Meta-Analysis:Efficacy And Safety Of Combination Therapy Of Infliximab And Thiopurines For Moderate-to-Severe Inflammatory Bowel Disease

Objective:To conduct a meta-analysis to evaluate the efficacy and safety of combination therapy of infliximab plus thiopurines compared with monotherapy for moderate and severe inflammatory bowel disease(IBD), which is including ulcerative colitis(UC) and Crohn’s disease(CD).Methods:PubMed、Embase. Cochrane Library、CBM、CNKI、WANGFANG and VIP databases, which were published before March2014, were searched for randomized controlled trials (RCTs) about treatment for moderate and severe inflammatory bowel disease. The treatment was about the infliximab combined with thiopurines, which were compared with monotherapy. The primary end point was clinical remission. Some adverse were analyzed, such as total adverse events, severe adverse event, infection etc. Data also were analyzed with Stata12.0.Results:A total of6studies involving1015patients were included in our meta-analysis. The results showed the combination therapy in IBD treatment was more effective than infliximab therapy (OR=1.89,95%CI1.34to2.68, P=0.000); and the efficacy also higher than thiopurines therapy (OR=2.67,95%CI1.90to3.75, P=0.000); The infliximab therapy in IBD treatment was more safe than combination therapy (OR=1.79,95%CI1.10to2.92, P=0.019); No significant difference observed between combination therapy and thiopurines of adverse events occurrence (OR=1.06,95%CI0.47to2.38, P=0.890)Conclusions:Patients with moderate-to-severe inflammatory bowel disease who were treated with infliximab combined with thiopurines were more likely to have better efficacy. The infliximab therapy in IBD treatment was safer than combination therapy.