Evidence map›Paper›PMID 31118391›Full record

ArticleInternal medicine (Tokyo, Japan)2019

Azathioprine Is Useful for Maintaining Long-term Remission Induced by Tacrolimus for the Treatment of Ulcerative Colitis: An Inverse Probability of a Treatment Weighing Analysis.

Yu Nishida, Shuhei Hosomi, Hirokazu Yamagami, Naoko Sugita, Shigehiro Itani, Tomomi Yukawa, Koji Otani, Yasuaki Nagami, Fumio Tanaka, Koichi Taira and 5 more

Open access · diamondAbstract read
In one paragraph

Article in Internal medicine (Tokyo, Japan), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 38% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
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

15 authors at 2 institutions in 1 country.

Yu NishidaDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Shuhei HosomiDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Hirokazu YamagamiDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Naoko SugitaDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Shigehiro ItaniDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Tomomi YukawaDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Koji OtaniDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Yasuaki NagamiDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Fumio TanakaDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Koichi TairaDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Noriko KamataDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Kazuki KakimotoSecond Department of Internal Medicine, Osaka Medical College, Japan.
Tetsuya TanigawaDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Toshio WatanabeDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Yasuhiro FujiwaraDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Japan.
Osaka City University · JPOsaka Medical and Pharmaceutical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective The need for and efficacy of immunomodulators for maintaining remission after tacrolimus therapy have not been sufficiently defined. This study evaluated the efficacy of immunomodulators for maintaining remission in patients with ulcerative colitis after tacrolimus therapy. Methods Patients with active ulcerative colitis who started oral tacrolimus between January 2009 and September 2017 and were responsive were retrospectively evaluated. Long-term outcomes were compared using Cox proportional hazard regression with inverse probability of treatment weighting. Results Among the 63 patients in the study, 45 received immunomodulators. During the follow-up, 30 patients (47.6%) experienced a relapse. The relapse-free survival rate was significantly worse in the group that did not receive immunomodulators than in those that did (p=0.01, log-rank test); the 2-year relapse-free rates were 22.5% and 63.6% in the non-immunomodulator and immunomodulator groups, respectively. A multivariate analysis showed immunomodulator treatment to be an independent protective factor for clinical relapse (adjusted hazard ratio: 0.35, 95% confidence interval: 0.16-0.78, p=0.01). A Cox regression analysis using inverse probability of treatment weighting also showed that immunomodulator maintenance therapy was correlated with a longer relapse-free survival (hazard ratio: 0.31, 95% confidence interval: 0.15-0.64, p<0.01), A similar response was also observed in non-steroid-dependent patients (hazard ratio: 0.36, 95% confidence interval: 0.14-0.99, p=0.047). No serious adverse events occurred due to tacrolimus or immunomodulator, and immunomodulator use did not increase the incidence of adverse events caused by tacrolimus. Conclusion Our data suggest that the use of immunomodulators to maintain remission after tacrolimus therapy is beneficial for patients with ulcerative colitis.

Indexed as

Remission InductionAdultAzathioprineColitis, UlcerativeFemaleFollow-Up StudiesHumansImmunologic FactorsImmunosuppressive AgentsMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesTacrolimusTreatment OutcomeYoung AdultAzathioprineImmunologic FactorsImmunosuppressive AgentsTacrolimusimmunomodulatortacrolimusulcerative colitis

Identifiers

PMID31118391
PMCPMC6746627
OpenAlexW2945511519

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.