P689 UK Asians are prescribed vedolizumab earlier in disease history than Caucasians, but respond equally well to therapy
Notice bibliographique
Résumé
The phenotype and natural history of IBD in British Asians differs from Caucasians. As such response to treatment may also differ. UK Asians with CD at Royal London Hospital are more likely to stop anti TNFs due to treatment failure.1 This study investigates whether British and Caucasian patients also have a difference in response to Vedolizumab. A single-centre retrospective cohort study of patients prescribed Vedolizumab was undertaken. Cases were identified from attendance records of infusion clinics 2015–2017. Data collected included: ethnicity, Montreal Classification, disease duration until therapy, persistence on therapy and indication for cessation. Patients with ethnicity other than Asian and Caucasian were excluded. After screening 82 patients were identified, 47.6% (n = 39)CD, 50% (n = 41) UC and 2.4% (n = 2) IBD-U. Ethnicity was as follows: Asian (40.2%, n = 33) and Caucasian (59.8%, n = 49). Asian patients were younger at first infusion of Vedolizumab; median (IQR)age was 30 years (24–37.5) for Asians and 34 years (25.75–55.5)for Caucasians (p = 0.0272). The duration to follow-up did not vary with ethnicity for CD or UC: CD Asian 375 days (294.3–675.3), CD Caucasian 389 days (183–564) (p = 0.6874), UC Asian 428.5 days (233.8–609.8), Caucasian 494.5 days (141–745.5 days) (p = 0.8227). Montreal classification including perianal involvement did not vary with ethnicity. 76.8% (n = 63) of patients prescribed Vedolizumab had previously been prescribed a TNF antagonist. Prior anti TNF use also did not vary with ethnicity (p = 0.434). Asians with CD are prescribed Vedolizumab over 5 years earlier in disease course, as measured as duration of disease until first infusion; Asian 8.31 years (6.5–12.5) vs Caucasian 14.0 years (8.3–21.4) (p = 0.016). However disease duration at first prescription did not vary with UC; Asian 9.5 years (4.7–14.1) vs. Caucasian 9.6 years (3.6–14.8) (p = 0.789). Disease duration until Vedolizumab 46.3% patients prescribed Vedolizmab stopped therapy due to intolerance or suboptimal response. Rates of therapy failure did not differ with ethnicity (Asian 51.52% vs. Caucasian 40.82% p = 0.3727). Median persistence on Vedolizumab did not vary with ethnicity (CD Asian 152 days vs. Caucasian 183 days, p = 0.6947, UC Asian 218 days vs. Caucasian 162 days, p = 0.2791). Vedolizumab is prescribed earlier in disease course in British Asians with CD in comparison with Caucasians. However, persistence on Vedolizumab until treatment failure and rates of treatment failure did not differ between groups. 1. Gadhok et al. ECCO 2017: anti-TNFs more frequently stopped due to loss of response in British Asians with Crohn’s disease: a single-centre retrospective analysis. 2017.
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 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| 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 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,003 |
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 ».