Table 1.
Therapeutic efficacy in regard to location in Crohn's disease.
| Therapy | Outcome Measure | Number of patients | Results in regard to disease location | Reference |
|---|---|---|---|---|
| Enteral Nutrition | Clinical remission (PCDAI) | 65 (pediatric) | Colonic: 50% | (13) |
| Ileocolonic: 82% | ||||
| Ileal: 92% | ||||
| Enteral Nutrition | Clinical remission (CDAI <150) | 241 | Colonic: 52% | (15) |
| Non-isolated colonic: 68% | ||||
| Metronidazole | Improvement (CDAI) | 63 | Small intestine +86 (38–134) (n = 24) | (16) |
| Small/large intestine +60 (19–101) (n = 31) | ||||
| Large intestine + 145 (26–265) (n = 8) | ||||
| Budesonide, Ciprofloxacin, Metronidazole | Clinical remission (CDAI <150) | 80 | Ileocolonic: 53% | (17) |
| Ileal: 26% | ||||
| Certolizumab pegol (CZP) | Likeliness to achieve clinical remission (CDAI <150) at week 6 | 438 | Colonic: OR 2.39 vs. placebo (95% CI 0.99–5.75, p = 0.052) | (26) |
| Ileocolonic: OR 2.07 (95% CI 1.01–4.28, p = 0.048) | ||||
| Ileal: OR 0.42 (95% CI 0.18–0.99, p = 0.048) | ||||
| Infliximab | Clinical response (HBI reduction by > 3) at week 4 | 37 | Colonic: 88% | (27) |
| Ileal: 54% | ||||
| (p = 0.042, OR 3.83) | ||||
| Infliximab | Clinical response at week 8 (reduction of CDAI by ≥ 100) | 44 | Colonic: 83.3% | (28) |
| Ileal/ileocolonic: 50% | ||||
| (p = 0.03) | ||||
| Infliximab | Response at week 4 (reduction CDAI ≥70) or week 10 (50% decrease in draining fistulae) | 240 | Colonic: 81% | (29) |
| Ileocolonic: 74% | ||||
| Ileal: 55% | ||||
| OR 1.905 (95% CI 1.010–3.597) | ||||
| Infliximab | Loss of response | 284 (pediatric) | Colonic: HR 2.72 (95% CI 1.30–5.71, p = 0.008) | (30) |
| Adalimumab | Dose escalation (weeks) | 75 | Colonic: 13.2 | (31) |
| Other sites: 34.6 | ||||
| P = 0.0062 | ||||
| Ustekinumab (UST) | Clinical response or remission (CDAI) | 306 | Ileal: 33.5% | (5) |
| Colonic: 49.2% | ||||
| Relative risk 0.68 (95% CI, 0.50–0.92) | ||||
| Vedolizumab (VDZ) | Clinical response or remission (CDAI) | 155 | Ileal: 21.2% | (35) |
| Colonic: 22.4% | ||||
| Relative risk 0.82 (95% CI, 0.42–1.60) | ||||
| Meat-analysis RCTs (CZP, UST, VDZ) | Clinical response or remission (CDAI) | 288 | Ileal: 29% | (5) |
| Colonic: 38% | ||||
| Relative risk 0.70 (95% CI, 0.56–0.87; I2 ¼ 0%) | ||||
| Vedolizumab | Clinical remission (CDAI <150) at week 52 | 168 | Colonic VDZ: 49.1% | (36) |
| Colonic placebo: 23.1% of Estimate 26.0 (95% CI, 5.1–46.9) | ||||
| Ileal VDZ: 36.4% | ||||
| Ileal Placebo: 42.9% | ||||
| Estimate −6.5 (95% CI, −30.6-17.6) | ||||
| Ustekinumab | Loss of steroid-free clinical response (CDAI) | 104 | Colonic: aHR 0.33 (0.11–0.98) Ileocolonic: aHR 0.26 (0.10–0.68) | (37) |
| Ustekinumab | Clinical response (CDAI) | 152 | Colonic: OR, 3.5 (95% CI: 1.34–9.41) | (38) |
| Ustekinumab | Clinical response (CDAI) at week 26 | 407 | Colonic: OR, 0.56 (95% CI, 0.32–0.96) | (39) |
| Ileocolonic: OR, 0.34 (95% CI, 0.16–0.69) | ||||
| Adalimumab | Mean change (CDEIS); Global Histologic Disease Activity Scores | 70 | Rectum-transverse colon: | (41) |
| −68.5% to −90.6% CDEIS | ||||
| Right colon-ileum: −22.3% to −50.0% CDEIS | ||||
| Colonic: 28.3% GHDAS healing Ileum: 21.2% GHDAS healing | ||||
| Anti-TNF | Endoscopic healing (SES-CD) ≤ 5) at a median of 13 months | 156 | Colonic: 79% | (42) |
| Small bowel: 36% | ||||
| SONIC-study | Endoscopic remission (ER) at week 26 (CDEIS, SES-CD) | 172 | ER rate of ileal ulcers significantly lower than colonic ulcers (P < 0.0001) | (44) |
| TAILORIX-study | Endoscopic remission (CDEIS <3) at week 12 and 54 | 122 | Lower ER rates in the ileum vs. colonic segments (P < 0.01 all comparisons) | (45) |
| Infliximab | Mucosal healing (SES-CD: 0) and SES-CD change at week 30/38 | 101 | MH transverse colon: 81% | (46) |
| MH ileum: 45% | ||||
| SES-CD change (week 30/38) transverse colon: −94%/-94% | ||||
| SES-CD change (week 30/38) ileum: 67%/69% | ||||
| Vedolizumab | Mucosal healing (absence of any ulcers, including aphthae) at week 26 | 101 | Rectum 38.5%; descending colon 31.7%; transverse colon 51%; ascending colon 46.1%; ileum 20.6% | (47) |