Systematic review with meta‐analysis: high prevalence and cost of continued aminosalicylate use in patients with ulcerative colitis escalated to immunosuppressive and biological therapies Article Swipe
Christopher Ma
,
Leonardo Guizzetti
,
Lauren E. Cipriano
,
Claire E. Parker
,
Tran M Nguyen
,
James C. Gregor
,
Nilesh Chande
,
Brian G. Feagan
,
Vipul Jairath
·
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1111/apt.15090
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1111/apt.15090
Summary Background Aminosalicylates are the most frequently prescribed treatment for ulcerative colitis (UC). In the absence of empirical evidence, clinicians are uncertain whether to continue aminosalicylates in patients with UC after escalating therapy. Aims To quantify concomitant aminosalicylate use in UC randomised clinical trials (RCTs), identify factors associated with their use, and estimate treatment costs of concomitant aminosalicylate therapy. Methods MEDLINE, Embase, and CENTRAL were searched from inception to 1 March 2017 for placebo‐controlled RCTs of immunosuppressants, biologics, or oral small molecules in adults with UC. The proportion of patients prescribed concomitant aminosalicylates at trial entry was pooled using a random‐effects model. Meta‐regression was performed to assess trial‐level factors associated with aminosalicylate use. Treatment costs were estimated using 2018 formulary data from five Canadian provinces. Results Thirty‐two trials were included (23 induction only, nine induction, and maintenance trials). The pooled proportion of patients co‐prescribed aminosalicylates was 80.7% (95% CI 75.5%‐85.1%), with considerable observed heterogeneity ( I 2 = 95%). In univariable meta‐regression, aminosalicylate use was not associated with trial design, setting, year of publication, disease severity, disease duration, or drug class. The estimated direct annual treatment cost of concomitant aminosalicylates is ~$20 million for the Canadian UC population, assuming conservative estimates of UC prevalence, aminosalicylate use and dose, and the lowest cost formulation. Conclusions Approximately 80% of UC patients entering clinical trials of immunosuppressants, biologics, or oral small molecules continue to use aminosalicylates. An RCT is needed to inform the benefits and harms of continuing vs stopping aminosalicylates in patients escalating therapy.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1111/apt.15090
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/apt.15090
- OA Status
- bronze
- Cited By
- 4
- References
- 75
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2906509712
All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W2906509712Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1111/apt.15090Digital Object Identifier
- Title
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Systematic review with meta‐analysis: high prevalence and cost of continued aminosalicylate use in patients with ulcerative colitis escalated to immunosuppressive and biological therapiesWork title
- Type
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reviewOpenAlex work type
- Language
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enPrimary language
- Publication year
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2018Year of publication
- Publication date
-
2018-12-19Full publication date if available
- Authors
-
Christopher Ma, Leonardo Guizzetti, Lauren E. Cipriano, Claire E. Parker, Tran M Nguyen, James C. Gregor, Nilesh Chande, Brian G. Feagan, Vipul JairathList of authors in order
- Landing page
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https://doi.org/10.1111/apt.15090Publisher landing page
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/apt.15090Direct link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/apt.15090Direct OA link when available
- Concepts
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Medicine, Concomitant, Internal medicine, Ulcerative colitis, Placebo, Population, Meta-analysis, Clinical trial, Randomized controlled trial, Disease, Alternative medicine, Environmental health, PathologyTop concepts (fields/topics) attached by OpenAlex
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4Total citation count in OpenAlex
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2024: 2, 2023: 1, 2020: 1Per-year citation counts (last 5 years)
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75Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.estimated | 116, 182 |
| abstract_inverted_index.estimates | 200 |
| abstract_inverted_index.evidence, | 18 |
| abstract_inverted_index.formulary | 119 |
| abstract_inverted_index.inception | 67 |
| abstract_inverted_index.induction | 131 |
| abstract_inverted_index.molecules | 81, 228 |
| abstract_inverted_index.performed | 104 |
| abstract_inverted_index.severity, | 175 |
| abstract_inverted_index.treatment | 8, 53, 185 |
| abstract_inverted_index.uncertain | 21 |
| abstract_inverted_index.Background | 1 |
| abstract_inverted_index.associated | 47, 109, 166 |
| abstract_inverted_index.biologics, | 77, 224 |
| abstract_inverted_index.clinicians | 19 |
| abstract_inverted_index.continuing | 244 |
| abstract_inverted_index.escalating | 31, 250 |
| abstract_inverted_index.frequently | 6 |
| abstract_inverted_index.induction, | 134 |
| abstract_inverted_index.prescribed | 7, 90 |
| abstract_inverted_index.proportion | 87, 140 |
| abstract_inverted_index.provinces. | 124 |
| abstract_inverted_index.randomised | 41 |
| abstract_inverted_index.ulcerative | 10 |
| abstract_inverted_index.Conclusions | 213 |
| abstract_inverted_index.concomitant | 36, 56, 91, 188 |
| abstract_inverted_index.maintenance | 136 |
| abstract_inverted_index.population, | 197 |
| abstract_inverted_index.prevalence, | 203 |
| abstract_inverted_index.univariable | 160 |
| abstract_inverted_index.Thirty‐two | 126 |
| abstract_inverted_index.conservative | 199 |
| abstract_inverted_index.considerable | 151 |
| abstract_inverted_index.formulation. | 212 |
| abstract_inverted_index.publication, | 173 |
| abstract_inverted_index.Approximately | 214 |
| abstract_inverted_index.heterogeneity | 153 |
| abstract_inverted_index.trial‐level | 107 |
| abstract_inverted_index.75.5%‐85.1%), | 149 |
| abstract_inverted_index.aminosalicylate | 37, 57, 111, 162, 204 |
| abstract_inverted_index.co‐prescribed | 143 |
| abstract_inverted_index.Aminosalicylates | 2 |
| abstract_inverted_index.aminosalicylates | 25, 92, 144, 189, 247 |
| abstract_inverted_index.random‐effects | 100 |
| abstract_inverted_index.Meta‐regression | 102 |
| abstract_inverted_index.aminosalicylates. | 232 |
| abstract_inverted_index.meta‐regression, | 161 |
| abstract_inverted_index.immunosuppressants, | 76, 223 |
| abstract_inverted_index.placebo‐controlled | 73 |
| cited_by_percentile_year.max | 96 |
| cited_by_percentile_year.min | 89 |
| corresponding_author_ids | https://openalex.org/A5034135548 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 9 |
| corresponding_institution_ids | https://openalex.org/I125749732, https://openalex.org/I4210105758 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.699999988079071 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.64532033 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |