{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:12:16Z","timestamp":1785287536297,"version":"3.55.0"},"reference-count":61,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Numerous biologics and small molecules are licensed as maintenance therapy for ulcerative colitis (UC). Differences in the design of randomised controlled trials (RCTs) have not been considered when comparing efficacy between them.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine the relative efficacy of biologics and small molecules by network meta\u2010analysis according to trial design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched the literature to 27 February 2025 for RCTs. We judged efficacy using clinical remission, endoscopic improvement, endoscopic remission, or corticosteroid\u2010free remission and according to previous exposure or non\u2010exposure to advanced therapies. Random effects model with data reported as pooled relative risks (RR) with 95% confidence intervals (CI); drugs ranked by <jats:italic>p<\/jats:italic>\u2010score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 28 RCTs, 16 re\u2010randomising 6568 patients and 12 treating through 3771 patients. In re\u2010randomised studies, upadacitinib 30\u2009mg o.d. ranked first for clinical remission (RR of failure to achieve clinical remission\u2009=\u20090.52; 95% CI 0.44\u20130.61, <jats:italic>p<\/jats:italic>\u2010score 0.99) and endoscopic improvement (RR\u2009=\u20090.43; 95% CI 0.35\u20130.52, <jats:italic>p<\/jats:italic>\u2010score 0.99). Vedolizumab 300\u2009mg 4\u2010weekly ranked first for endoscopic remission (RR\u2009=\u20090.73; 95% CI 0.64\u20130.84, <jats:italic>p<\/jats:italic>\u2010score 0.92) and guselkumab 200\u2009mg 4\u2010weekly first for corticosteroid\u2010free remission (RR\u2009=\u20090.40; 95% CI 0.28\u20130.55, <jats:italic>p<\/jats:italic>\u2010score 0.95). In treat\u2010through studies, etrasimod 2\u2009mg o.d. ranked first for clinical remission (RR\u2009=\u20090.73; 95% CI 0.64\u20130.83, <jats:italic>p<\/jats:italic>\u2010score 0.88) and infliximab 10\u2009mg\/kg 8\u2010weekly first for endoscopic improvement (RR\u2009=\u20090.64; 95% CI 0.56\u20130.74, <jats:italic>p<\/jats:italic>\u2010score 0.94).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In network meta\u2010analysis, upadacitinib and etrasimod were consistently efficacious as maintenance therapy in UC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70209","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T10:09:58Z","timestamp":1747994998000},"page":"4-21","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Network Meta\u2010Analysis: Efficacy of Biological Therapies and Small Molecules as Maintenance Therapy in Ulcerative Colitis"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3164-8243","authenticated-orcid":false,"given":"Brigida","family":"Barberio","sequence":"first","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology (DISCOG), Gastroenterology Unit University of Padova\u2010Azienda Ospedaliera di Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Gracie","sequence":"additional","affiliation":[{"name":"Leeds Gastroenterology Institute St. James's University Hospital  Leeds UK"},{"name":"Leeds Institute of Medical Research St. James's, University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5449-3603","authenticated-orcid":false,"given":"Christopher J.","family":"Black","sequence":"additional","affiliation":[{"name":"Leeds Gastroenterology Institute St. James's University Hospital  Leeds UK"},{"name":"Leeds Institute of Medical Research St. James's, University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6371-4359","authenticated-orcid":false,"given":"Alexander C.","family":"Ford","sequence":"additional","affiliation":[{"name":"Leeds Gastroenterology Institute St. James's University Hospital  Leeds UK"},{"name":"Leeds Institute of Medical Research St. James's, University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32126-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2022.08.039"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-021-07200-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.03.028"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050516"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1215734"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1900750"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1513248"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1606910"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-023-02675-w"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1905725"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280207080643"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-024-03003-8"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.07.033"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.07.046"},{"key":"e_1_2_10_17_1","unstructured":"J. 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