title: Effectiveness and risk associated with infliximab alone and in combination with immunosuppressors for Crohn's disease: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Infliximab (IFX) monotherapy and IFX combined with immunosuppressors have been used in the treatment of Crohn's disease. However, the differences between combination therapy and IFX alone remain controversial. The aim of this meta-analysis was to evaluate the effectiveness and risk associated with combination therapy and IFX monotherapy.
  
  
  METHODS
  Systematic searches were performed for randomized controlled trials with PubMed, Web of Science, OVID, and the Cochrane Library. The analyzed contents included induction of remission, short-term maintenance of remission, long-term maintenance of remission, and risks. The final results were estimated using statistical data of odds ratio (OR), relevant 95% confidence interval (CI), and P value.
  
  
  RESULTS
  6 out of 1041 citations met the selection criteria. There was no statistical difference in the effectiveness of induction and long-term maintenance of remission between two groups (P=0.07, 0.12). However, for short-term maintenance of remission, there was mild statistical difference between two groups (P=0.02, OR=1.66). For risks, apart from the difference in the aspect of reaction to infusion (OR=0.43, 95% CI=0.29-0.65, P<0.0001), there was no statistical difference.
  
  
  CONCLUSIONS
  There was no significant difference in effectiveness and risks between the therapy groups. However, these outcomes should be interpreted with caution. Specific categories of combination therapy and periodic medication should be paid more attention in future studies.
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Jingshuai
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Fu
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Dong
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Yanli
authors.initials: Y
authors.lastname: Ge
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Binbin
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, Bengbu Medical College Anhui 233400, China.
authors.forename: Qizhi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine Shanghai 200065, China.
authors.forename: Zhirong
authors.initials: Z
authors.lastname: Wang
keywords: Crohn’s disease; combination therapy; immunosuppressors; infliximab; meta-analysis