Evidence map›Paper›PMID 31755121›Full record

ArticleAlimentary pharmacology & therapeutics2020

Prevalence of endoscopic improvement and remission according to patient-reported outcomes in ulcerative colitis.

Parambir S Dulai, Siddharth Singh, Vipul Jairath, Christopher Ma, Neeraj Narula, Niels Vande Casteele, Laurent Peyrin-Biroulet, Severine Vermeire, Geert D'Haens, Brian G Feagan and 1 more

Erratum issuedOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 8% 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

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

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  4. Applying Biomarkers in Treat-to-target Approach for IBD.Current gastroenterology reports · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 5 countries.

Parambir S DulaiDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-9514-2321
Siddharth SinghDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-2640-7269
Vipul JairathDepartment of Medicine, University of Western Ontario, London, ON, Canada.
Christopher MaDivision of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada.ORCID 0000-0002-4698-9948
Neeraj NarulaDivision of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-1536-8436
Niels Vande CasteeleDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-2380-2124
Laurent Peyrin-BirouletNancy University Hospital, Nancy, France.ORCID 0000-0003-2536-6618
Severine VermeireDivision of Gastroenterology, University Hospitals Leuven, Leuven, Belgium.
Geert D'HaensDepartment of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Brian G FeaganDepartment of Medicine, University of Western Ontario, London, ON, Canada.ORCID 0000-0002-6914-3822
William J SandbornDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-3314-7960
University of California San Diego · USWestern University · CAAmsterdam UMC Location University of Amsterdam · NLCentre Hospitalier Régional et Universitaire de Nancy · FRKU Leuven · BEMcMaster University · CAUniversity of Calgary · CA

Funding

Comparative Risks and Benefits of Pharmacological Therapies for Older Patients with Inflammatory Bowel DiseasesK23DK117058 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SINGH, SIDDHARTH · 2018 to 2022
$971k
American College of Gastroenterology 144271American Gastroenterology AssociationCrohn's and Colitis Foundation 404614McMaster UniversityNIDDK NIH HHS K23 DK117058
6 · The paper itself

Abstract

backgroundTreatment targets for ulcerative colitis are evolving towards achievement of endoscopic improvement and remission in addition to symptom resolution. It remains to be accurately quantified what proportion of patients with symptom resolution have residual endoscopic activity that might warrant treatment modification.

aimTo quantify the prevalence of endoscopic improvement and remission amongst ulcerative colitis patients with various permutations of patient-reported outcomes.

methodsIndividual participant data from active intervention and placebo arms of clinical trials of infliximab, golimumab, vedolizumab and tofacitinib were pooled to estimate the prevalence of endoscopic improvement (Mayo endoscopic sub-score [MES] 0 or 1) and remission (MES 0) scores with various permutations of the rectal bleeding sub-score (RBS) and stool frequency sub-score (SFS) of the Mayo score, following induction (6-8 weeks) and maintenance (30-54 weeks) therapy. Subgroup analyses were performed by year of publication and centrally read endoscopy scoring.

resultsData from 2586 trial participants were analysed. Using locally scored endoscopy, the prevalence of endoscopic improvement and remission was highest among participants with a RBS 0 + SFS 0 post-induction (MES 0/1:81%, [95% CI 78-84]; MES 0:29% [26-33]) and during maintenance (MES 0/1:91% [87-93]; MES 0:57% [52-62]). Prevalence estimates were lower for more recently performed trials (P < .01). In comparison to locally scored endoscopy, when using central endoscopy scoring, the prevalence of endoscopic improvement and remission was lower post-induction (MES 0/1 57% [50-64], P < .001; MES 0 15% [11-21], P = .09) and during maintenance (MES 0/1 74% [67-81], P = .001; MES 0 31% [24-38], P = .001) for participants achieving a RBS 0 + SFS 0.

conclusionsApproximately 8 of 10 patients with normalisation of rectal bleeding and stool frequency have improvement in endoscopic disease activity, whereas approximately only half of these patients have endoscopic remission.

Indexed as

Patient Reported Outcome MeasuresAdultAgedAntibodies, Monoclonal, HumanizedClinical Trials as TopicCohort StudiesColitis, UlcerativeEndoscopy, GastrointestinalFemaleGastrointestinal AgentsGastrointestinal HemorrhageHumansInduction ChemotherapyInfliximabMaintenance ChemotherapyMaleAntibodies, Monoclonal, HumanizedGastrointestinal AgentsInfliximabPiperidinesPyrimidinesPyrrolestofacitinibvedolizumab

Identifiers

PMID31755121
PMCPMC6989392
OpenAlexW2989665281

What OpenQuestion holds

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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.