ArticleTherapeutic advances in gastroenterology2026
Immunomodulators and advanced therapies for maintenance of remission in Crohn's disease: systematic review and network meta-analysis.
Article in Therapeutic advances in gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: With the range of options available for the treatment of Crohn's disease, therapy selection can be challenging in clinical practice. Comparative efficacy data are needed to clarify the relative position of the increasingly complex portfolio of advanced therapies and guide decision-making. Objectives: Our aim was to compare all advanced and immunomodulator treatments for efficacy and safety in maintenance of remission. Design: Systematic review and network meta-analysis. Data sources and methods: We searched databases up to June 2025. Our outcomes were clinical relapse, loss of response, endoscopic relapse, and safety outcomes. We estimated risk ratio (RR) and 95% confidence interval (CI). We used GRADE to assess certainty of results, and surface under the cumulative ranking curve for ranking treatments. Results: A total of 37 randomised controlled trials with 7415 participants were included. Interventions ranged between 22 weeks and 2 years. Adalimumab probably prevents clinical relapse over placebo (RR 0.68, 95% CI 0.54-0.84, Number Needed to Treat (NNT) = 2, moderate effect magnitude). CT-P13 (RR 0.52, 95% CI 0.38-0.71) and infliximab (RR 0.61, 95% CI 0.49-0.76) may prevent clinical relapse. Upadacitinib is more effective than placebo at preventing loss of clinical response (RR 0.64, 95% CI 0.57-0.72, NNT = 2, small magnitude), while CT-P13 (RR 0.46, 95% CI 0.35-0.53, NNT = 1, large magnitude), natalizumab (RR 0.54, 95% CI 0.43-0.68, NNT = 2, moderate magnitude), certolizumab (RR 0.57, 95% CI 0.47-0.7), NNT = 2, moderate magnitude), adalimumab (RR 0.68, 95% CI 0.61-0.75, NNT = 2, small effect magnitude) and ustekinumab (RR 0.73, 95% CI 0.61-0.86, NNT = 2, small magnitude) probably prevent loss of clinical response. Infliximab (RR 0.7, 95% CI 0.59-0.82) and vedolizumab (RR 0.82, 95% CI 0.68-0.99) may prevent loss of clinical response. Endoscopic relapse could not be analysed. Safety evidence is uncertain, but treatments appear generally safe in the short term. Conclusion: Adalimumab has moderate certainty for maintaining clinical remission with a moderate effect size. Novel therapies seem to have similar effect sizes, though imprecision due to limited evidence precludes further conclusions. Trial registration: https://knowledge.lancashire.ac.uk/id/eprint/53237/.
Indexed as
Identifiers
What OpenQuestion holds
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.