P592 Efficacy of vedolizumab for induction and maintenance of clinical remission in ulcerative colitis: The UCLH experience
Notice bibliographique
Résumé
Vedolizumab is an α4β7 integrin antagonist which blocks gut-specific leucocyte migration. It is indicated for induction and maintenance of remission in moderate to severe ulcerative colitis (UC) and Crohn’s disease.1 The aim of this study was to characterise the use and efficacy of vedolizumab in the induction and maintenance of remission in UC patients at University College London Hospital, a tertiary UK IBD centre. A retrospective review of all UC patients initiated on vedolizumab from October 2015 to November 2016 was completed. A 52-week follow-up was completed on all patients. Patient characteristics and clinical review data with SCCAI score were collected. Clinical response was defined as a reduction of SCCAI to <3 from baseline at Week 14, 30 and Week 52. Clinical remission was defined as SCCAI ≤2 or endoscopic evidence of quiescent disease. Forty-five UC patient records were examined; six patients were excluded due to incomplete data for Weeks 0–14 outcomes. Clinical review at 1 year of excluded patients showed five patients in clinical remission. Complete data were reviewed for 39 patients, 26 male, 13 female. Montreal classification identified 19 patients with pancolitis (E3), 14 with left sided disease (E2) and 6 with proctitis (E1). Average age at diagnosis was 26 and age at starting vedolizumab was 32 with average duration of disease 6.23 years. 43% had failed at least one previous tumour necrosis factor antagonist (anti-TNF). Concomitant immunomodulators were used in 69% of patients, 19 with a thiopurine analogue, and 8 using methotrexate. Average number of vedolizumab infusions to clinical response was 2.41. Average faecal calprotectin reduced from 2163 to 828. No difference was identified in number of infusions required to induce clinical remission between anti-TNF naive and exposed patients (2.5 vs. 2.18). 10 patients were primary non-responders at 14 weeks. Three patients required colectomy with one planned. Anti-TNF therapy was used in six patients of which only one patient has responded well. No difference was identified in average SCCAI scores at Week 0 between responders and primary non-responders. Clinical response at Week 14 predicted remission in all but five patients at Week 52 review. This real-world study demonstrates that vedolizumab is equally efficacious in anti-TNF therapy naive and exposed UC patients. Clinical response at 14 weeks predicts the likelihood of maintaining clinical remission at 52 weeks. Use of anti-TNF medication to induce remission in UC patients after failure of vedolizumab may not be of benefit. 1. Feagan B et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. New Eng J Med, 2013;369: 699–710, doi:10.1056/NEJMoa1215734.
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 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| 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) | 0,001 | 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 ».