Evidence map›Paper›PMID 41206929›Full record

SynthesisJournal of Crohn's & colitis2025

Placebo rates in randomized clinical trials of ulcerative colitis: an individual patient data meta-analysis.

Virginia Solitano, Malcolm Hogan, Siddharth Singh, Silvio Danese, Laurent Peyrin-Biroulet, Sudheer Vuyyuru, John K Macdonald, Guangyong Zou, Yuhong Yuan, Bruce E Sands and 8 more

Erratum issuedAbstract readMeta-Analysis
In one paragraph

Synthesis in Journal of Crohn's & colitis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Virginia SolitanoDivision of Gastroenterology, Western University, London, Ontario N6A 3K7, Canada.ORCID 0000-0002-2935-6778
Malcolm HoganAlimentiv Inc, London, Ontario N6A 5B6, Canada.
Siddharth SinghDivision of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA 92037, United States.
Silvio DaneseDivision of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan 20132, Italy.ORCID 0000-0001-7341-1351
Laurent Peyrin-BirouletDepartment of Gastroenterology, Nancy University Hospital, Vandœuvre-lès-Nancy F-54500, France.
Sudheer VuyyuruDivision of Gastroenterology, Western University, London, Ontario N6A 3K7, Canada.
John K MacdonaldAlimentiv Inc, London, Ontario N6A 5B6, Canada.
Guangyong ZouAlimentiv Inc, London, Ontario N6A 5B6, Canada.
Yuhong YuanLawson Health Research Institute, London, Ontario N6A 4V2, Canada.ORCID 0000-0003-4374-3042
Bruce E SandsDr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
Remo PanaccioneDivision of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta T2N 4Z6, Canada.ORCID 0000-0002-5247-940X
Brian G FeaganDivision of Gastroenterology, Western University, London, Ontario N6A 3K7, Canada.
Juri HanzelAlimentiv Inc, London, Ontario N6A 5B6, Canada.ORCID 0000-0003-3158-8014
Rocio SedanoDivision of Gastroenterology, Western University, London, Ontario N6A 3K7, Canada.
Parambir DulaiDivision of Gastroenterology, Northwestern University, Chicago, IL 60611, United States.
Neeraj NarulaDepartment of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario L8S 4K1, Canada.ORCID 0000-0002-1536-8436
Christopher MaAlimentiv Inc, London, Ontario N6A 5B6, Canada.ORCID 0000-0002-4698-9948
Vipul JairathDivision of Gastroenterology, Western University, London, Ontario N6A 3K7, Canada.ORCID 0000-0002-1092-0033

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsWe assessed placebo rates and associated factors using individual patient data (IDP) from randomized clinical trials (RCTs) in ulcerative colitis (UC).

methodsWe conducted an IPD meta-analysis using Vivli and Yale University Open Data Access data-sharing platforms. Phase 2 and 3 RCTs of advanced biologics in adults with moderate-to-severe UC published since 2010 were included. Pooled placebo rates and 95% CIs were estimated using one- and two-stage meta-analytical approaches. Significant patient-level factors (P < .05) were identified using regression analyses. Primary outcomes were clinical response and remission.

resultsData were available for 1703 patients from nine studies. For induction trials, overall placebo response and remission rates were 33% (95% CI 29%-38%) and 9% (95% CI 7%-11%). Overall placebo response and remission rates in maintenance trials were 28% (95% CI 18%-41%) and 14% (95% CI 9%-20%). A lower body mass index reduced the odds of placebo response and remission, while higher baseline albumin levels and left-sided (compared to extensive) UC increased the odds of these outcomes. A 1-point increase in the Mayo Clinic Score (MCS) and adapted MCS was associated with a 26% and 27% reduction in odds of clinical remission. For induction trials, prior biologic exposure was associated with lower odds of response and remission. Multicenter trials have lower placebo effects than single-center trials.

conclusionsThese results enable future trials to incorporate design elements that reduce placebo rates as well as a precise benchmark for expected rates in clinical trials that do not include placebo.

Indexed as

Biological ProductsColitis, UlcerativeRandomized Controlled Trials as TopicHumansPlacebo EffectRemission InductionBiological Productsclinical trialsinflammatory bowel diseaseplaceboulcerative colitis

Identifiers

PMID41206929
PMCPMC12668678

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.