SynthesisGastroenterology2025
Comparative Efficacy of Advanced Therapies for Management of Moderate-to-Severe Crohn's Disease: 2025 AGA Evidence Synthesis.
Synthesis in Gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of Biological and Steroid Therapies in Adolescent and Adult Patients With Eosinophilic Esophagitis: A Systematic Review and Network Meta-Analysis With Meta-Regression.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Pooled it
- Comparative Risk of Serious Infections With Biologic Agents and Oral Small Molecules in Inflammatory Bowel Diseases: 2026 Update.Gastroenterology · 2026Article
- Bridging the gap between guidelines and practice: comparative effectiveness of ustekinumab and vedolizumab in Crohn's disease.Proceedings (Baylor University. Medical Center) · 2026Article
- Targeted Therapies in Inflammatory Bowel Disease: Mechanisms, Comparative Evidence, and Clinical Translation.Journal of clinical medicine · 2026Review
- Comparing the Efficacy of Advanced Interleukin Inhibitors for Crohn's Disease: A Systematic Review and Network Meta-Analysis.Journal of clinical medicine · 2026Review
- The impact of global recruitment and country income on placebo rates in inflammatory bowel disease clinical trials.Journal of Crohn's & colitis · 2026Article
- Real-world effectiveness of guselkumab for induction of remission in Crohn's disease: a prospective multicenter cohort study with propensity score-matched comparison to risankizumab.Crohn's & colitis 360 · 2026Article
- From Conventional Therapy to Precision Medicine in Inflammatory Bowel Disease: A State-of-the-Art Review.Biomedicines · 2026Review
- Interleukin-23p19 Inhibitors in Inflammatory Bowel Disease: From Current Insights to Future Directions.Journal of personalized medicine · 2026Review
- Optimizing Drug Positioning in IBD: Clinical Predictors, Biomarkers, and Practical Approaches to Personalized Therapy.Biomedicines · 2026Review
- ANGPT1-GABARAP axis modulates NLRP3 inflammasome-mediated pyroptosis in Crohn's disease.Frontiers in immunology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
BACKGROUND &
aimsWe performed an updated systematic review and network meta-analysis to inform the 2025 American Gastroenterological Association Clinical Guidelines on the management of moderate-to-severe Crohn's disease (CD).
methodsWe searched multiple electronic databases from inception through August 14, 2024, to identify randomized controlled trials in adults with moderate-to-severe CD, comparing advanced therapies (eg, tumor necrosis factor antagonists, vedolizumab, interleukin 12/23, or interleukin 23p19 antagonists, and/or Janus kinase inhibitors) with placebo or another active comparator. Our primary outcomes were induction and maintenance of clinical remission; analyses were stratified by biologic therapy exposure status. We performed a network meta-analysis using a frequentist approach and applied the Grading of Recommendations, Assessment, Development and Evaluation to appraise certainty of evidence.
resultsWe identified 28 trials of induction therapy and 22 trials of maintenance therapy of advanced therapies in patients with moderate-to-severe CD. In biologic-naïve patients, moderate-to-high certainty evidence supported the use of infliximab, adalimumab, vedolizumab, ustekinumab, risankizumab, mirikizumab, and guselkumab, and low certainty evidence supported the use of certolizumab pegol and upadacitinib over no treatment for inducing remission. Among active comparators, moderate-to-high certainty evidence supported the use of adalimumab and ustekinumab compared with certolizumab pegol and upadacitinib. Among patients with prior exposure to biologics, moderate-to-high certainty evidence supported the use of adalimumab, ustekinumab, risankizumab, guselkumab, and upadacitinib, and low certainty evidence supported the use of vedolizumab and mirikizumab, over no treatment, for inducing remission. Among active comparators, moderate certainty evidence supported the use of risankizumab and guselkumab compared with vedolizumab and ustekinumab.
conclusionsUsing Grading of Recommendations, Assessment, Development and Evaluation to appraise quality of evidence, this updated network meta-analysis can inform positioning of advanced therapies for the treatment of biologic-naïve and biologic-exposed patients with moderate-to-severe CD.
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Registered trials
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.