ReviewGastro hep advances2026
Comparative Efficacy of all Available Pharmaceutical Therapies for Moderate to Severe Crohn's Disease: A Systematic Review and Network Meta-Analysis.
Review in Gastro hep advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 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
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The predictive value of machine learning for the response to anti-TNF-α therapy in patients with Crohn's disease: a systematic review and meta-analysis.Frontiers in immunology · 2026Pooled it
- Management of Pregnancy in Women with Inflammatory Bowel Disease: Positioning Janus Kinase Inhibitors Within Current Evidence.Current issues in molecular biology · 2026Review
- Network meta-analyses in IBD: pitfalls and promise for clinicians.Therapeutic advances in gastroenterology · 2026Review
- Cost-Utility Analysis of Treatment Sequences for Moderate-to-Severe Crohn's Disease.PharmacoEconomics · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: The therapeutic landscape for Crohn's disease (CD) has expanded, offering increased treatment possibilities, but with limited comparative evidence.This study compares efficacy and discontinuation rates of all pharmaceutical therapies in moderate-to-severe CD. Methods: We conducted a systematic review (until October 2023) and network meta-analyses (NMAs) of phase-III randomized controlled trials for induction and maintenance of clinical remission and drug discontinuation rates. Frequentist NMA results and surface under the cumulative ranking (SUCRA) rankings were reported for immunomodulator (IM)-naive, biologic-naive and -exposed patients. Confidence in results was evaluated using Confidence in Network Meta-Analysis. Results: The search resulted in 3017 references, of which 77 randomized controlled trials from 1990 and later were included in the NMA. Networks were sparse and therapies had overlapping confidence intervals. The smaller IM-naive network and the larger biologic-naive network produced highly comparable relative risks. In biologic-naive patients, adalimumab (high induction regimen) had the highest SUCRA ranking for induction of clinical remission, and infliximab/azathioprine combination therapy had the highest SUCRA ranking for maintenance of remission. Among IMs, methotrexate had the highest ranking for induction and azathioprine for maintenance of remission. In biologic-exposed patients, upadacitinib had the highest SUCRA ranking for induction and maintenance of clinical remission, although for maintenance this finding may be biased due to the trial designs. Adverse event related discontinuation was numerically highest for methotrexate, azathioprine and upadacitinib. Confidence rating was moderate, low, or very low for most comparisons. Conclusion: This NMA including IMs, biologics and small molecules, suggests that anti-tumor necrosis factor (combination) therapy is most efficacious in biologic-naive patients and upadacitinib in biologic-exposed patients. Differences in relative risks were small and confidence intervals overlapping. Findings show that conventional therapies remain important in the treatment algorithm for CD patients.
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