P-106 Evaluation of the Association Between Fecal Lactoferrin Status and Clinical, Serologic and Endoscopic Outcomes
Notice bibliographique
Résumé
In the SONIC trial, patients with Crohn's disease (CD) treated with infliximab (IFX) alone or in combination with azathioprine achieved higher rates of mucosal healing (MH) at wk 26 than patients treated with azathioprine alone. In a post-hoc analysis of SONIC, clinical symptoms as measured by the Crohn's Disease Activity Index (CDAI) were inaccurate to detect MH1. Recently, fecal biomarkers, such as lactoferrin (LF) and calprotectin, are being increasingly used in monitoring the activity of CD. This post-hoc analysis of SONIC reports on the association of fecal LF to clinical, serologic and endoscopic outcomes, and serum IFX levels in CD patients enrolled in centers in the United States who had evaluable measurements of LF, CDAI, serum CRP, and ileocolonoscopy both at baseline and wk 26, and evaluable serum IFX levels at wk 30. LF was measured by an ELISA assay and expressed as positive (pooled +2, +3, and +4 scores) or negative (pooled negative and +1 scores). MH was defined as absence of any ulceration. Corticosteroid-Free Clinical Remission (CFCR) was defined as clinical remission (CDAI <150) and no treatment with corticosteroids for >6 weeks. Post-hoc analyses were performed using the Fisher's exact test and the Kruskal-Wallis test where appropriate. Among the 109 patients (median age 43 yrs, 54% male), 33.9% were LF+ and 19.3% were LF- at both baseline and wk26; 36.7% patients changed from LF+ to LF- from baseline at wk 26 whereas 10.1% changed from LF- to LF+ (P < 0.0001). At baseline, LF was significantly associated with CDAI (P = 0.024) and serum CRP (P = 0.01) (Table 1); in addition, LF showed a trend of association with normal levels of CRP (65.6% versus 36.4% with CRP <0.8 mg/dL for LF—and LF+, respectively, P = 0.064, Table 1). At wk 26, there was no association between LF and CDAI (P = 0.09), serum CRP (P = 0.18), CRP normalization (0.512), CFCR (P = 0.245) (Table 1). The association between LF and MH (ulceration) was evaluated in 168 patients at baseline and 110 patients at wk 26 who had both LF and MH data at these measurement points. At baseline, ulcerations were not found in 43.1% (25/58) LF- patients versus 21.8% (24/110) LF+ patients (sensitivity 0.72, specificity 0.51, P = 0.004). In contrast, at wk26, 44.3% (27/61) of LF- patients versus 30.6% (15/49) LF+ patients had MH (sensitivity 0.50, specificity 0.64, P = 0.143). In this post-hoc analysis of the SONIC trial, LF was collected as a categorical variable. The association between LF and other clinical parameters may be better estimated if LF was on a continuous scale. Semi-quantitative LF does not seem to be a good biomarker in CD. Although it was useful to identify active clinical and biological disease at baseline, it could not confirm clinical, biological, or endoscopic remission at wk26. 1. L Peyrin-Biroulet, WJ Sandborn, et al. Clinical disease activity, C-reactive protein normalization and mucosal healing in Crohn's disease in the SONIC trial. Gut. 2013;63:88–95.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».