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Lumbar disc herniation (LDH) is a common spinal disease. In recent years, an increasing number of observational studies have reported the impact of inflammatory factors on LDH. By conducting Mendelian randomization (MR) analysis on 91 inflammatory factors, it is possible to reveal their causal relationship with LDH, providing new insights for prevention and treatment strategies. ⋯ Ultimately, only 1 cytokine, tumor necrosis factor-beta levels (genome-wide association study ID: GCST90274840), showed a significant association after the combined MR analysis and multiple corrections, with an odds ratio of 1.073 (95% confidence interval: 1.034-1.113, P = .0154). Furthermore, this positive cytokine did not display any reverse causality with LDH from either data source. Tumor necrosis factor-beta levels are a risk factor for LDH, potentially increasing the risk of developing the condition and exacerbating its symptoms.
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Several biologic therapies are available for the treatment of mild-to-moderate Crohn's disease (CD). This network meta-analysis (NMA) aimed to assess the comparative efficacy of ustekinumab, adalimumab, vedolizumab and infliximab in the maintenance of clinical response and remission after 1 year of treatment. ⋯ The NMA suggest that ustekinumab is associated with the highest likelihood of reaching response or remission at 1 year compared with placebo, adalimumab and vedolizumab. Results should be interpreted with caution because this is a novel methodology; however, the treatment sequence analysis may be the most methodologically sound analysis to derive estimates of comparative efficacy in CD in the absence of head-to-head evidence.