SynthesisBritish journal of clinical pharmacology2018
Comparative safety of systemic and low-bioavailability steroids in inflammatory bowel disease: Systematic review and network meta-analysis.
Synthesis in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 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
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Comparative assessment of budesonide-MMX and mesalamine in active, mild-to-moderate ulcerative colitis: A systematic review and network meta-analysis.British journal of clinical pharmacology · 2019Pooled it
- Comparative safety of systemic and low-bioavailability steroids in inflammatory bowel disease: Systematic review and network meta-analysis.British journal of clinical pharmacology · 2018Pooled it
- Glucocorticoid use and risk of first and recurrent venous thromboembolism: self-controlled case-series and cohort study.British journal of haematology · 2021Trial
- Efficacy and safety of ulcerative colitis therapies do not differ by age: A post hoc analysis of randomized controlled trials.Inflammatory bowel diseases · 2026Article
- Efficacy and Safety of Oral Prednisolone and Budesonide MMX for Outpatient Induction Therapy in Active Ulcerative Colitis: A Multicenter Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Escalation to biologics after corticosteroids in patients with newly diagnosed Crohn's disease in Japan: a claims analysis from 2010 to 2021.Intestinal research · 2026Article
- Efficacy of budesonide and vedolizumab for IBD-U associated with Muckle-Wells syndrome.Clinical journal of gastroenterology · 2026Article
- Real-world use of biologics during the first year of treatment for newly diagnosed Crohn's disease in Japan: a claims analysis from 2010 to 2021.Intestinal research · 2026Article
- Oral Budesonide in Oncology: A Novel Approach to Managing Gastrointestinal Immune-Related Adverse Events.Current treatment options in oncology · 2025Review
- Steroid-refractory immune mediated hepatitis managed with budesonide in patients with metastatic melanoma: proof of concept and literature review.The oncologist · 2025Review
- Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition.Intestinal research · 2025Review
- Glucocorticoid treatment and adrenal suppression in children: current view and open issues.Journal of endocrinological investigation · 2025Review
- Outcomes of Budesonide as a Treatment Option for Immune Checkpoint Inhibitor-Related Colitis in Patients with Cancer.Cancers · 2024Article
- Drug Optimization in Patients with Mild-to-Moderate Ulcerative Colitis: A Global Survey.Journal of clinical medicine · 2024Article
- Treating the Side Effects of Exogenous Glucocorticoids; Can We Separate the Good From the Bad?Endocrine reviews · 2023Review
- Pharmacological Therapy in Inflammatory Bowel Diseases: A Narrative Review of the Past 90 Years.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Assessment of the effectiveness of Budesonide MMXPrzeglad gastroenterologiczny · 2023Article
- Comparative Effectiveness Research: A Roadmap to Sail the Seas of IBD Therapies.Journal of clinical medicine · 2022Review
- Patient preferences and current practice for adults with steroid-resistant ulcerative colitis: POPSTER mixed-methods study.Health technology assessment (Winchester, England) · 2022Article
- Inflammatory Bowel Disease Management during the COVID-19 Pandemic: A Literature Review.Middle East journal of digestive diseases · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsOral systemic corticosteroids have been used to induce remission in patients with active inflammatory bowel disease (IBD) for over 50 years; however, the wide array of adverse events (AEs) associated with these drugs prompted the development of steroid compounds with targeted delivery and low systemic bioavailability. This study assessed corticosteroids' comparative harm using network meta-analysis.
methodsWe searched PubMed, Scopus, Embase, the Cochrane Library, clinical trial registries, regulatory authorities' websites and major conference proceedings, through March 2017. Randomized controlled trials that recruited adult IBD patients and compared oral systemic corticosteroids (prednisone/prednisolone) or compounds/formulations with low systemic bioavailability (budesonide, budesonide MMX, and beclomethasone dipropionate) with placebo, or against each other, were considered eligible for inclusion. Two reviewers independently extracted study data and outcomes, and rated each trial's risk-of-bias.
resultsWe identified and synthesized evidence from 31 trials including 5689 IBD patients. Budesonide MMX was associated with significantly fewer corticosteroid-related AEs than oral systemic corticosteroids [odds ratio (OR): 0.25, 95% confidence interval (CI): 0.13-0.49] and beclomethasone (OR: 0.35, 95% CI: 0.13-1.00), but not significantly fewer AEs than budesonide (OR: 0.64, 95% CI: 0.37-1.11); it performed equally good with placebo. By contrast, the occurrence of serious AEs, and treatment discontinuations due to AEs, did not differ between the comparator treatments.
conclusionsBudesonide MMX is associated with fewer corticosteroid-related AEs than its comparator steroid treatments for adult IBD patients. Further high-quality research is warranted to illuminate the steroid drugs' comparative safety profiles.
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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.