Evidence map›Paper›PMID 32468382›Full record

SynthesisIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2020

Reversal of anti-drug antibodies against tumor necrosis factor inhibitors with addition of immunomodulators: A systematic review and meta-analysis.

Banreet Singh Dhindsa, Amaninder Dhaliwal, Harmeet Singh Mashiana, Syed Mohsin Saghir, Harlan Sayles, Mohamad Mubder, Gordon Ohning, Derrick Eichele

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 27% 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

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Editorial commentary on the Indian Journal of Gastroenterology March-April 2020 issue.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2020
    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

8 authors at 2 institutions in 1 country.

Banreet Singh DhindsaDepartment of Internal Medicine, University of Nevada Las Vegas School of Medicine, 1701 W Charleston Blvd Ste 230, Las Vegas, NV, 89102, USA.
Amaninder DhaliwalDivision of Gastroenterology and Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198-2000, USA.
Harmeet Singh MashianaDivision of Gastroenterology and Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198-2000, USA.
Syed Mohsin SaghirDepartment of Internal Medicine, University of Nevada Las Vegas School of Medicine, 1701 W Charleston Blvd Ste 230, Las Vegas, NV, 89102, USA.
Harlan SaylesDepartment of Biostatistics, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198-2000, USA.
Mohamad MubderDepartment of Internal Medicine, University of Nevada Las Vegas School of Medicine, 1701 W Charleston Blvd Ste 230, Las Vegas, NV, 89102, USA.
Gordon OhningDivision of Gastroenterology, University of Nevada Las Vegas School of Medicine, 1701 W Charleston Blvd Ste 230, Las Vegas, NV, 89102, USA.
Derrick EicheleDivision of Gastroenterology and Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, 68198-2000, USA. Derrick.eichele@unmc.edu.
University of Nebraska Medical Center · USUniversity of Nevada, Las Vegas · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe development of anti-drug antibodies (ADA) to tumor necrosis factor (TNF-α) inhibitors is a significant result contributing to the loss of clinical response in inflammatory bowel disease (IBD).

aimsWe performed a systematic review and meta-analysis to assess whether the addition of immunomodulators to TNF-α inhibitors lead to reversal of antibody formation in TNF-α inhibitor-treated IBD patients.

methodsWe conducted a comprehensive search of electronic databases from inception through October 2018 in order to identify specific studies describing clinical response in IBD patients following the addition of immunomodulators (methotrexate or thiopurines) to TNF-α inhibitors. Clinical response was expressed as an improvement of symptoms, with a noted decrease or complete elimination of ADA against TNF-α inhibitors. The meta-analysis was performed using the DerSimonian and Laird random-effect model.

resultsFour studies were included in our final meta-analysis, which reported outcomes in 72 patients receiving TNF-α inhibitors. Forty-nine of the seventy-two (68%) patients received either methotrexate (19) or thiopurines (30). The average follow up period was 13.5 months. The overall pooled clinical response was 73.86% (95% confidence interval [CI] = 47.36-94.38, I

conclusionIn our meta-analysis, addition of immunomodulators to TNF-α inhibitors was shown to restore the clinical response in 74% of the patients by either decreasing or completely eliminating anti-drug antibody levels. Further long-term multicenter studies are needed to validate these findings.

Indexed as

AntibodiesAntibody FormationImmunologic FactorsInflammatory Bowel DiseasesMercaptopurineMethotrexateTreatment OutcomeTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAntibodiesazathiopurineImmunologic FactorsMercaptopurineMethotrexateTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAnti-drug antibodiesImmunomodulatorsInflammatory bowel diseaseTNF-α inhibitors

Identifiers

PMID32468382
OpenAlexW2979745783

What OpenQuestion holds

Textmetadata
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.