Efficacy and Safety of Natalizumab and Vedolizumab in the Treatment of Crohn’s Disease: A Systematic Review and Meta-Analysis

Background — This study compared the effectiveness and safety of natalizumab and vedolizumab in managing Crohn’s disease (CD), focusing on clinical remission, response to therapy, and adverse events. Material and Methods — A systematic review conducted using the PRISMA guidelines included 11 studies (9 randomized controlled trials and 2 cohort studies). Quality was assessed using the Risk of Bias 2 (RoB 2) tool and the Newcastle-Ottawa Scale (NOS). Outcomes were analyzed using Review Manager 5.4 using odds ratios (OR), 95% confidence intervals (CI), and p-values. Results — Natalizumab improved clinical response (OR=2.14; 95% CI: 1.68-2.71, p<0.00001) and remission (OR=2.47; 95% CI: 1.12-5.42, p=0.02) compared with placebo. Vedolizumab also improved response (OR=1.60; 95% CI: 1.28-1.99, p<0.0001) and remission (OR=1.86; 95% CI: 1.42-2.43, p<0.00001). Both drugs demonstrated similar safety profiles to placebo in terms of infections, fatigue, and serious adverse events. Conclusion — Natalizumab and vedolizumab effectively improve clinical outcomes in CD, with comparable safety profiles, supporting their therapeutic use.