N023 Characterisation of IBD patients with multiple sclerosis at a large IBD unit
Notice bibliographique
Résumé
Targeting TNF-α is an important and effective therapeutic approach for patients with moderate-to-severe inflammatory bowel diseases (IBD). TNF-α antibodies have a favourable safety profile. However, known side effects of this treatment are for example allergic reactions and infections. Rare adverse events like central nervous system (CNS) demyelinating disorders (e.g. multiple sclerosis, optic neuritis) in association with TNF-α antibody (AB) therapy have been reported. In summary of this complex and important therapeutic area, we reviewed our patient collective of 1200 patients for known CNS diagnosis, e.g. multiple sclerosis (MS) independent of their IBD treatment. All patients were recruited from our IBD outpatient clinic seen between June 2006 and October 2017. Only patient with MS and IBD diagnosis were included. The data were retrospectively collected by chart review and patients were split into 2 groups (CNS diagnosis without any TNF-alpha antibody treatment= cohort 1; and CNS diagnosis developed during TNF-alpha AB treatment=cohort 2). Data were analysed for age, age at diagnosis, sex, IBD diagnosis, Montreal Classification (Behaviour (B), Location (L)) and IBD family history with Student t-test and chi-square test. Overall, 13 patients with CNS diagnosis were included in this study. Six IBD patients were diagnosed with MS (cohort 1) without TNF-alpha AB treatment. Seven IBD patients were diagnosed during TNF-alpha AB treatment with MS (cohort 2). IBD diagnosis in cohort 1 was Crohns disease (CD) in 83.3 %, Ulcerative colitis (UC) in 16.7 %; and cohort 2 was CD in 57.1 % and UC in 42.9 %. Patients of cohort 2 were diagnosed significant early with IBD (p = 0.01; 16–53 years; SD 9.7 years) compared with cohort 1 (34–53 years; SD 7.3 years). The time between first Anti-TNF AB application and MS diagnosis differs about 12–109 months in cohort 2. Patients of this cohort reported more extraintestinal manifestations like arthralgia (p = 0.16; 85.7% vs. 50.0%) before MS diagnosis. Disease Behaviour (Montreal Classification) of cohort 2 patients was more severe (p = 0.19; B3 60.0%, B1 20.0%, B1p 20.0%) compared with cohort 1 (B2 40.0 %, B1 60.0%). In cohort 1 more patient had a family history of IBD than in cohort 2 (p = 0.20; 60.0% vs. 20.0%). Despite the small sample size, in our cohort patients with MS developed during TNF-AB have a more severely IBD disease with a significant earlier onset of their symptoms including inflammation, structuring and penetrating complication and extraintestinal manifestations than MS patients without TNF-AB. In IBD patients unit neurological symptoms (like paresthesia, weakness at extremities) CNS disorders should be at one’s mind, especially in TNF-α AB-treated patients.
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 | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 ».