OBJECTIVES: Mucosal healing is an important treatment goal in Crohn’s disease (CD) and ulcerative colitis (UC). The objective of this study was to assess the overall treatment effect of biologics for mucosal healing in CD and UC.

METHODS: PubMed, Embase and NOVEL-IBD databases were searched for English language papers and conference abstracts published through December 1, 2021. Studies were selected for inclusion if patients were treated with biologics for Ulcerative Colitis (UC) and Crohn’s disease (CD). DerSimonian and Laird (D+L) random-effects meta-analyses were conducted to pool mucosal healing rates in patients treated with biologics versus placebo. Inter-study heterogeneity was assessed with Cochrane Q and I2 tests (with significant heterogeneity indicated by P < .10 or I2 ≥ 50%).

RESULTS:

A total of 3129 records were identified, of which 14 references for RCTs met the selection criteria for systematic review and meta-analysis (5 were in CD; 8 were in UC). A total of 4409 patients were studied, with 2358 in the intervention arm (biologics included Risankizumab, Infliximab, Adalimumab, Vedolizumab and Golimumab) and 2051 in the placebo arm. Meta-analysis found that all included biologic treatments led to endoscopic improvements versus placebo, with an Odd Ratio (OR) 2.279 (98% CI-1.715, 3.029, p<0.05, Heterogeneity chi-squared = 53.09, z= 5.68).

CONCLUSIONS: Systematic review and meta-analysis suggests that biologic treatments for CD and UC lead to musical healing compared to placebo.