{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:47:08Z","timestamp":1789480028764,"version":"build-2803163510"},"reference-count":59,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T00:00:00Z","timestamp":1728086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Histology has prognostic value in ulcerative colitis (UC). However, direct comparisons of histological endpoints are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To perform a network meta\u2010analysis (NMA) to compare histological endpoints with biologics and small molecules.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched four databases up until July 2024 for randomised controlled trials (RCTs) on advanced therapies for moderate\u2010to\u2010severe UC reporting histological endpoints. Outcomes included histological improvement or remission, and histo\u2010endoscopic improvement after induction or during maintenance. We used a random\u2010effects frequentist model and have reported outcomes as relative risk and 95% confidence interval. We estimated relative drug efficacy with the <jats:italic>P<\/jats:italic>\u2010score. We conducted subgroup analysis by trial phase and evaluated risk of bias and evidence certainty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 24 RCTs (15 therapies, 8874 patients). Nineteen provided data on induction and 10 on maintenance; outcome definitions were similar. Etrasimod 2 mg\/day ranked highest in achieving histologic improvement (<jats:italic>P<\/jats:italic>\u2010score 0.98) and remission (<jats:italic>P<\/jats:italic>\u2010score 0.90) following induction. Globally, guselkumab 200\u2013400\u2009mg ranked first for histo\u2010endoscopic improvement, while etrasimod 2\u2009mg\/day and upadacitinib 45\u2009mg\/day were superior in the subgroup analysis. During maintenance, upadacitinib 30\u2009mg\/day was superior in achieving histologic improvement and remission (<jats:italic>P<\/jats:italic>\u2010score 0.88 for both) and histo\u2010endoscopic improvement (<jats:italic>P<\/jats:italic>\u2010score 0.94). Etrasimod 2 mg\/day ranked second for histologic remission (<jats:italic>P<\/jats:italic>\u2010score 0.70) and histo\u2010endoscopic improvement (<jats:italic>P<\/jats:italic>\u2010score 0.73), while mirikizumab 200 mg\/month ranked second for histologic improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results support the ability of small molecules to achieve stringent endpoints in moderate\u2010to\u2010severe UC. Histological outcome data for biologics was sparser, particularly during maintenance. Head\u2010to\u2010head RCTs are imperative to better inform clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18315","type":"journal-article","created":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T07:20:12Z","timestamp":1728112812000},"page":"1276-1292","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Network Meta\u2010Analysis: Histologic and Histo\u2010Endoscopic Improvement and Remission With Advanced Therapy in Ulcerative Colitis"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7171-0139","authenticated-orcid":false,"given":"Maria\u00a0Manuela","family":"Estevinho","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Unidade Local de Sa\u00fade Gaia Espinho  Vila Nova de Gaia Portugal"},{"name":"Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine University of Porto  Porto 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