Evidence map›Paper›PMID 37589498›Full record

SynthesisAlimentary pharmacology & therapeutics2023

Systematic review with meta-analysis: Medical therapies for treatment of ulcerative proctitis.

Achuthan Aruljothy, Siddharth Singh, Neeraj Narula, Gordon W Moran, Sudheer K Vuyyuru, Malcolm Hogan, Alexa Zayadi, John K MacDonald, Benedicte Caron, Silvio Danese and 3 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Alimentary pharmacology & therapeutics, 2023. 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
4.7field-weighted citation impact, top 5% 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, 15 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. 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

13 authors at 7 institutions in 5 countries.

Achuthan AruljothyDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada.
Siddharth SinghDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA.ORCID 0000-0002-2640-7269
Neeraj NarulaDivision of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-1536-8436
Gordon W MoranNational Institute of Health Research Nottingham Biomedical Research Centre, University of Nottingham and Nottingham University Hospitals, Nottingham, UK.ORCID 0000-0002-8906-6908
Sudheer K VuyyuruDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada.
Malcolm HoganAlimentiv, Inc., London, Ontario, Canada.
Alexa ZayadiAlimentiv, Inc., London, Ontario, Canada.
John K MacDonaldAlimentiv, Inc., London, Ontario, Canada.
Benedicte CaronDepartment of Gastroenterology, University of Lorraine, CHRU-Nancy, Nancy, France.
Silvio DaneseGastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milan, Italy.ORCID 0000-0001-7341-1351
Laurent Peyrin BirouletDepartment of Gastroenterology, University of Lorraine, CHRU-Nancy, Nancy, France.ORCID 0000-0003-2536-6618
Christopher MaAlimentiv, Inc., London, Ontario, Canada.ORCID 0000-0002-4698-9948
Vipul JairathDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada.ORCID 0000-0002-1092-0033
Western University · CAInserm · FRIRCCS Ospedale San Raffaele · ITMcMaster University · CAUniversity of Calgary · CAUniversity of California San Diego · USUniversity of Nottingham · GB

Funding

San Diego Biomedical Informatics Education & Research (SABER)T15LM011271 · NLM · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SHAMIM NEMATI · 2012 to 2026
$9.7M
NLM NIH HHS T15 LM011271
6 · The paper itself

Abstract

backgroundUlcerative proctitis (UP) is a common highly symptomatic form of ulcerative colitis that can be difficult to treat.

aimTo assess the efficacy of medical treatments for UP.

methodsWe searched MEDLINE, EMBASE, and CENTRAL on 23 November 2022 for randomised controlled trials (RCTs) of medical therapy for adults with UP. Primary outcomes included induction and maintenance of clinical remission. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for each outcome.

resultsWe included 53 RCTs (n = 4096) including 46 induction studies (n = 3731) and seven maintenance studies (n = 365). First-line therapies included topical 5-aminosalicylic acid (5-ASA), conventional corticosteroids, budesonide, and oral 5-ASA. Therapy for refractory UP included topical tacrolimus and small molecules. Topical 5-ASA was superior to placebo for induction (RR 2.72, 95% CI 1.94-3.82) and maintenance of remission (RR 2.09, 95% CI 1.26-3.46). Topical corticosteroids were superior to placebo for induction of remission (RR 2.83, 95% CI 1.62-4.92). Topical budesonide was superior to placebo for induction of remission (RR 2.34, 95% CI 1.44-3.81). Combination therapy with topical 5-ASA and topical corticosteroids was superior to topical monotherapy with either agent. Topical tacrolimus was superior to placebo. Etrasimod was superior to placebo for induction (RR 4.71, 95% CI 1.2-18.49) and maintenance of remission (RR 2.08, 95% CI 1.31-3.32).

conclusionsTopical 5-ASA and corticosteroids are effective for active UP. Topical 5-ASA may be effective for maintenance of remission. Tacrolimus may be effective for induction of remission. Etrasimod may be effective for induction and for maintenance of remission. Trials should include UP to expand the evidence base for this under-represented population.

Indexed as

Colitis, UlcerativeProctitisAcetatesAdministration, OralAdultAnti-Inflammatory Agents, Non-SteroidalBudesonideHumansIndolesMesalamineRemission InductionTacrolimusAcetatesAnti-Inflammatory Agents, Non-SteroidalBudesonideetrasimodIndolesMesalamineTacrolimus

Identifiers

PMID37589498
PMCPMC11162959
OpenAlexW4385898583

What OpenQuestion holds

Textmetadata
LicenceTDM
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.