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Supplementary material: Efficacy and safety of advanced therapies for moderately to severely active ulcerative colitis in induction and maintenance: systematic literature review and Bayesian network meta-analysis

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posted on 2025-03-17, 16:23 authored by Vipul Jairath, Tim Raine, Thomas P Leahy, Ravi Potluri, Karolina Wosik, David Gruben, Joseph C. Cappelleri, Peter Hur, Lauren Bartolome

These are peer-reviewed supplementary materials for the article 'Efficacy and safety of advanced therapies for moderately to severely active ulcerative colitis in induction and maintenance: systematic literature review and Bayesian network meta-analysis' published in the Journal of Comparative Effectiveness Research.

  • Supplementary material 1: Systematic literature review search strategies
  • Supplementary material 2: Clinical response and clinical remission outcome definitions
  • Supplementary material 3: Responder analysis
  • Supplementary material 4: Sensitivity and supportive analyses
  • Supplementary material 5: Prior distributions
  • Supplementary material 6: Characteristics of trials included in analyses
  • Supplementary material 7: Quality assessment of RCTs
  • Supplementary material 8: Additional results
  • Supplementary material 9: Additional network plots
  • Supplementary material: References

Aim: Several therapies have recently been licensed for the treatment of patients with moderately to severely active ulcerative colitis (UC). To provide comparative evidence of newly available treatments, Bayesian network meta-analyses were conducted to compare their relative efficacy and safety profiles in both the induction and maintenance phases. Materials & methods: A systematic literature review was conducted to identify the available literature on randomized controlled trials for advanced treatments (AT) of moderately to severely active UC. Bayesian network meta-analyses were used to synthesize evidence on prespecified efficacy and safety outcomes. Primary efficacy end points clinical response and clinical remission were measured at the end of induction and clinical response and clinical remission among induction phase responders were assessed at the end of the maintenance period. Efficacy outcomes were analyzed separately for AT-naive and -experienced populations. Safety outcomes included serious infections over the induction period, and serious infections among others over the maintenance period. Treat-through trial outcomes were adjusted to alignwith responder rerandomized trial outcomes. Results: The systematic review identified 58 relevant trials ofwhich 28 met criteria for inclusion in the main analysis networks. At the end of the induction period, all treatments were efficacious against placebo for both ATnaive and AT-experienced populations. Upadacitinib 45 mg demonstrated a higher likelihood of clinical response and remission compared with other treatments. Adalimumab had less favorable performance over the induction period. Among induction phase responders, most treatments demonstrated similar efficacy at the end of the maintenance period. Tofacitinib 10 mg was more likely to achieve clinical response and remission than several other treatments in the AT-naive population. In the AT-experienced population, upadacitinib 30 mg demonstrated a higher likelihood of clinical response and remission compared with other treatments. The safety outcomes among treatments were similar. Conclusion: This study provides an updated comparison of treatments for moderately to severely active UC. Most treatments demonstrated comparable efficacy at the end of maintenance. The findings from this study can inform decision making in treatment choice for patients with moderately to severely active UC.

Funding

This work was sponsored by Pfizer Inc.

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