A133 EFFECTIVENESS AND SAFETY OF VEDOLIZUMAB INDUCTION THERAPY IN PATIENTS WITH ULCERATIVE COLITIS: REAL-WORLD EXPERIENCE IN A TERTIARY IBD CENTRE
Notice bibliographique
Résumé
Vedolizumab (VDZ) is a humanized monoclonal IgG1 antibody which inhibits leukocyte vascular adhesion and migration into the gastrointestinal tract through α4β7 integrin blockade. This agent became available in Canada in mid-2015 for the treatment of moderate to severe ulcerative colitis (UC). To investigate the real-world efficacy and safety of vedolizumab (VDZ) as induction therapy in UC patients at a tertiary IBD centre and to examine predictors of remission. Demographic and clinical data for UC patients treated with 300mg VDZ infusions at weeks 0, 2, 6 and 14 was gathered retrospectively. Clinical remission (CR, partial Mayo score≤2) and steroid-free clinical remission (SFCR) after the first 3 infusions (induction phase) between weeks 8–12 were the primary endpoints. Secondary endpoints were CR and SFCR after 4 infusions (1st maintenance infusion) between weeks 16–20. Adverse events were also recorded. Data from 68 UC patients (63% male, median age 33 years, median disease duration 6 years, median pMayo 7) were analyzed. Anti-TNF naive were 31% and 69% had pancolitis. At the time of first infusion, 49% were on systemic steroids and 20% on an immunomodulator, while 44% patients were started on VDZ monotherapy. Median partial Mayo scores and median CRP levels improved significantly after 3 and 4 VDZ infusions compared to baseline (p<0.05). After 3 infusions (n=68), 37% and 31% of the patients achieved CR and SFCR respectively. After 4 infusions (n=53), 36% and 32% of the patients were in CR and SFCR respectively. Seventy percent of the non-responders after the 3rd infusion remained non-responders after the 4th infusion. Baseline characteristics including disease duration less than 5 years, no prior anti-TNF exposure, immunomodulator concurrent treatment, mild disease (p=0.025) and CRP less than 5mg/L (p=0.004) were associated with clinical remission after the first 3 infusions. Clinical remission after 3 VDZ infusions was significantly associated with sustained clinical remission after 4 infusions (p<0.001). Overall, 12% discontinued VDZ due to no response and 7% underwent elective proctocolectomy. There were no infusion reactions or serious side effects. The most common side effect was headache (7%). VDZ is an effective, safe and well tolerated treatment option in refractory UC patients. Clinical remission and steroid-free clinical remission can be achieved in 1/3 of the patients after the induction phase. This real life series in a tertiary care centre demonstrates similar efficacy results as the other real-world clinical studies. Assessment of VDZ response after the 3rd infusion could be critical to determine treatment benefits and decide further management. Baseline characteristics and vedolizumab treatment outcomes in UC patients None
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 | 0,004 |
| 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 | 0,000 |
| 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 ».