| Objecton:This study aimed to evaluate the therapeutic value and safe of adalimumab(ADA)for fistula in Crohn's disease(CD).Methods:A computerized search of electronic databases,including Pub Med,Web of Science,Embase,Google scholar,and the Cochrane Library from 2000 to October 2016,was performed.Randomized controlled trials(RCTs)or nonrandomized controlled trials(n-RCTs)were included in this article to evaluate the role of ADA in the management of fistula in CD.The methodological index for nonrandomized studies(MINORS evaluation tools)was used to assess the quality of everystudy.Data from the included studies were extracted and summarized independently by two of the authors who were both blinded to the writers,the institutions,and the journals of each article.Each disagreement had been solved by the senior author.Through the Stata 12 software,the results of complete closure,partial closure and the incidence of side effects was analyzed in the literature.If the study had high heterogeneity,the model of data analysis was replaced by random effect mode.Otherwise,the model of data analysis was not changed.If there was a significant heterogeneity on clinical manifestation,the analysis was not combined,and then sensitivity analysis could be chosen.According to the representativeness of the literature,the researchers conducted an analysis of publication bias and detected it by funnel plot(funnel plot).If the funnel plot showed asymmetry,Egger test was used to evaluate it later.Result:Overall,seven studies and 379 patients comforted to the inclusion criteria of this meta-analysis.The result showed that 36%(95% CI: 0.31–0.41)of patients with complete fistula closure,31%(95% CI: 0.031–0.61)of patients,with partial response and no significant difference in the incidence of adverse reactions(p=0.845>0.1)were received in CD with ADA treatment,compared with placebo group.Conclusion:We concluded that ADA is effective and safe for the treatment of fistula in CD according to current evidence. |
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