no significant difference in the adverse reaction rates between the anti-integrin antibody group and the placebo group in the treatment of CD and UC in the induction period and maintenance period.Conclusion:Anti-integrin antibodies are superior to placebo in inducing and maintaining remission in CD and UC,and can effectively promote the mucosa healing of UC.Anti-integrin antibodies have good efficacy in CD and UC patients who have failed previous anti-TNF-αtherapy.In terms of safety,the rate of adverse reactions in the anti-integrin antibody group was similar to that in the placebo group.