Evidence map›Paper›PMID 38070932›Full record

SynthesisBMJ open2023

Use of external control arms in immune-mediated inflammatory diseases: a systematic review.

Alexa Zayadi, Robert Edge, Claire E Parker, John K Macdonald, Blue Neustifter, Joshua Chang, Guowei Zhong, Siddharth Singh, Brian G Feagan, Christopher Ma and 1 more

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.1field-weighted citation impact, top 20% 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

7 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
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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

11 authors at 3 institutions in 2 countries.

Alexa ZayadiAlimentiv Inc, London, Ontario, Canada.
Robert EdgeAlimentiv Inc, London, Ontario, Canada.
Claire E ParkerAlimentiv Inc, London, Ontario, Canada.
John K MacdonaldAlimentiv Inc, London, Ontario, Canada.
Blue NeustifterAlimentiv Inc, London, Ontario, Canada.
Joshua ChangAlimentiv Inc, London, Ontario, Canada.
Guowei ZhongAlimentiv Inc, London, Ontario, Canada.
Siddharth SinghDivision of Gastroenterology, University of California, San Diego, La Jolla, California, USA.
Brian G FeaganAlimentiv Inc, London, Ontario, Canada.
Christopher MaAlimentiv Inc, London, Ontario, Canada.
Vipul JairathAlimentiv Inc, London, Ontario, Canada vjairath@uwo.ca.ORCID 0000-0001-8603-898X
Western University · CAUniversity of Calgary · CAUniversity of California San Diego · US

Funding

Comparative effectiveness research in Hispanic patients with inflammatory bowel diseasesR01DK135937 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Siddharth Singh · 2024 to 2026
$1.9M
NIDDK NIH HHS R01 DK135937
6 · The paper itself

Abstract

objectivesExternal control arms (ECAs) provide useful comparisons in clinical trials when randomised control arms are limited or not feasible. We conducted a systematic review to summarise applications of ECAs in trials of immune-mediated inflammatory diseases (IMIDs).

designSystematic review with an appraisal of ECA source quality rated across five domains (data collection, study populations, outcome definitions, reliability and comprehensiveness of the dataset, and other potential limitations) as high, low or unclear quality. DATA SOURCES: Embase, Medline and Cochrane Central Register of Controlled Trial were searched through to 12 September 2023. ELIGIBILITY CRITERIA: Eligible studies were single-arm or randomised controlled trials (RCTs) of inflammatory bowel disease, pouchitis, rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and atopic dermatitis in which an ECA was used as the comparator. DATA EXTRACTION AND SYNTHESIS: Two authors independently screened the search results in duplicate. The characteristics of included studies, external data source(s), outcomes and statistical methods were recorded, and the quality of the ECA data source was assessed by two independent authors.

resultsForty-three studies met the inclusion criteria (inflammatory bowel disease: 16, pouchitis: 1, rheumatoid arthritis: 12, juvenile idiopathic arthritis: 1, ankylosing spondylitis: 5, psoriasis: 3, multiple indications: 4). The majority of these trials were single-arm (33/43) and enrolled adult patients (34/43). All included studies used a historical control rather than a contemporaneous ECA. In RCTs, ECAs were most often derived from the placebo arm of another RCT (6/10). In single-arm trials, historical case series were the most common ECA source (19/33). Most studies (31/43) did not employ a statistical approach to generate the ECA from historical data.

conclusionsStandardised ECA methodology and reporting conventions are lacking for IMIDs trials. The establishment of ECA reporting guidelines may enhance the rigour and transparency of future research.

Indexed as

Arthritis, RheumatoidInflammatory Bowel DiseasesPouchitisPsoriasisSpondylitis, AnkylosingAdultHumansImmunomodulating AgentsImmunomodulating Agentsclinical trialsgeneral medicine (see internal medicine)inflammatory bowel diseasepsoriasisrheumatology

Identifiers

PMID38070932
PMCPMC10729249
OpenAlexW4389504862

What OpenQuestion holds

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LicenceCC BY-NC
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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.