Evidence map›Paper›PMID 28407755›Full record

SynthesisBMC gastroenterology2017

Inflammatory Bowel Disease (IBD) pharmacotherapy and the risk of serious infection: a systematic review and network meta-analysis.

Chelle L Wheat, Cynthia W Ko, Kindra Clark-Snustad, David Grembowski, Timothy A Thornton, Beth Devine

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
4.4field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Chelle L WheatDepartment of Health Services, School of Public Health, University of Washington, 1959 NE Pacific Street, Magnuson Health Sciences Center, Room H-680, Box 357660, Seattle, WA, USA. wheatc@uw.edu.
Cynthia W KoDivision of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA.
Kindra Clark-SnustadDivision of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA, USA.
David GrembowskiDepartment of Health Services, School of Public Health, University of Washington, 1959 NE Pacific Street, Magnuson Health Sciences Center, Room H-680, Box 357660, Seattle, WA, USA.
Timothy A ThorntonDepartment of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA.
Beth DevineDepartment of Health Services, School of Public Health, University of Washington, 1959 NE Pacific Street, Magnuson Health Sciences Center, Room H-680, Box 357660, Seattle, WA, USA.
University of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe magnitude of risk of serious infections due to available medical therapies of inflammatory bowel disease (IBD) remains controversial. We conducted a systematic review and network meta-analysis of the existing IBD literature to estimate the risk of serious infection in adult IBD patients associated with available medical therapies.

methodsStudies were identified by a literature search of PubMed, Cochrane Library, Medline, Web of Science, Scopus, EMBASE, and ProQuest Dissertations and Theses. Randomized controlled trials comparing IBD medical therapies with no restrictions on language, country of origin, or publication date were included. A network meta-analysis was used to pool direct between treatment comparisons with indirect trial evidence while preserving randomization.

resultsThirty-nine articles fulfilled the inclusion criteria; one study was excluded from the analysis due to disconnectedness. We found no evidence of increased odds of serious infection in comparisons of the different treatment strategies against each other, including combination therapy with a biologic and immunomodulator compared to biologic monotherapy. Similar results were seen in the comparisons between the newer biologics (e.g. vedolizumab) and the anti-tumor necrosis factor agents.

conclusionsNo treatment strategy was found to confer a higher risk of serious infection than another, although wide confidence intervals indicate that a clinically significant difference cannot be excluded. These findings provide a better understanding of the risk of serious infection from IBD pharmacotherapy in the adult population. PROSPERO REGISTRATION: The protocol for this systematic review was registered on PROSPERO ( CRD42014013497 ).

Indexed as

Adrenal Cortex HormonesAnti-Bacterial AgentsAnti-Inflammatory Agents, Non-SteroidalBiological ProductsHumansImmunologic FactorsInfectionsInflammatory Bowel DiseasesRisk FactorsAdrenal Cortex HormonesAnti-Bacterial AgentsAnti-Inflammatory Agents, Non-SteroidalBiological ProductsImmunologic FactorsIBD pharmacotherapyInfectionInflammatory bowel diseaseNetwork meta-analysis

Identifiers

PMID28407755
PMCPMC5391579
OpenAlexW2605741432

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.