Evidence map›Paper›PMID 39863289›Full record

ArticleBMJ open gastroenterology2025

Monitoring for 5-aminosalicylate nephrotoxicity in adults with inflammatory bowel disease: prognostic model development and validation using data from the Clinical Practice Research Datalink.

Abhishek Abhishek, Georgina Nakafero, Tim Card, Maarten W Taal, Matthew J Grainge, Guruprasad P Aithal, Christian D Mallen, Matthew D Stevenson, Richard D Riley

Abstract readValidation Study
In one paragraph

Article in BMJ open gastroenterology, 2025. 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

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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. 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

9 authors.

Abhishek AbhishekAcademic Rheumatology, University of Nottingham, Nottingham, East Midlands, UK.
Georgina NakaferoAcademic Rheumatology, University of Nottingham, Nottingham, East Midlands, UK georgina.nakafero@nottingham.ac.uk.ORCID http://orcid.org/0000-0002-3859-7354
Tim CardLifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID http://orcid.org/0000-0003-2555-2250
Maarten W TaalCentre for Kidney Research and Innovation, Translational Medical Sciences, University of Nottingham, Nottingham, UK.
Matthew J GraingeLifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.
Guruprasad P AithalNottingham NIHR BRC, Nottingham, UK.
Christian D MallenPrimary Care Centre Versus Arthritis, Keele University, Keele, UK.
Matthew D StevensonSchool of Health and Related Research, University of Sheffield, Sheffield, UK.
Richard D RileyInstitute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo develop and validate a prognostic model for risk-stratified monitoring of 5-aminosalicylate nephrotoxicity.

methodsThis UK retrospective cohort study used data from the Clinical Practice Research Datalink Aurum and Gold for model development and validation respectively. It included adults newly diagnosed with inflammatory bowel disease and established on 5-aminosalicylic acid (5-ASA) treatment between 1 January 2007 and 31 December 2019. Drug discontinuation associated with 5-ASA nephrotoxicity defined as a prescription gap of ≥90 days with decline in kidney function was the outcome. Patients prescribed 5-ASAs for ≥6 months were followed-up for up to 5 years. Penalised Cox regression was used to develop the risk equation with bootstrapping for internal validation and optimism adjustment. Model performance was assessed in terms of calibration and discrimination.

results13 728 and 7318 participants who contributed 40 378 and 20 679 person-years follow-up formed the development and validation cohorts with 170 (1.2%) and 98 (1.3%) outcome events respectively. Nine predictors were included in the final model, including chronic kidney disease stage 3 and hazardous alcohol use as strong predictors. Age and Body Mass Index were weak predictors. The optimism-adjusted calibration slope, C and D statistics in the development and validation data were 0.90, 0.64 and 0.98, and 1.01, 0.66 and 0.94 respectively.

conclusionThis prognostic model used information from routine clinical care and performed well in an independent validation cohort. It can be used to risk-stratify blood test monitoring during established 5-ASA treatment. A key limitation is that the decline in kidney function could have been due to factors other than 5-ASA nephrotoxicity.

Indexed as

Anti-Inflammatory Agents, Non-SteroidalInflammatory Bowel DiseasesKidney DiseasesMesalamineAdultDatabases, FactualFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk AssessmentRisk FactorsUnited KingdomAnti-Inflammatory Agents, Non-SteroidalMesalamine5-AMINOSALICYLIC ACID (5-ASA)CROHN'S COLITISULCERATIVE COLITIS

Identifiers

PMID39863289
PMCPMC11784381

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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.