P0728 Interventions for ocular extraintestinal manifestations in inflammatory bowel disease: an umbrella review of systematic reviews
Bibliographic record
Abstract
Abstract Background A significant proportion of patients with inflammatory bowel disease (IBD) develop extraintestinal manifestations (EIM). Ocular involvement occurs in an estimated 12–25% of ulcerative colitis cases and 25–50% of Crohn’s disease cases, making it the third most common EIM after rheumatological and dermatological manifestations. There is limited information on treatment options for ocular EIM. To address this gap, we reviewed all systematic reviews (SRs) evaluating drug interventions for ocular EIM. Methods We searched three databases (MEDLINE, Embase, and the Cochrane Database of Systematic Reviews) from inception to May 2024 to identify SRs addressing therapeutic interventions for ocular EIM. The exclusion criteria ruled out studies that were not systematic reviews, did not focus on patients with IBD, or were unrelated to ocular interventions. Screening, selection, and data extraction were performed independently by two authors, with a third author consulted when necessary. The quality of SRs was assessed using the AMSTAR-2 tool. Results Of 1,436 studies, six met the inclusion criteria. The ocular EIMs most commonly reported included uveitis, iritis, scleritis, and episcleritis. The number of studies reporting ocular EIM within each SR varied from two (Guillo, 2021) to 22 (Peyrin-Biroulet, 2017). Therapeutic interventions differed: two SRs evaluated vedolizumab (Zheng, 2024; Chateau, 2019), one focused on ustekinumab (Guillo, 2021), while the others assessed different advanced therapies. Quality assessment using AMSTAR-2 rated the reviews from high to low confidence, with most achieving moderate confidence due to some non-critical weaknesses. The incidence of new ocular EIM after treatment was 1% for both vedolizumab and ustekinumab in two SRs. For existing EIM, ocular symptoms improved in 55–59% of cases with ustekinumab (data from two SRs). However, there was no consistent evidence supporting vedolizumab for treating established ocular EIM. Anti-tumor necrosis factor (TNF) drugs were evaluated in two SRs, showing benefits for most patients with ocular manifestations without notable differences in the effectiveness among the different anti-TNF agents. No SRs focused on the risk of new ocular EIM after starting anti-TNF therapy. Conclusion Infliximab, adalimumab, certolizumab and ustekinumab appear effective for ocular EIM. There is no strong evidence that vedolizumab is effective for treating existing ocular EIM, though it may reduce the occurrence of new EIM. Further research with clear definitions and systematic assessments of ocular manifestations is needed. A multidisciplinary approach remains crucial. References Licona Vera E, Betancur Vasquez C, Peinado Acevedo JS, Rivera Bustamante T, Martinez Redondo JM. Ocular Manifestations of Inflammatory Bowel Disease. Cureus. 2023;15(6):e40299
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.090 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.011 | 0.008 |
| Bibliometrics | 0.023 | 0.023 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".