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. 2019 Mar 7;25(9):1142–1157. doi: 10.3748/wjg.v25.i9.1142

Table 5.

Meta-analyses included for induction of clinical response in ulcerative colitis

Study Intervention Comparator Follow-up n Clinical response, RR (95%CI) or OR (95%CI) Quality of evidence
Komaki et al[28] Tacrolimus Placebo 2 wks (RCT) 103 RR 4.61 (2.09-10.17)1 High
Baumgart et al[25] Tacrolimus Placebo 2 wk 63 OR 8.66 (1.79-42.00)2 High
Lasa et al[26] Tacrolimus Placebo 12 wk 127 RR 0.58 (0.45-0.73)3 High
Narula et al[29] IFX Cyclosporine 3 mo (RCT) 412 43.8% (IFX); 41.7% (C) OR 1.08 (0.73-1.60)4 Low
IFX Cyclosporine 3 mo (non RCT) 801 74.8% (IFX); 55.4% (C) OR 2.96 (2.12-4.14)5 Very low
1

Clinical response defined as reduction in Disease Activity Index (DAI) ≥ 4 with improvement of all categories;

2

Clinical response (partial or complete response) based on the DAI score. A complete response was defined as complete resolution of all symptoms with a zero scored for all assessments of the DAI. A partial response was defined as a reduction of more than four points on the DAI with improvement in all categories, but not a complete response;

3

Clinical response defined according to each individual study, and not shown by the meta-analysis;

4

Definitions from individual studies: Failure to respond to treatment was combined end point of the absence of clinical response at day 7 (based on Lichtiger score < 10 and at least 3 points less than baseline), relapse between day 7 and 98, absence of steroid-free remission at day 98, severe adverse event leading to treatment interruption, colectomy; response based on Powell-Tuck index ≤ 3; doubling of the Crohn's and ulcerative colitis questionnaire-32 score at 3 mo;

5

Definitions from individual studies: Failure to respond including ongoing or worsening symptoms of bloody diarrhea, abdominal pain and persistently elevated inflammatory markers, or the development of a complication (perforation, severe hemorrhage, toxic megacolon); good response to treatment was decrease in stool frequency (< 6/d), little or no blood in feces, absence of complications; clinical remission, as per clinical symptom questionnaire used locally at this institution; being discharged from hospital without surgery or additional rescue therapy; physician global assessment of patient response—those deemed medical failure were treated with colectomy; steroid-free clinical remission (mild or inactive based on the Montreal severity score) plus no need for second rescue therapy or colectomy; modified Truelove and Witts Severity Index score decrease ≥ 4points; remission based on Colitis Activity Index ≤ 4 within 4 wk; in 5 studies, treatment response was not reported. C: Cyclosporine; CI: Confidence interval; IFX: Infliximab; n: Number of patients; OR: Odds ratio; RCT: Randomized clinical trial; RR: Risk ratio.