Efficacy of 5-aminosalicylic acid continuation versus discontinuation in patients with ulcerative colitis escalated to advanced therapy: a systematic review and meta-analysis of adjusted effect estimates
Bibliographic record
Abstract
BACKGROUND AND AIMS: The benefit of continuing 5-aminosalicylates (5-ASA) in patients with ulcerative colitis (UC) escalated to advanced therapies remains uncertain. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of 5-ASA continuation vs discontinuation in this population. METHODS: We systematically searched the PubMed, Embase, and Cochrane databases for studies comparing 5-ASA continuation vs discontinuation in adult patients with UC escalated to advanced therapies. Adjusted effect estimates were pooled using random-effects models. RESULTS: The meta-analysis comprised nine observational cohorts and two studies presenting post-hoc analyses from eight clinical trials. We included 11 487 patients, with 9105 assigned to 5-ASA continuation and 2382 to 5-ASA discontinuation. Compared to discontinuation, 5-ASA continuation was associated with decreased odds of achieving clinical remission (adjusted odds ratio [aOR] 0.72; 95% CI 0.52-0.99; I2 = 0%). There were no significant differences between groups for corticosteroid-free clinical remission (aOR 0.71; 95% CI 0.41-1.23; I2 = 0%), clinical response (aOR 0.94; 95% CI 0.69-1.28; I2 = 0%), endoscopic healing (OR 1.00; 95% CI 0.71-1.41; I2 = 54.6%), and biochemical remission (aOR 1.13; 95% CI 0.76-1.68; I2 = 31%). In time-to-event analyses, no significant differences were found between groups for UC-related hospitalization (adjusted hazard ratio [aHR] 0.99; 95% CI 0.86-1.13; I2 = 0%), UC-related surgery (aHR 1.02; 95% CI 0.80-1.29; I2 = 13%), new corticosteroid prescription (aHR 0.97; 95% CI 0.88-1.07; I2 = 0%), composite adverse events (aHR 0.96; 95% CI 0.87-1.06; I2 = 0%), and loss of response (aHR 0.92; 95% CI 0.75-1.12; P = .39; I2 = 61%). CONCLUSION: In patients with UC escalated to advanced therapies, 5-ASA continuation was associated with decreased odds of achieving clinical remission compared to discontinuation, with no significant differences observed for secondary efficacy or safety endpoints.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.020 | 0.038 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.025 | 0.052 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".