P054 Use of corticosteroids at time of diagnosis in ulcerative colitis is common and this practice remains unchanged over time
Notice bibliographique
Résumé
BACKGROUND: Corticosteroids (CS) have been the mainstay for treatment of moderate to severe ulcerative colitis for more than 60 years. Side effects and complications are increasingly recognized, and the aim in clinical practice is generally to minimize its use. The aims of this study were to describe whether the practice of administering CS as standard tapered courses at the time of diagnosis had changed during a 6-year period (2012–2017), and also to investigate if patients selected for this regimen overall had more severe and extensive disease. METHODS: In total, 203 patients, aged 16 years and above, were consecutively included at time of UC diagnosis in a single center cross sectional study conducted at Stavanger University Hospital, Norway, from 2012 to 2017. Demographic data, medication, CRP, albumin, fecal calprotectin and Partial Mayo Score (PMS) were recorded. In addition, disease distribution (Montreal Classification) and severity (Mayo Endoscopic Score, MES-UC) were assessed at index colonoscopy. A time trend analysis for yearly CS administration was performed using logistic regression, other variables were compared pairwise. RESULTS: Overall median (range) age was 34 (16–76) years, and 59% were males. Median CRP concentration was 5.5 mg/L (1–184), albumin 39.5 g/L (10.3–49.6) and fecal calprotectin 695 mg/kg (17–5,466), whereas median PMS was 5 (0–9). Proctitis (E1) was diagnosed in 27.7% of the patients, whereas 28.2% had left sided colitis (E2) and 44.6 % had pancolitis (E3). All patients received 5-ASA treatment (12.5% topical, 35% oral, and 52.5% combined). Antibiotic treatment was prescribed in 13.3 % of the patients, whereas 6.4% received a biological agent and 2% conventional immunosuppressive drugs. CS treatment rate at time of diagnosis was 41.9%, with no significant year-to-year variation, ranging from 30% to 50%, in the selected time period, P = 0.32. Patients treated with CS had higher median CRP (22 vs 2.9 mg/L, P < 0.001), fecal calprotectin (1,052 vs 575 mg/kg, P = 0.02) and PMS (6.5 vs 4, P < 0.001), and a lower albumin (36.0 vs 41.8 g/L, P < 0.001) than patients not receiving CS. CS-treated patients were also more likely to have pancolitis (E3) than left sided colitis (E2), P = 0.001, and more severe disease activity (MES-UC score 3 vs 2), P < 0.001. CONCLUSION(S): The practice of administering CS courses at time of diagnosis in UC remained high, with no significantly yearly variation in treatment rate during the selected 6-year period. Commencing CS courses was associated with higher disease activity and more extensive disease. This indicates that CS treatment still has an essential role in the treatment of severe UC disease.
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) | 0,000 | 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) | 0,003 | 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 ».