Cochrane · systematic review · CD012623
Infliximab for medical induction of remission in Crohn's disease
Gordon, M, Sinopoulou, V, Akobeng, AK, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
GutAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
27
current version
GRADE rated
23
No studies
4
Included studies
NR
No studies 4 · 14.8%Ungraded 0 · 0%Very low 12 · 44.4%Low 9 · 33.3%Moderate 2 · 7.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Infliximab 5–10 mg/kg compared to placebo
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission defined as CDAI < 150 at week 4 Infliximab 5–10 mg/kg vs placebo | RR 4.55 [1.53, 13.5] | 1 study · 80 participants | Low Downgraded: risk of bias, imprecision |
Clinical response defined as improvement in the scores on the CDAI score ≥ 70 at week 4 Infliximab 5–10 mg/kg vs placebo | RR 4.09 [1.63, 10.25] | 1 study · 80 participants | Low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events Infliximab 5–10 mg/kg vs placebo | no estimate extracted | NR | No studies |
Infliximab 5–10 mg/kg compared to placebo for exclusively fistulating population
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission defined as absence of any draining fistulas at ≥ 2 consecutive visits, at a median 12 weeks Infliximab 5–10 mg/kg vs placebo | RR 3.57 [1.38, 9.25] | 1 study · 94 participants | Very low Downgraded: risk of bias, imprecision |
Clinical response defined as reduction of 50% in the number of draining fistulas at ≥ 2 consecutive visits, at a median 12 weeks Infliximab 5–10 mg/kg vs placebo | RR 1.94 [1.1, 3.41] | 2 studies · 181 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events Infliximab 5–10 mg/kg vs placebo | RR 2.5 [0.12, 50.54] | 1 study · 94 participants | Very low Downgraded: risk of bias, imprecision |
Infliximab 5 mg/kg and purine analogues compared to purine analogues alone
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission as defined by the studies at weeks 24–26 Infliximab 5 mg/kg and purine analogues vs purine analogues alone | RR 1.92 [1.59, 2.32] | 4 studies · 630 participants | Moderate Downgraded: risk of bias |
Clinical response as defined by the studies at week 26 Infliximab 5 mg/kg and purine analogues vs purine analogues alone | RR 1.64 [1.31, 2.05] | 2 studies · 355 participants | Moderate Downgraded: risk of bias |
Withdrawals due to adverse events at week 26 Infliximab 5 mg/kg and purine analogues vs purine analogues alone | RR 0.87 [0.63, 1.21] | 4 studies · 603 participants | Low Downgraded: risk of bias, imprecision |
Infliximab 5 mg/kg compared to purine analogues
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission at week 26 Infliximab 5 mg/kg vs purine analogues | RR 1.5 [1.15, 1.95] | 2 studies · 355 participants | Low Downgraded: risk of bias, imprecision |
Clinical response at week 26 Infliximab 5 mg/kg vs purine analogues | RR 1.44 [1.13, 1.82] | 2 studies · 355 participants | Low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events Infliximab 5 mg/kg vs purine analogues | RR 0.7 [0.46, 1.06] | 2 studies · 355 participants | Low Downgraded: risk of bias, imprecision |
Infliximab 5 mg/kg compared to infliximab 10 mg/kg
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission defined as CDAI < 150 at week 4 Infliximab 5 mg/kg vs infliximab 10 mg/kg | RR 1.79 [1.06, 3.02] | 1 study · 55 participants | Very low Downgraded: risk of bias, imprecision |
Clinical response defined as reduction in CDAI by 70 points at week 4 Infliximab 5 mg/kg vs infliximab 10 mg/kg | RR 1.63 [1.08, 2.46] | 1 study · 55 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events Infliximab 5 mg/kg vs infliximab 10 mg/kg | no estimate extracted | NR | No studies |
Infliximab 5 mg/kg compared to infliximab 10 mg/kg for exclusively fistulating population
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission defined as absence of any draining fistulas at ≥ 2 consecutive visits, at a median length of time of 12 weeks Infliximab 5 mg/kg vs infliximab 10 mg/kg | RR 1.46 [0.84, 2.53] | 1 study · 63 participants | Very low Downgraded: risk of bias, imprecision |
Clinical response defined as reduction of 50% in the number of draining fistula at ≥ 2 consecutive visits, at a median length of time of 12 weeks Infliximab 5 mg/kg vs infliximab 10 mg/kg | RR 1.2 [0.82, 1.78] | 1 study · 63 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events Infliximab 5 mg/kg vs infliximab 10 mg/kg | RR 1.03 [0.07, 15.79] | 1 study · 63 participants | Very low Downgraded: risk of bias, imprecision |
Infliximab 5 mg/kg compared to infliximab 20 mg/kg
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission at week 4 Infliximab 5 mg/kg vs infliximab 20 mg/kg | RR 1.79 [1.06, 3.02] | 1 study · 55 participants | Very low Downgraded: risk of bias, imprecision |
Clinical response as defined by the studies week 4 Infliximab 5 mg/kg vs infliximab 20 mg/kg | RR 1.27 [0.91, 1.76] | 1 study · 55 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events Infliximab 5 mg/kg vs infliximab 20 mg/kg | no estimate extracted | NR | No studies |
Infliximab 10 mg/kg compared to infliximab 20 mg/kg
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission defined as CDAI < 150 at week 4 Infliximab 10 mg/kg vs infliximab 20 mg/kg | RR 1 [0.52, 1.92] | 1 study · 56 participants | Very low Downgraded: risk of bias, imprecision |
Clinical response defined by reduction of CDAI score by ≥ 70 at week 4 Infliximab 10 mg/kg vs infliximab 20 mg/kg | RR 0.78 [0.49, 1.23] | 1 study · 56 participants | Very low Downgraded: risk of bias, imprecision |
Withdrawals due to adverse events Infliximab 10 mg/kg vs infliximab 20 mg/kg | no estimate extracted | NR | No studies |
Infliximab 5 mg/kg compared to CT‐P13 biosimilar 5 mg/kg
Population: active Crohn's disease
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical remission defined as CDAI < 150 at week 6 Infliximab 5 mg/kg vs CT‐P13 biosimilar 5 mg/kg | RR 0.98 [0.72, 1.32] | 1 study · 220 participants | Low Downgraded: imprecision |
Clinical response defined by reduction of CDAI score by ≥ 100 at week 6 Infliximab 5 mg/kg vs CT‐P13 biosimilar 5 mg/kg | RR 0.97 [0.79, 1.2] | 1 study · 220 participants | Low Downgraded: imprecision |
Withdrawals due to adverse events Infliximab 5 mg/kg vs CT‐P13 biosimilar 5 mg/kg | RR 1.26 [0.7, 2.25] | 1 study · 220 participants | Low Downgraded: imprecision |