Table 11.
GRADE Evidence Profile comparing continuation of combination of biologic agent + immunomodulator therapy (thiopurines, methotrexate) vs. withdrawal of immunomodulators for preventing relapse in adult patients with quiescent CD on combination therapy with biologic and immunomodulators for >6 months.
| Outcomes | Study event rates (95% CI) | Relative effect (95% CI) | Absolute effect* | No of participants (studies) | Quality of the evidence (GRADE) | |
|---|---|---|---|---|---|---|
| Risk with continuing combination of biologic agent + immunomodulator therapy | Risk with withdrawal of immunomodulators | |||||
| Risk of relapse at 12m (CRITICAL) | 28/78 (35.9%) | 29/83 (34.9%) | RR 1.02 (0.71 to 1.46) | 7 more per 1,000 (from 101 fewer to 161 more) | 161 (3 RCT) | ⨁◯◯◯1,2 VERY LOW |
1
Rated down for risk of bias (unblinded studies)
2
Rated down for very serious risk of imprecision (due to very wide 95% CI, unable to exclude significant benefit or harm with continuing combination therapy