Evidence map›Paper›PMID 39509741›Full record

SynthesisJournal of autoimmunity2024

Efficacy and safety of Advanced Combination Treatment in immune-mediated inflammatory disease: A systematic review and meta-analysis of randomized controlled trials.

Virginia Solitano, Yuhong Yuan, Siddharth Singh, Christopher Ma, Olga Maria Nardone, Gionata Fiorino, Maria Laura Acosta Felquer, Lillian Barra, Maria-Antonietta D'Agostino, Janet Pope and 3 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of autoimmunity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–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

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Advanced Combination Therapy in Inflammatory Bowel Disease: What Does the Future Hold?BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2026
    Review
  3. [Advanced Combination Therapy in Inflammatory Bowel Disease].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2026
    Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Review
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.

Virginia SolitanoDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada; Gastroenterology and Endoscopy, IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Milan, Italy.
Yuhong YuanDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada; Lawson Health Research Institute, London Health Science Center, London, Ontario, Canada.
Siddharth SinghDivision of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA.
Christopher MaDivision of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Olga Maria NardoneGastroenterology, Department of Public Health, University Federico II of Naples, Naples, Italy.
Gionata FiorinoGastroenterology and Endoscopy, IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; IBD Unit, Department of Gastroenterology & Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152, Rome, Italy.
Maria Laura Acosta FelquerRheumatology Unit, Internal Medical Services, Hospital Italiano de Buenos Aires, Argentina and Instituto Universitario, Peron 4190 (C1199ABB), CABA, Argentina.
Lillian BarraSchulich School of Medicine, University of Western Ontario, London, Ontario, Canada; Department of Medicine, Division of Rheumatology, Western University, London, ON, Canada.
Maria-Antonietta D'AgostinoDepartment of Rheumatology, Fondazione Policlinico Universitario A. Gemelli, IRCSS, Catholic University of Sacred Heart, Rome, Italy.
Janet PopeDepartment of Medicine, Division of Rheumatology, Western University, London, ON, Canada.
Laurent Peyrin-BirouletDepartment of Gastroenterology, Nancy University Hospital, F-54500, Vandœuvre-lès-Nancy, France; INFINY Institute, Nancy University Hospital, F-54500, Vandœuvre-lès-Nancy, France; Groupe Hospitalier Privé Ambroise Paré - Hartmann Paris IBD Center, 92200, Neuilly sur Seine, France.
Silvio DaneseGastroenterology and Endoscopy, IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Milan, Italy.
Vipul JairathDepartment of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada. Electronic address: vjairath@uwo.ca.

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

objectivesAdvanced combination treatment (ACT), defined as a combination of at least 2 biologic agents, a biologic agent and an oral small molecule, 2 oral small molecules drug with different mechanisms of action is a proposed strategy to improve outcomes in patients with immune-mediated inflammatory disease (IMID). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ACT with monotherapy in patients with select IMIDs.

methodsThrough a systematic literature search, we identified 10 RCTs (n = 1154) comparing ACT with single agent therapy (monotherapy). The primary outcome was induction of clinical remission. Secondary outcomes were adverse events, serious adverse events, infections, and serious infections. We performed random-effects meta-analysis and used GRADE to appraise certainty of evidence.

resultsEight out of 10 trials investigated an anti-TNF-α drug (e.g., etanercept, infliximab, golimumab, certolizumab) combined with another biologic (e.g anti-IL-23, anti-integrin, anti-IL-1) or an oral small molecule. There was no significant difference in the likelihood of achieving clinical remission with ACT vs. monotherapy in patients with rheumatoid arthritis (n = 7 RCTs) (RR, 1.75 [95 % CI 0.60-5.13]; moderate heterogeneity (I

conclusionsACT did not offer clinical benefit in patients with rheumatological IMIDs and resulted in higher rate adverse events in rheumatoid arthritis. ACT may offer clinical benefit without a clear safety signal in patients with IBD, but further trials are warranted. The variability in ACT regimens across studies limits the generalizability of these findings.

Indexed as

Drug Therapy, CombinationRandomized Controlled Trials as TopicBiological ProductsHumansInflammationTreatment OutcomeBiological ProductsCrohn's diseaseDesignDualRASLEUlcerative colitis

Identifiers

PMID39509741
PMCPMC12186700

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.