SynthesisJournal of gastroenterology2017
Systematic review with meta-analysis: loss of response and requirement of anti-TNFα dose intensification in Crohn's disease.
Synthesis in Journal of gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
110 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Second United Arab Emirates consensus guidance on the diagnosis and management of inflammatory bowel disease.World journal of gastroenterology · 2025Pooled it
- Tumor necrosis factor-alpha antagonists for treatment of pediatric Crohn's disease.The Cochrane database of systematic reviews · 2025Pooled it
- Systematic Review and Meta-analysis: Loss of Response and Need for Dose Escalation of Infliximab and Adalimumab in Ulcerative Colitis.Inflammatory bowel diseases · 2023Pooled it
- Effectiveness of Reinduction and/or Dose Escalation of Ustekinumab in Crohn's Disease: A Systematic Review and Meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Pooled it
- Efficacy and Safety of Mesenchymal Stem/Stromal Cell Therapy for Inflammatory Bowel Diseases: An Up-to-Date Systematic Review.Biomolecules · 2021Pooled it
- Efficacy of enteral nutrition in patients with Crohn's disease on maintenance anti-TNF-alpha antibody therapy: a meta-analysis.Journal of gastroenterology · 2020Pooled it
- Pooled it
- Ustekinumab Intravenous Reinduction after Secondary Loss of Response in Patients with Crohn's Disease.Inflammatory bowel diseases · 2025Trial
- Stopping of adalimumab in juvenile idiopathic arthritis-associated uveitis (ADJUST): a multicentre, double-masked, randomised controlled trial.Lancet (London, England) · 2025Trial
- Oral low-dose methotrexate improves infliximab pharmacokinetics, immunogenicity, and endoscopic outcomes in Crohn's disease: a propensity score-adjusted real-world study.International journal of clinical pharmacy · 2026Article
- The association between 6-thioguanine nucleotide levels, adalimumab exposure, immune response, and drug clearance.Crohn's & colitis 360 · 2026Article
- The TAAR1 antagonist EPPTB ameliorates colitis via serotonin inhibition.Biochemistry and biophysics reports · 2026Article
- Real-World Efficacy and Safety of Adalimumab Biosimilar (HS016) in Biologic-Naïve Patients with Perianal Fistulizing Crohn's Disease: A Prospective, Single-Arm, Observational Study.Drug design, development and therapy · 2026Observational
- Subcutaneous infliximab in inflammatory bowel disease: bridging the gap between theory and practice.Crohn's & colitis 360 · 2026Article
- Interpretable Artificial Neural Network Models for Predicting Anti-Adalimumab Immune Complex and Serum Drug Level in Crohn's Disease: A Proof-of-Concept Study.Pharmaceutics · 2025Article
- Development and Validation of a Machine Learning Model to Predict Anti-Drug Antibody Formation During Infliximab Induction in Crohn's Disease.Biomedicines · 2025Article
- Ustekinumab trough concentrations predict clinical remission in perianal fistulizing crohn's disease: a real-world retrospective cohort study.BMC gastroenterology · 2025Article
- Impact of Treatment Adjustment on the Endoscopic Prognosis of Postoperative Anastomotic Lesions in Patients With Crohn's Disease.Clinical and translational gastroenterology · 2025Article
- The War in Gaza and Barriers to Inflammatory Bowel Disease Care.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Treat-to-target of endoscopic remission in patients with inflammatory bowel disease in symptomatic remission on advanced therapies (QUOTIENT): rationale, design and protocol for an open-label, multicentre, pragmatic, randomised controlled trial.BMJ open gastroenterology · 2025Article
50 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo review the frequency with which anti-TNF-α loses its effect and dose "intensification" is required for Crohn's disease (CD) treatment.
methodsElectronic databases were searched for eligible studies. Raw data from studies meeting inclusion criteria were pooled for effect estimates. Subgroup analyses were performed for exploration of heterogeneity regarding all outcomes.
resultsEighty-six eligible studies were included. Estimates of loss of response (LOR) incidence ranged from 8 to 71%. The random effects pooled incidence of LOR with a median follow-up of 1-year was 33% (95% CI 29-38, 55 studies, n = 6135). The effect estimate based on data from patients with infliximab was 33% (95% CI 27-40), 30% (95% CI 22-39) for adalimumab, and 41% (95% CI 30-53) for certolizumabpegol. Overall, the mean percentage of patients' LOR to anti-TNFs was 38.5%. The annual risk for LOR was 20.9% per patient-year. The random-effects pooled rate of need for dose intensification with a median follow-up of 1 year was 34% (95% CI 28-41, 38 studies, n = 10,690). The effect estimate for infliximab was 38% (95% CI 28-50), 36% (95% CI 30-43) for adalimumab, and 2% (95% CI 2-3) for certolizumab-pegol. The mean percentage of patients who needed an anti-TNF dose escalation was 23% with an annual risk of 18.5% per patient-year. There was no evidence of publication bias for incidence of LOR but not for the dose intensification (p = 0.001).
conclusionsOverall, around one-third of CD patients experience a LOR and required dose intensification in primary anti-TNF-α responders.
Indexed as
Identifiers
28275925What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.