What is the optimal biological therapy for moderate to severe ulcerative colitis: a systematic review and network meta-analysis
ObjectiveThe biologics for moderate to severe ulcerative colitis (UC) have expanded with an increasing array. We performed an updated network meta-analysis to evaluate and compare the relative efficacy and safety profiles of biologics in moderate to severe UC.DesignWe searched literature to 18 May 2...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1602024/full |
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| _version_ | 1839632857633390592 |
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| author | Longbin Huang Chen Kong Ningning Yue Hailan Zhao Yuan Zhang Chengmei Tian Zhiliang Mai Daoru Wei Ruiyue Shi Ruiyue Shi Jun Yao Jun Yao Lisheng Wang Lisheng Wang Defeng Li Defeng Li |
| author_facet | Longbin Huang Chen Kong Ningning Yue Hailan Zhao Yuan Zhang Chengmei Tian Zhiliang Mai Daoru Wei Ruiyue Shi Ruiyue Shi Jun Yao Jun Yao Lisheng Wang Lisheng Wang Defeng Li Defeng Li |
| author_sort | Longbin Huang |
| collection | DOAJ |
| description | ObjectiveThe biologics for moderate to severe ulcerative colitis (UC) have expanded with an increasing array. We performed an updated network meta-analysis to evaluate and compare the relative efficacy and safety profiles of biologics in moderate to severe UC.DesignWe searched literature to 18 May 2024, to identify eligible studies. The clinical remission, clinical response, or endoscopic improvement, stratified by previous exposure or naive to biologics, and safety were assessed. A network meta-analysis was performed through the bayesian model, obtaining pairwise relative ratios (RR) and 95% confidence intervals (CI). The surface under the cumulative ranking probabilities (SUCRA) was used to rank the included agents for each outcome.ResultsA total of 23 trials (10,839 patients) were included. In induction therapy, based on achieving clinical remission and endoscopic improvement, infliximab 5 mg/kg ranked first. For clinical response, ustekinumab 6 mg/kg superior to other drugs. Infliximab 5 mg/kg demonstrated superior efficacy in biologic-naive patients, whereas ustekinumab 6 mg/kg was the most effective in biologic-exposed patients. No significant differences between active interventions were observed when assessing safety outcomes, except for visilizumab. In maintenance therapy, for clinical remission and endoscopic improvement, vedolizumab 108 mg every other week and vedolizumab 300 mg every 4 weeks ranked first respectively, with infliximab 5 mg/kg performed best in achieving clinical response. Regarding safety ranking, golimumab 100 mg was the lowest.ConclusionIn this network meta-analysis, infliximab and vedolizumab emerged as the most effective biologics for inducing and maintaining efficacy outcomes for patients with UC. Most drugs were found to be safe and well-tolerated, with ustekinumab and mirikizumab exhibiting particularly favorable safety profiles. |
| format | Article |
| id | doaj-art-0aa71103885c4e8c829d41450dba87b4 |
| institution | Matheson Library |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-0aa71103885c4e8c829d41450dba87b42025-07-11T08:10:26ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-07-011610.3389/fphar.2025.16020241602024What is the optimal biological therapy for moderate to severe ulcerative colitis: a systematic review and network meta-analysisLongbin Huang0Chen Kong1Ningning Yue2Hailan Zhao3Yuan Zhang4Chengmei Tian5Zhiliang Mai6Daoru Wei7Ruiyue Shi8Ruiyue Shi9Jun Yao10Jun Yao11Lisheng Wang12Lisheng Wang13Defeng Li14Defeng Li15Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Medical Administration, Huizhou Institute of Occupational Diseases Control and Prevention, Huizhou, Guangdong, ChinaDepartment of Emergency, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Rehabilitation, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, ChinaObjectiveThe biologics for moderate to severe ulcerative colitis (UC) have expanded with an increasing array. We performed an updated network meta-analysis to evaluate and compare the relative efficacy and safety profiles of biologics in moderate to severe UC.DesignWe searched literature to 18 May 2024, to identify eligible studies. The clinical remission, clinical response, or endoscopic improvement, stratified by previous exposure or naive to biologics, and safety were assessed. A network meta-analysis was performed through the bayesian model, obtaining pairwise relative ratios (RR) and 95% confidence intervals (CI). The surface under the cumulative ranking probabilities (SUCRA) was used to rank the included agents for each outcome.ResultsA total of 23 trials (10,839 patients) were included. In induction therapy, based on achieving clinical remission and endoscopic improvement, infliximab 5 mg/kg ranked first. For clinical response, ustekinumab 6 mg/kg superior to other drugs. Infliximab 5 mg/kg demonstrated superior efficacy in biologic-naive patients, whereas ustekinumab 6 mg/kg was the most effective in biologic-exposed patients. No significant differences between active interventions were observed when assessing safety outcomes, except for visilizumab. In maintenance therapy, for clinical remission and endoscopic improvement, vedolizumab 108 mg every other week and vedolizumab 300 mg every 4 weeks ranked first respectively, with infliximab 5 mg/kg performed best in achieving clinical response. Regarding safety ranking, golimumab 100 mg was the lowest.ConclusionIn this network meta-analysis, infliximab and vedolizumab emerged as the most effective biologics for inducing and maintaining efficacy outcomes for patients with UC. Most drugs were found to be safe and well-tolerated, with ustekinumab and mirikizumab exhibiting particularly favorable safety profiles.https://www.frontiersin.org/articles/10.3389/fphar.2025.1602024/fullulcerative colitisbiological therapyclinical trialsbayesian network meta-analysissystematic review |
| spellingShingle | Longbin Huang Chen Kong Ningning Yue Hailan Zhao Yuan Zhang Chengmei Tian Zhiliang Mai Daoru Wei Ruiyue Shi Ruiyue Shi Jun Yao Jun Yao Lisheng Wang Lisheng Wang Defeng Li Defeng Li What is the optimal biological therapy for moderate to severe ulcerative colitis: a systematic review and network meta-analysis Frontiers in Pharmacology ulcerative colitis biological therapy clinical trials bayesian network meta-analysis systematic review |
| title | What is the optimal biological therapy for moderate to severe ulcerative colitis: a systematic review and network meta-analysis |
| title_full | What is the optimal biological therapy for moderate to severe ulcerative colitis: a systematic review and network meta-analysis |
| title_fullStr | What is the optimal biological therapy for moderate to severe ulcerative colitis: a systematic review and network meta-analysis |
| title_full_unstemmed | What is the optimal biological therapy for moderate to severe ulcerative colitis: a systematic review and network meta-analysis |
| title_short | What is the optimal biological therapy for moderate to severe ulcerative colitis: a systematic review and network meta-analysis |
| title_sort | what is the optimal biological therapy for moderate to severe ulcerative colitis a systematic review and network meta analysis |
| topic | ulcerative colitis biological therapy clinical trials bayesian network meta-analysis systematic review |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1602024/full |
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