Evidence map›Paper›PMID 32514466›Full record

ArticleJGH open : an open access journal of gastroenterology and hepatology2020

Optimal use of biologics with endoscopic balloon dilatation for repeated intestinal strictures in Crohn's disease.

Akihito Uda, Hiroyo Kuwabara, Sayuri Shimizu, Ryuichi Iwakiri, Kiyohide Fushimi

Open access · goldAbstract read
In one paragraph

Article in JGH open : an open access journal of gastroenterology and hepatology, 2020. 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
0.5field-weighted citation impact, top 30% 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, 5 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

5 authors at 4 institutions in 1 country.

Akihito UdaDepartment of Health Policy and Informatics, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan.ORCID https://orcid.org/0000-0002-4880-1195
Hiroyo KuwabaraHealthcare Management Research Center Chiba University Hospital Chiba Japan.
Sayuri ShimizuResearch Department Institute for Health Economics and Policy Tokyo Japan.
Ryuichi IwakiriDepartment of Medicine Saga University Saga Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan.ORCID https://orcid.org/0000-0002-1894-0290
Tokyo Medical and Dental University · JPChiba University Hospital · JPInstitute for Health Economics and Policy · JPSaga University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimIntestinal strictures in Crohn's disease (CD) have a high rate of repeated surgery. As alternatives to surgery, endoscopic balloon dilatation (EBD), immunomodulators (IMs), and antitumor necrosis factor alpha (anti-TNFα) have been proposed. We aimed to assess the effectiveness of the combined therapy with anti-TNFα and EBD in preventing intestinal stricture recurrence and surgery in patients with CD.

methodsThis retrospective cohort study included patients from the nationwide administrative database in Japan who were hospitalized and underwent at least one EBD between 1 April 2010 and 31 March 2017. The effectiveness of anti-TNFα was evaluated by performing survival analysis for the primary outcome. We selected the inverse probability of treatment weighting method for adjustment of covariates. As an exploratory analysis, we evaluated the association of anti-TNFα initiation timing with intestinal stricture recurrence.

resultsThe anti-TNFα exposed group had a significantly lower risk of intestinal stricture recurrence than that of the anti-TNFα nonexposed group (hazard ratio = 0.38, 95% confidence interval 0.31-0.48,

conclusionThe combined therapy with anti-TNFα and EBD could have preventive effects for intestinal stricture recurrence and surgery in hospitalized patients with CD. In particular, anti-TNFα initiation may be recommended before or after EBD, not immediately after EBD. With respect to EBD, it is important to clarify the effectiveness of combination therapy with several new medication treatments, such as biologics.

Indexed as

antitumor necrosis factor alphaCrohn's diseaseimmunomodulatorintestinal stricturesobservational studysteroid

Identifiers

PMID32514466
PMCPMC7273704
OpenAlexW3013990295

What OpenQuestion holds

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LicenceCC BY
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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.