SynthesisFrontiers in medicine2026
Stratified by baseline corticosteroid use: which advanced therapy works best for whom in ulcerative colitis?
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Corticosteroids (CS) are commonly used as bridging therapy in ulcerative colitis (UC), but whether baseline CS use modifies the subsequent efficacy of advanced therapies remains unclear. With differing mechanisms across drug classes, it is uncertain whether CS impact on outcomes is consistent or drug-class-dependent. Methods: We searched PubMed, Embase, Web of Science, and Cochrane Library for CS-stratified randomized controlled trials (RCTs) comparing active drugs with placebo in moderate-to-severe UC. After deduplication, studies were selected per predefined criteria. Bias risk was assessed with the Cochrane tool. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model; robustness was tested by leave-one-out sensitivity analyses. Results: Ten RCTs (7 publications, 6,286 patients) were included. Overall, CS-naïve patients showed significantly higher rates of endoscopic improvement (RR = 1.91, 95% CI: 1.33-2.74, Conclusions: Baseline CS status may influence the efficacy of advanced therapies in UC. IL-23 inhibitors appeared to benefit CS-naïve patients across multiple endpoints, whereas JAK inhibitors showed a numerical but nonsignificant advantage in CS-exposed patients. Short-term concomitant CS did not significantly increase adverse events, supporting the clinical acceptability of CS bridging in highly active disease. These findings support stratified reporting in future RCTs and call for prospective studies to validate these observations. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251248449, identifier, CRD420251248449.
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