A retrospective study on advanced therapy for Inflammatory Bowel Disease (IBD) found minimal new complications (8%) and comparable improvement in existing issues, except for joint problems, suggesting a generally positive impact on extraintestinal manifestations.

The following is a summary of “Beyond the Gut: A Systematic Review and Meta-analysis of Advanced Therapies for Inflammatory Bowel Disease-associated Extraintestinal Manifestations,” published in the January 2024 issue of Gastroenterology by Tímár et al.

Despite frequent debilitating extraintestinal issues in Inflammatory Bowel Disease (IBD), evidence remains elusive for guiding drug choices beyond anti-tumor necrosis factor [anti-TNF] treatment.

Researchers started a retrospective study to determine the impact of advanced therapy on the emergence and course of extraintestinal manifestations in IBD.

They initiated a systematic search and included randomized controlled trials, cohorts, and case series (November 15, 2022) that documented the occurrence and behavior of extraintestinal manifestations in patients with IBD who underwent advanced therapy [non-TNF inhibitor biologicals and JAK inhibitors]. Extraintestinal manifestations were assessed with 95% CIs, and bias risk was determined with the QUIPS tool.

The results showed 61 studies involving 13,806 patients provided data on extraintestinal manifestations. During advanced therapy, The proportion of new extraintestinal manifestations was 8% [95% CI, 6–12%]. There was no significant difference in the frequency of new extraintestinal manifestations between vedolizumab and ustekinumab therapy [11%, 95% CI, 8–15% vs 6%, 95% CI, 3–11%, P=0.166]. Improvement of existing issues was comparable in patients treated with vedolizumab and ustekinumab, except for joint problems.[42%, 95% CI, 32–53% vs 54%, 95% CI, 42–65%, P=0.029].

Investigators concluded that advanced therapy had minimal new complications and improved existing ones, except for joint problems.

Source: academic.oup.com/ecco-jcc/advance-article/doi/10.1093/ecco-jcc/jjae002/7512824