Evidence map›Paper›PMID 38719549›Full record

ArticleBMJ open gastroenterology2024

Effects of prednisolone tapering on effectiveness of infliximab in patients with ulcerative colitis: data from a retrospective cohort.

Pernille Dige Ovesen, Mohamed Attauabi, Johan F K F Ilvemark, Mads Damsgaard Wewer, David J Warren, Johan Burisch, Rolf A Klaasen, Nils Bolstad, Casper Steenholdt, Jakob Benedict Seidelin

Abstract read
In one paragraph

Article in BMJ open gastroenterology, 2024. 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
–field-weighted citation impact
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.

  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

10 authors.

Pernille Dige OvesenDepartment of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Herlev Hospital, Copenhagen, Denmark.
Mohamed AttauabiDepartment of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Herlev Hospital, Copenhagen, Denmark.
Johan F K F IlvemarkDepartment of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Herlev Hospital, Copenhagen, Denmark.
Mads Damsgaard WewerGastrounit, Hvidovre Hospital Gastro Unit, Hvidovre, Denmark.
David J WarrenDepartment of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
Johan BurischGastrounit, Hvidovre Hospital Gastro Unit, Hvidovre, Denmark.
Rolf A KlaasenDepartment of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
Nils BolstadDepartment of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
Casper SteenholdtDepartment of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Herlev Hospital, Copenhagen, Denmark.
Jakob Benedict SeidelinDepartment of Gastroenterology and Hepatology, Copenhagen University Hospital-Herlev and Gentofte, Herlev Hospital, Copenhagen, Denmark Jakob.Benedict.Seidelin@regionh.dk.ORCID http://orcid.org/0000-0003-3230-7966

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveThe influence of concomitant prednisolone on clinical outcomes and safety in infliximab-treated ulcerative colitis (UC) patients is unknown. DESIGN, SETTING, PARTICIPANTS AND OUTCOME MEASURES: A retrospective cohort study was performed, including 147 UC patients treated with infliximab at a tertiary inflammatory bowel disease (IBD) centre. Primary outcome was corticosteroid-free clinical remission (CFCR) at week 14 and week 52. Patients were grouped according to prednisolone tapering regimens: standard (≤5 mg/week), fast (>5 mg/week), direct discontinuation or no prednisolone. Patients intolerant to corticosteroids and patients stopping corticosteroids in preparation for surgery including colectomy during their initial admission were excluded.

resultsThere was no overall association between prednisolone exposure or no exposure and CFCR at weeks 14 or 52 of infliximab. The proportion of patients with C reactive protein ≤5 mg/L was higher in the standard tapering at week 14 as compared with faster regimens or no prednisolone. In subgroup analyses, the standard tapering was associated with a higher rate of CFCR at week 14 compared with the fast-tapering regimen in patients receiving ≥40 mg prednisolone at initiation of infliximab (64.3% vs 26.3%, p=0.04) and among patients admitted with acute severe UC (66.6% vs 23.5%, p<0.05). Similar data were seen at week 52. Prednisolone did not affect infliximab trough levels but increased infection rates (10/77 vs 2/70, p=0.03), in particular

conclusionIn UC patients with limited disease burden, prednisolone did not affect effectiveness of infliximab. However, patients with increased disease burden seem to benefit from corticosteroid combination therapy.

Indexed as

Colitis, UlcerativeGastrointestinal AgentsInfliximabPrednisoloneRemission InductionAdultAnti-Inflammatory AgentsC-Reactive ProteinDrug TaperingDrug Therapy, CombinationFemaleGlucocorticoidsHumansMaleMiddle AgedRetrospective StudiesAnti-Inflammatory AgentsC-Reactive ProteinGastrointestinal AgentsGlucocorticoidsInfliximabPrednisoloneINFLAMMATORY BOWEL DISEASEINFLIXIMABULCERATIVE COLITIS

Identifiers

PMID38719549
PMCPMC11085681

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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.