Evidence map›Paper›PMID 39732355›Full record

SynthesisClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2025

Differential Efficacy of Advanced Therapies in Inducing Remission in Ulcerative Colitis Based on Prior Exposure to TNF Antagonists.

Han Hee Lee, Virginia Solitano, Sujay Singh, Ashwin N Ananthakrishnan, Vipul Jairath, Gaurav Syal, Brigid S Boland, Pradipta Ghosh, John T Chang, Siddharth Singh

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 4 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

16 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Comparative Safety of Janus Kinase Inhibitors vs Tumor Necrosis Factor Antagonists in Patients With Inflammatory Bowel Diseases.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026
    Article
  8. Review
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  13. [The intestinal microbiota in inflammatory bowel diseases].Innere Medizin (Heidelberg, Germany) · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Han Hee LeeDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Gastroenterology, Department of Internal Medicine, Yeouido St. Mary's Hospital College of Medicine, Catholic University of Korea, Seoul, South Korea.
Virginia SolitanoDivision of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada; Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.
Sujay SinghCollege of Human Medicine, Michigan State University, East Lansing, Michigan.
Ashwin N AnanthakrishnanDivision of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Vipul JairathDivision of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
Gaurav SyalDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California.
Brigid S BolandDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California.
Pradipta GhoshDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, California.
John T ChangDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California.
Siddharth SinghDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California. Electronic address: sis040@ucsd.edu.

Funding

Macrophage Polarization in Response to Infections and InflammationR01AI155696 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GHOSH, PRADIPTA, SAHOO, DEBASHIS · 2020 to 2024
$4.9M
Comparative effectiveness research in Hispanic patients with inflammatory bowel diseasesR01DK135937 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Siddharth Singh · 2024 to 2026
$1.9M
Precision therapeutics of inflammatory bowel disease guided by Boolean logicUG3TR003355 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DAS, SOUMITA, GHOSH, PRADIPTA · 2020 to 2022
$937k
Precision therapeutics of inflammatory bowel disease guided by Boolean logicUH3TR003355 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GHOSH, PRADIPTA, SAHOO, DEBASHIS · 2023 to 2023
$356k
NCATS NIH HHS UG3 TR003355NCATS NIH HHS UH3 TR003355NCCDPHP CDC HHS U01 DP006745NIAID NIH HHS R01 AI155696NIDDK NIH HHS R01 DK135937
6 · The paper itself

Abstract

BACKGROUND &

aimsWe sought to ascertain how prior exposure to tumor necrosis factor (TNF) antagonists impacts treatment response with various classes of advanced therapies in patients with ulcerative colitis (UC), through a systematic review and meta-analysis.

methodsThrough a systematic review of multiple databases through June 30, 2024, we identified 17 randomized controlled trials in 8871 adults with moderate-severe UC who were treated with different advanced therapies vs placebo, and reported efficacy in induction of clinical remission, stratified by prior exposure to TNF antagonists. We calculated the ratio of odds ratio of achieving remission with active drug vs placebo, in TNF antagonist-naïve vs TNF antagonist-exposed patients. We grouped advanced therapies based on primary mechanism of action: lymphocyte trafficking inhibitors (anti-integrins and sphingosine-1 phosphate [S1P] receptor modulators), anti-interleukins (interleukin-12/23 antagonist and selective interleukin-23 antagonists) and Janus kinase inhibitors.

resultsLymphocyte trafficking inhibitors were more efficacious in TNF antagonist-naïve vs exposed patients (5 trials; odds ratio [OR], 1.88; 95% confidence interval [CI], 1.02-3.49), whereas JAK inhibitors were less efficacious in TNF antagonist-naïve vs exposed patients (6 trials; ratio of OR, 0.47; 95% CI, 0.22-1.01). No significant difference was observed in efficacy of selective interleukin-23 antagonists vs placebo in TNF antagonist-naïve vs exposed patients (6 trials; ratio of OR, 1.07; 95% CI, 0.64-1.80). There was minimal heterogeneity across analyses.

conclusionsThere is significant heterogeneity of treatment efficacy with different advanced therapies in inducing remission in patients with UC based on prior exposure to TNF antagonists, with plausible potentiation of JAK inhibitors and attenuation of lymphocyte trafficking inhibitors. Future studies on the mechanistic basis for these observations are warranted.

Indexed as

Colitis, UlcerativeTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAdultHumansRandomized Controlled Trials as TopicRemission InductionTreatment OutcomeTumor Necrosis Factor-alphaTumor Necrosis Factor Inhibitorsbiologicsinflammatory bowel diseasesinfliximabrisankizumabUpadacitinib

Identifiers

PMID39732355
PMCPMC12209402

What OpenQuestion holds

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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.