Eficacia y seguridad de la terapia biológica en pacientes mayores de 18 años con colitis ulcerosa moderada y grave: revisión sistemática

Abstract

Background: Ulcerative Colitis (UC) is the most frequent form of Inflammatory Bowel Disease (IBD), impacts the quality of life of patients and generates high costs in treatment. Objective: to determine the efficacy and safety of biological therapy in patients over 18 years of age with moderate and severe Ulcerative Colitis. Methods: observational study, systematic review of treatment clinical trials, including 16 published in the last 5 years, without language discrimination, with quality of evidence from quintile 1 to 4, and comparison reports of placebo, immunosuppressants or other biologicals, with different quantitative, cross-sectional, controlled clinical trials, meta-analysis, prospective designs in various scientific databases. Results: the efficacy rate of the biological therapy was observed by the clinical improvement and the healing of the mucosa with the intervention of Vedolizumab, Adalimumab and Tofacitinib. Remission at 13 weeks with Tofacitinib. The adverse effects were associated in a higher percentage to Tofacitinib, Golimumab, Vedolizumab, related to: headache, nausea, herpes zoster, arthragia, neoplasms, nasopharyngitis and serious infections. Conclusions: the Vedolizumab was the most effective (clinical response and mucosal healing). The highest remission rates were with infliximab, tofacitinib, and vedolizumab. The duration of remission was between 13-56 weeks, the longest time corresponding to vedolizumab and the shortest time with Tofacitinib. Adverse effects were more associated with Tofacitinib, Golimumab, and Vedolizumab.