P-167 Comparison of Efficacy and Safety Between Infliximab and Tacrolimus for the Treatment of Active Ulcerative Colitis: A Meta-Analysis

Background: Infliximab (IFX) and tacrolimus (Tac) have been shown to be effective for the treatment of moderate to severe active ulcerative colitis (UC). The efficacy of IFX and Tac has been compared in some retrospective studies, however, it remains uncertain which medication exerts better therapeutic effect. Methods: We performed a PubMed literature search up to August 20, 2016 and carried out a systemic review of published studies that compared therapeutic efficacies between IFX and Tac among patients with moderate to severe active UC. In addition to the subjects of our previous analysis, we included another 13 patients (8 subjects for Tac and 5 subjects for IFX) in the present analysis. This meta-analysis was carried out using the inverse variance-weighted method or the DerSimonian-Laird method after estimating the heterogeneity among the studies. Outcomes included short-term clinical remission, clinical response and the incidence of adverse events. Results: Three retrospective studies including 244 UC patients were selected. Although the rates of clinical remission and clinical response of IFX were higher than those of Tac, no significant difference in the therapeutic efficacy was found between IFX and Tac (odds ratio [OR] 1.17, 95% confidence interval [CI] 0.68–2.02, and OR = 1.55, 95% CI, 0.85–2.84, respectively). The incidence of adverse events in the IFX group was lower than that in the Tac group, whereas those of serious adverse events were comparable between the 2 groups. Conclusions: This meta-analysis demonstrates equivalent therapeutic efficacy and safety between IFX and Tac.