{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:05:52Z","timestamp":1793066752664,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Extraintestinal manifestations (EIMs) occur commonly in patients with inflammatory bowel disease (IBD), affecting joints, skin, eyes and other organs, and contributing to morbidity and long\u2010term disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To synthesise evidence from systematic reviews (SRs) on the effectiveness and safety of medical treatments for IBD EIMs in IBD of joints, skin and eyes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this umbrella review, we searched three databases for relevant SRs published until May 30, 2024. Two independent reviewers performed screening, data extraction and quality appraisal (AMSTAR\u20102).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten, 12 and six SRs, respectively, provided data on medical therapies for articular, dermatological and ocular manifestations. Anti\u2010TNF therapy showed high response rates for axial (59.1%\u201361.8%) and peripheral arthritis (73.4%\u201381.2%). The lowest improvement was in patients treated with vedolizumab for joint manifestations. Ustekinumab was effective for arthralgia and psoriatic arthritis, but not for axial spondylarthritis. High heterogeneity of response was reported for anti\u2010TNF, vedolizumab, ustekinumab and tofacitinib (21%\u2013100%) depending on the dermatological manifestation. No SRs evaluated IL\u201023 p40 antagonists or other oral small molecules. The incidence of new ocular EIMs was 1% for vedolizumab and ustekinumab. Anti\u2010TNF agents were effective for most ocular EIM cases. Ustekinumab improved ocular symptoms in 55%\u201359%. Safety data were limited, with evidence certainty ranging from moderate to low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Evidence for medical therapies for joint, skin and eye EIMs in IBD is heterogeneous and of low quality. Further research is needed, including a multidisciplinary approach and novel and practical methods for endpoint evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70181","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T05:40:44Z","timestamp":1746596444000},"page":"1854-1871","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Effectiveness of Medical Therapies for Joint, Skin and Eye Extraintestinal Manifestations in IBD\u2014An Umbrella Review"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9554-4785","authenticated-orcid":false,"given":"Olga M.","family":"Nardone","sequence":"first","affiliation":[{"name":"Gastroenterology, Department of Public Health University Federico II of Naples  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3426-6408","authenticated-orcid":false,"given":"Nurulamin M.","family":"Noor","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Cambridge School of Clinical Medicine  Cambridge UK"},{"name":"Department of Gastroenterology Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniruddh","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Cambridge School of Clinical Medicine  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Cambridge School of Clinical Medicine  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirudh","family":"Krishnakumar","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Cambridge School of Clinical Medicine  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz","family":"Alajmi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4374-3042","authenticated-orcid":false,"given":"Yuhong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1092-0033","authenticated-orcid":false,"given":"Vipul","family":"Jairath","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Western University  London Ontario Canada"},{"name":"Department of Epidemiology and Biostatistics Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7171-0139","authenticated-orcid":false,"given":"Maria Manuela","family":"Estevinho","sequence":"additional","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 Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2935-6778","authenticated-orcid":false,"given":"Virginia","family":"Solitano","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Western University  London Ontario Canada"},{"name":"Division of Gastroenterology and Gastrointestinal Endoscopy IRCCS Ospedale San Raffaele, Universit\u00e0 Vita\u2010Salute San Raffaele  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.02.026"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16853"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.07.042"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.06.021"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640620958902"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izaa359"},{"key":"e_1_2_10_8_1","first-page":"235","article-title":"Extraintestinal Manifestations of Inflammatory Bowel Disease","volume":"7","author":"Levine J. 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