Evidence map›Paper›PMID 40071763›Full record

SynthesisThe American journal of gastroenterology2025

IL-23p19 Antagonists vs Ustekinumab for Treatment of Crohn's Disease: A Meta-Analysis of Randomized Controlled Trials.

Claudia Dziegielewski, Yuhong Yuan, Christopher Ma, Brigid S Boland, John T Chang, Gaurav Syal, Sudheer Kumar Vuyyuru, Laurent Peyrin-Biroulet, Vipul Jairath, Siddharth Singh

Abstract readMeta-AnalysisSystematic ReviewComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The American journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

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

  1. Guideline
  2. Review
  3. Practical guidelines on medical management of adults with moderate-to-severe inflammatory bowel disease.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026
    Article
  4. Article
  5. Review
  6. Review
  7. 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

10 authors.

Claudia DziegielewskiDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA.ORCID 0000-0002-7309-1316
Yuhong YuanDivision of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.ORCID 0000-0003-4374-3042
Christopher MaDivision of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID 0000-0002-4698-9948
Brigid S BolandDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA.
John T ChangDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA.ORCID 0000-0003-0873-6218
Gaurav SyalDivision of Gastroenterology, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Sudheer Kumar VuyyuruDivision of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.ORCID 0000-0002-8281-3237
Laurent Peyrin-BirouletINFINY Institute, Department of Gastroenterology, CHRU Nancy, INSERM NGERE, Université de Lorraine, Vandœuvre-lès-Nancy, France.
Vipul JairathDivision of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.
Siddharth SinghDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA.

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
Predicting Short- and Long-term Risk of Serious Infections in Older Patients with Inflammatory Bowel DiseasesR03DK129631 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SINGH, SIDDHARTH · 2021 to 2022
$203k
CSRD VA I01 CX002396NIDDK NIH HHS R01 DK135937NIDDK NIH HHS R01DK13593701A1NIDDK NIH HHS R03 DK129631U.S. Department of Veterans Affairs I01CX002396
6 · The paper itself

Abstract

introductionWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing interleukin (IL)-23p19 antagonists with ustekinumab, stratified by prior biologic exposure, in patients with moderate-to-severe Crohn's disease (CD).

methodsThrough a systematic review through August 17, 2024, we identified phase 2 and 3 RCTs comparing IL-23p19 antagonists vs ustekinumab in adults with moderate-to-severe CD. The primary outcome was achieving clinical remission at ∼1 year, and secondary outcomes were achieving endoscopic remission and serious adverse events. We performed subgroup analyses based on prior exposure to biologic therapy, primarily tumor necrosis factor antagonists. Certainty of evidence was appraised using the Grading of Recommendations Assessment, Development, and Evaluation approach.

resultsWe included 5 head-to-head RCTs with a treat-through design (n = 2,506), of which 1 was conducted exclusively in patients with prior tumor necrosis factor antagonist exposure. On meta-analysis, patients treated with IL-23p19 inhibitors may be more likely to achieve clinical remission (relative risk [RR], 1.18 95% confidence interval [CI] 1.02-1.36) (low certainty of evidence) and endoscopic remission (RR 1.53, 95% CI 1.07-2.20) compared with ustekinumab. On subgroup analysis, IL-23p19 antagonists are probably more efficacious than ustekinumab in patients with prior biologic exposure (clinical remission: RR 1.31, 95% CI 1.16-1.48; endoscopic remission: RR 1.61, 95% CI 1.27-2.05) (moderate to high certainty), but not in biologic-naive patients (clinical remission: RR 0.99, 95% CI 0.90-1.08; endoscopic remission: RR 1.16, 95% CI 0.82-1.65). IL-23p19 antagonists may be associated with a lower risk of serious adverse events as compared with ustekinumab (RR 0.79, 95% CI 0.61-1.02). DISCUSSION: IL-23p19 antagonists are probably more efficacious and safer than ustekinumab in patients with moderate-to-severe CD in patients with prior biologic exposure, but not in biologic-naive patients.

Indexed as

Crohn DiseaseInterleukin-23 Subunit p19UstekinumabHumansRandomized Controlled Trials as TopicRemission InductionInterleukin-23 Subunit p19Ustekinumabcomparative efficacyguselkumabhead-to-head trialsinflammatory bowel diseaserisankizumab

Identifiers

PMID40071763
PMCPMC12353511

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.