SynthesisAdvances in therapy2026
Comparative Efficacy and Safety of Advanced Therapies in Maintenance Treatment of Adult Patients with Moderate-to-Severe Crohn's Disease: A Systematic Literature Review and Network Meta-Analysis.
Synthesis in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
introductionWhile the therapeutic options for Crohn's disease (CD) have broadened swiftly, direct comparative evidence on treatment efficacy remains limited. This study explored the relative efficacy and safety of available treatments based on current evidence.
methodsA network meta-analysis (frequentist random-effect model) evaluated comparative efficacy of licensed advanced therapies for CD using data on efficacy of maintenance therapy from fully published, randomised, controlled phase 3/3b studies with 48-64-week follow-up periods and placebo or active comparator controls, identified through a systematic literature review (PROSPERO number CRD42023413752). Intravenous (IV) and subcutaneous (SC) infliximab, SC adalimumab, IV and SC vedolizumab, SC ustekinumab, SC risankizumab, and oral upadacitinib were included. Clinical remission and endoscopic response rates attained through maintenance regimens were assessed according to line of use (e.g., first-line and second-or-later line). Safety (serious adverse event rates) was also compared.
resultsData from nine randomised controlled trials were analysed. SC infliximab 120 mg every 2 weeks (q.2.w.) exhibited the highest risk difference (95% confidence interval) vs. placebo in both first-line and second-or-later-line maintenance treatment for achieving clinical remission (0.38 [0.23-0.53] and 0.51 [0.19-0.83], respectively; 14 and 12 comparator arms, respectively), and endoscopic response (0.39 [0.29-0.49] and 0.35 [0.07-0.63], respectively; 5 comparator arms) compared with other treatments. Differences between therapies did not reach statistical difference. Safety was comparable among treatments in terms of rates of serious adverse events.
conclusionsThe current NMA integrating recently updated phase 3 data in CD indicated that no single treatment significantly outperformed others in achieving clinical remission and endoscopic response, although SC infliximab 120 mg q.2.w exhibited highest numerical efficacy as both a first-line and second-or-later-line maintenance treatment in adult patients with moderate-to-severe CD.
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