Table 7.
GRADE Evidence Profile comparing methotrexate vs. no methotrexate for achieving steroid-free remission, and preventing relapse in patients with steroid-dependent moderate to severe ulcerative colitis
|
Methotrexate COMPARED TO No Methotrexate FOR MODERATE TO SEVERE ULCERATIVE COLITIS | ||||||
|---|---|---|---|---|---|---|
| Outcomes | Study event rates (95% CI) | Relative effect (95% CI) | Absolute effect* | No of participants (studies) | Quality of the evidence (GRADE) | |
| Achieving clinical remission (CRITICAL) | 30/96 (31.3%) | 40/102 (39.2%) | RR 1.31 (0.89 to 1.94) | 97 more per 1,000 (from 34 fewer to 294 more) | 198 (3 RCTs) | ⨁◯◯◯1,2 VERY LOW |
| Relapse after achieving remission (CRITICAL) | 39/60 (65.0%) | 44/65 (67.7%) | RR 1.01 (0.79 to 1.29) | 7 more per 1,000 (from 136 fewer to 189 more) | 125 (3 RCTs) | ⨁◯◯◯1,2 VERY LOW |
|
GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1
Rated down for indirectness (different modes of administering MTX, majority of patients received corticosteroids for inducing remission)
2
Rated down for very serious imprecision with very wide CIs