Comparative Effectiveness of Biologic Agents for the Treatment of Moderate-to-Severe Crohn's Disease: A Network Meta-Analysis

Abstract

Background: Crohn's disease is a chronic inflammatory bowel disorder that can significantly impact patient quality of life. Several biologic agents are approved for the treatment of moderate-to-severe Crohn's disease, but their comparative effectiveness remains unclear.
Objectives: To conduct a network meta-analysis comparing the efficacy and safety of different biologic agents for the treatment of moderate-to-severe Crohn's disease.
Methods: A comprehensive literature search was performed to identify randomized controlled trials evaluating biologic therapies for Crohn's disease. A Bayesian network meta-analysis was conducted to compare the outcomes of different biologic agents, including clinical remission, clinical response, and adverse events. The analysis included 52 eligible studies.
Results: The network meta-analysis showed that all biologic agents were more effective than placebo in achieving clinical remission and response in patients with moderate-to-severe Crohn's disease. Among the biologic agents, infliximab, adalimumab, and ustekinumab demonstrated the highest probabilities of achieving clinical remission. Infliximab had the highest probability of achieving clinical response, while ustekinumab had the lowest risk of adverse events.
Conclusions: This comprehensive network meta-analysis provides robust evidence on the comparative effectiveness of different biologic agents for the treatment of moderate-to-severe Crohn's disease. The findings can inform clinical decision-making and guide the selection of appropriate biologic therapies for individual patients.