Seven relevant RCTs were identified: 2,228 participants (range 20 to 905) comprised 1,549 treated with anti-adhesion molecule therapy and 679 controls. The Jadad score was 4 for two RCTs and 5 for five RCTs.
Pooled analysis found a significant reduction in remission rates (RR 1.31, 95% CI 1.12 to 1.52, I2=22%, fixed-effects model; seven RCTs) and a modest significant improvement in clinical response rates (RR 1.26, 95% CI 1.05 to 1.50, I2=71%, random-effects model; five RCTs) for anti-adhesion molecule therapy compared to placebo. Subgroup analysis that excluded the two smallest studies did not change the overall conclusion for remission rates.
There was no significant difference in adverse events for anti-adhesion molecule therapy compared to placebo (RR 1.03, 95% CI 0.98 to 1.08 I2=0%, fixed effects model; five RCTs).
The authors considered that there was insufficient evidence to draw conclusions on whether remission could be maintained using anti-adhesion molecule therapy.