Thadiboina Ooha, Shah Syed Saim Ali, Ray Rubela, Hack Sarah A, Munir Mahpara, Shah Qalandar, Bhullar Amritveer, Shah Syed Zargham Hussain, Ali Mohammed Abdul Muhaimin, Nureen Uzma, Afzal Sana, Izzat Izzat
Internal Medicine, Osmania Medical College, Hyderabad, IND.
Anesthesia, Chaudhry Pervaiz Elahi (CPE) Institute of Cardiology, Multan, PAK.
Cureus. 2025 Jun 13;17(6):e85923. doi: 10.7759/cureus.85923. eCollection 2025 Jun.
Biological therapies have emerged as effective treatments for moderate-to-severe ulcerative colitis (UC). This systematic review and meta-analysis aimed to assess the efficacy of different biologic agents for inducing clinical response, remission, and mucosal healing in patients with moderate-to-severe UC. A systematic literature search was conducted in PubMed, Excerpta Medica database (EMBASE), and Cochrane Library from inception to February 2025. Randomized controlled trials (RCTs) and prospective cohort studies evaluating biologics in adults with moderate-to-severe UC were included. The primary outcomes were clinical response, clinical remission, and mucosal healing. Random-effects meta-analyses were performed to calculate pooled effect estimates. Forty-three studies were included. Biologics were significantly more effective than placebo for inducing clinical response rates (odds ratio (OR): 2.19 (CI 95%: 2.66-3.19) p<0.00001, I= 83%), remission rates (OR: 3.10 (CI 95%: 2.82-3.42) p<0.00001, I= 92%), and mucosal healing (OR: 1.66 (CI 95%: 1.47-1.88) p<0.00001, I= 85%) among UC patients. Heterogeneity was significant for most outcomes (I² > 50%). The quality of evidence ranged from low to moderate. Biologic therapies are effective for inducing response, remission, and mucosal healing in moderate-to-severe UC. Further high-quality studies are needed to directly compare different biologics and evaluate long-term outcomes.
生物疗法已成为中重度溃疡性结肠炎（UC）的有效治疗方法。本系统评价和荟萃分析旨在评估不同生物制剂对中重度UC患者诱导临床反应、缓解和黏膜愈合的疗效。从创刊至2025年2月，在PubMed、医学文摘数据库（EMBASE）和Cochrane图书馆进行了系统的文献检索。纳入了评估生物制剂在中重度UC成人患者中的随机对照试验（RCT）和前瞻性队列研究。主要结局为临床反应、临床缓解和黏膜愈合。进行随机效应荟萃分析以计算合并效应估计值。共纳入43项研究。在诱导UC患者的临床反应率（优势比（OR）：2.19（95%CI：2.66 - 3.19），p<0.00001，I² = 83%）、缓解率（OR：3.10（95%CI：2.82 - 3.42），p<0.00001，I² = 92%）和黏膜愈合（OR：1.66（95%CI：1.47 - 1.88），p<0.00001，I² = 85%）方面，生物制剂显著优于安慰剂。大多数结局的异质性显著（I²>50%）。证据质量从中等到低不等。生物疗法对诱导中重度UC的反应、缓解和黏膜愈合有效。需要进一步的高质量研究来直接比较不同生物制剂并评估长期结局。
