Effectiveness and safety of vedolizumab for treatment of Crohn's disease: a systematic review and meta-analysis.
BACKGROUND
The aim of this systematic review (SR) and meta-analysis was to assess the efficacy and safety of vedolizumab in the treatment of Crohn's disease (CD).


METHODS
A systematic literature search was conducted in Medline/PubMed, Embase and Cochrane Library until 25 January, 2015. Included studies were critically appraised according to the PRISMA protocol. Assessment in specified subgroups of CD patients and meta-analysis with Revman software were performed.


RESULTS
Two randomized controlled trial (RCTs) were included in a meta-analysis for the induction phase of therapy: GEMINI II and GEMINI III. The clinical response was significantly higher for patients who received vedolizumab compared to placebo in the general population (risk benefit (RB) = 1.48;p= 0.0006) and in both analyzed subgroups: patients with previous failure of anti-TNFs treatment (RB = 1.51;p= 0.006) and patients naive to earlier anti-TNFs (RB = 1.41;p= 0.001). The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for patients who received vedolizumab compared to placebo (RB = 1.77;p= 0.003; RB = 2.29;p= 0.0004; respectively). Meta-analysis for adverse events, serious adverse events (SAEs) and serious infections, revealed that vedolizumab was as safe as placebo in the induction phase of therapy.


CONCLUSIONS
The clinical response was significantly higher for patients who received vedolizumab in the general population and in both analyzed subgroups of patients. The clinical remission in the general population and subpopulation of TNF-antagonist naive patients was significantly higher for vedolizumab, but no significant differences were revealed in the subgroup of patients with previous TNF antagonist failure.
Drug Management Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Paweł
P
Moćko
Drug Management Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Paweł
P
Kawalec
Drug Management Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Beata
B
Smela-Lipińska
Institute of Pharmacology, Polish Academy of Sciences, Poland.
Andrzej
A
Pilc
Crohn's disease; MLN-002; meta-analysis; systematic review; vedolizumab
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