P358 Efficacy of golimumab for the treatment of ulcerative colitis patients in clinical practice: a retrospective cohort study
Notice bibliographique
Résumé
Background: Golimumab is the third anti-TNF agent which received marketing authorization for the treatment of ulcerative colitis (UC) patients who are refractory to conventional therapies. To date, only few data are available regarding its efficacy in UC patients in clinical practice. The aim of our study was to evaluate the efficacy of golimumab for the treatment of UC patients in two tertiary French referral centers. Methods: This was a retrospective cohort study including all consecutive UC patients treated with golimumab for induction of clinical remission in two French tertiary referral centers from August 2014 to April 2016. Clinical response and clinical remission during the induction phase was defined according to physician judgment. Previous treatments, duration, optimization and withdrawal of golimumab were also collected. Results: Twenty-four UC patients (13 Female and 11 Male) were included in the study. Montreal classification in UC patients at the time of golimumab introduction was a proctitis in 4% (1/24) of the patients, a left-sided colitis in 38% (9/24) and a pancolitis in 58% (14/24). Median delay between UC diagnosis and golimumab introduction was 81.7 months (IQR 1–3: 45–158). Golimumab was started in 7 (29%) patients who were naïve from biotherapies, in 4 (17%) patients who already received another anti-TNF and in 13 (54%) who already received more the one anti-TNF. Golimumab was associated with a concomitant immunosuppressant in 25% (6/24) of the cases. Short-term clinical response was achieved in 60% (13/22) of the patients. Clinical remission evaluated after a median treatment duration of 5 months (IQR 1–3: 3–5.3) was achieved in 29% (7/24) of the patients. A secondary loss of response was observed in 28% (2/7) of the UC patients who achieved clinical remission. Among UC patients with primary non-response to golimumab, 4 (24%) patients had an optimization of golimumab therapy with a clinical efficacy in 25% of the cases (1/4). Cumulative probability of golimumab withdrawal free survival was 27.4% ± 9.9 at one year. In univariate analysis, there was no association between failure of golimumab (withdrawal and/or optimization) and previous exposure to anti-TNF or disease extent. However, there was a trend regarding the association between the concomitant use of an immunosuppressant and the maintenance of golimumab therapy without optimization (RR=0.4; CI 95%: 0.12–1.4, p=0.163). Conclusions: In our cohort, golimumab was maintained with clinical efficacy in about 30% of the UC patients at one year. Previous exposure to anti-TNF seems to have non influence on treatment efficacy. Use of concomitant immunosuppressant may increase the efficacy of golimumab in the treatment of UC in clinical practice.
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 | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
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 ».