Serum or Plasma Oncostatin M for Predicting Primary Non-Response to Tumor Necrosis Factor-α Antagonist Therapy in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of diagnostic accuracy studies
PubMed 42505684 · doi:10.3390/clinpract16070124
What was done
Systematic review and meta-analysis of four databases (PubMed, Embase, Cochrane Library, and Web of Science) through March 2026 evaluating baseline serum or plasma oncostatin M (OSM) for predicting endoscopic or clinical non-response to anti-TNF therapy in adult IBD patients. Diagnostic performance was evaluated using a bivariate random-effects model, and study risk of bias was assessed with QUADAS-2.
What was found
Four studies comprising 441 patients were pooled. The pooled sensitivity was 82.8% (95% CI 71.4-90.3%) and pooled specificity was 88.4% (95% CI 82.7-92.4%). The pooled diagnostic odds ratio was 36.7 (95% CI 15.7-85.8), with a positive likelihood ratio of 7.1 and negative likelihood ratio of 0.19. The pooled AUC was 0.899 (95% CI 0.858-0.940, I2 = 16.0%) in assay-stratified analysis and 0.820 overall. Cutoff thresholds across studies ranged from 14 to 233.6 pg/mL.
Why it matters
Elevated baseline circulating oncostatin M shows promise as a non-invasive biomarker to identify IBD patients who are unlikely to respond to anti-TNF therapy, which could help guide biologic selection.
Limits
The analysis is constrained by a small total sample size of four studies and 441 patients. Substantial variability in assay methods and cutoff thresholds (14 to 233.6 pg/mL) currently limits standardization and clinical generalizability.