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- Title
Sphingosine 1-phosphate (S1P) receptor modulators as an induction and maintenance therapy for ulcerative colitis: a systematic review and meta-analysis of randomized controlled trials.
- Authors
Suilik, Husam Abu; Jaber, Fouad; Abuelazm, Mohamed; Ramadan, Alaa; Elzeftawy, Mohamed A.; Elrosasy, Amr; Youssef, Rana Ahmed; Abdelazeem, Basel; Hashash, Jana G.; Farraye, Francis A.; Ghoz, Hassan
- Abstract
Background and objective: One sphingosine-1-phosphate (S1P) receptor modulator is approved (ozanimod) and another (etrasimod) is under investigation for the induction and maintenance of remission of ulcerative colitis (UC). We aim to evaluate the efficacy and safety of S1P modulators in patients with active UC. Methods: We conducted a systematic review and meta-analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching: PubMed, Web of Science, SCOPUS, and Cochrane through May 13th, 2023. We used the fixed-effect model to pool dichotomous data using risk ratio (RR) with a 95% confidence interval (CI). Results: Five RCTs with a total of 1990 patients were included. S1P receptor modulators were significantly associated with increased clinical response during both the induction (RR 1.71 with 95% CI [1.50, 1.94], P = 0.00001) and maintenance phases (RR 1.89 with 95% CI [1.33, 2.69], P = 0.0004); clinical remission rates during both induction (RR 2.76 with 95% CI [1.88, 4.05], P = 0.00001) and maintenance phases (RR 3.34 with 95% CI [1.41, 7.94], P = 0.006); endoscopic improvement during both induction (RR 2.15 with 95% CI [1.71, 2.70], P = 0.00001) and maintenance phases (RR 2.41 with 95% CI [1.15, 5.05], P = 0.02); and histologic remission during both induction (RR 2.60 with 95% CI [1.89, 3.57] [1.17, 2.10], P = 0.00001) and maintenance phases (RR 2.52 with 95% CI [1.89, 3.37], P = 0.00001). Finally, there was no difference regarding safety outcomes as compared to placebo in both the induction and maintenance phases. Conclusion: S1P receptor modulators are effective in inducing and maintaining remission in patients with moderate to severe UC.
- Subjects
ULCERATIVE colitis; RANDOMIZED controlled trials; SPHINGOSINE; DISEASE remission; REMISSION induction; FECAL microbiota transplantation
- Publication
Inflammation Research, 2024, Vol 73, Issue 2, p183
- ISSN
1023-3830
- Publication type
Article
- DOI
10.1007/s00011-023-01829-6