Efficacy of IL-23 inhibitors and IL-12/23 inhibitors in the induction treatment of Crohn's disease: a meta-analysis based on randomized controlled trials

Abstract

Abstract Background A growing number of randomized controlled trials (RCTs) have demonstrated interleukin (IL)-23 and IL-12/23 inhibitors effectiveness in treating Crohn's disease (CD). This study evaluated the efficacy of IL-23 and IL-12/23 inhibitors in the induction phase for the treatment of CD. Methods We searched the following databases from inception until December, 2022: Medline, Embase, Web of Science and the Cochrane Library. The primary outcome was the proportion of CD patients who achieved clinical remission at the end of the induction therapy period. Secondary outcomes included clinical response, endoscopic remission, endoscopic response and normalized C-reactive protein (CRP). Results After screening, 7 RCTs were included in our study. The meta-analysis showed that, in the induction period, more patients treated with IL-23 inhibitors and IL-12/23 inhibitors achieved clinical remission than patients with placebo therapy (RR = 2.11; 95%CI: 1.83–2.44; RR = 1.94; 95%CI: 1.64–2.29; respectively). The IL-23 inhibitor group and the IL-12/23 inhibitor group showed higher clinical response rates than the placebo group (RR = 1.92; 95%CI: 1.74-2,11; RR = 1.83; 95%CI: 1.61–2.09; respectively). In addition, IL-23 inhibitor group had higher endoscopic remission rate and endoscopic response rate than placebo group, the corresponding pooled RR were 3.40 (95%CI: 2.57–4.50) and 2.65 (95%CI: 2.65–3.12), respectively. Conclusions IL-23 and IL-12/23 inhibitors were efficiency methods in the induction treatment of CD.