C-Reactive Protein Levels in Moderate to Severe Crohnʼs Disease Patients Decreased Rapidly and Significantly During Adalimumab Therapy
Notice bibliographique
Résumé
Purpose: C-reactive protein (CRP) is a plasma protein involved in the acute phase of inflammatory response. In patients with Crohn's disease (CD), CRP level provides a useful biologic marker for monitoring disease progression and treatment efficacy. Methods: We examined the effect of adalimumab induction therapy on rapid reduction in CRP levels among patients with moderate to severe CD (Crohn's Disease Activity Index [CDAI] 220-450), as well as moderate CD (baseline CDAI <300) only. The study used data from CHARM, a Phase III trial in which all patients received adalimumab 80 mg at baseline (Week 0) and 40 mg at Week 2 before being randomized to placebo or continuing adalimumab treatment at Week 4. Within the intent-to-treat sample (N=778), analyses included patients who had a CRP value recorded at both baseline and Week 2; patients without a CRP measurement at Week 4 had their Week-2 value carried forward. Mean changes in CRP from baseline to Weeks 2 and 4 were evaluated for statistical significance using paired Student t-tests. McNemar's tests were used to assess changes in the proportion of patients with elevated CRP (>1 mg/dL) from baseline to Weeks 2 and 4. As a subgroup analysis, CRP outcomes were also evaluated among patients with moderate CD. Results: At baseline, CRP levels (mean±standard deviation) were 2.15±3.28 mg/dL among patients with moderate to severe CD (N=767) and 1.63±2.22 among patients with moderate CD (N=367). After adalimumab induction therapy, mean changes from baseline in CRP were statistically significant by Week 2 (-1.26±2.96) and Week 4 (-0.97±3.14) in the overall sample (both p<0.001). The proportion of patients with CRP >1 mg/dL decreased from 46.4% at baseline to 21.3% at Week 2 and 24.1% at Week 4 (both p<0.001 vs. baseline). In the subset of patients with moderate CD, CRP decreased by an average of -0.93±1.84 and -0.60±2.09 from baseline to Weeks 2 and 4, respectively (both p<0.001). Significantly fewer patients with moderate CD showed elevated CRP at Weeks 2 and 4 compared to baseline (15.5% and 20.7% vs. 41.4%; both p<0.001). Among patients with elevated CRP at baseline but not Week 4 (N=189), remission rate at Week 52 was 35.8% for the adalimumab arm eow+weekly vs. 9.1% for the placebo arm (p<0.001). Conclusion: Adalimumab was associated with rapid and statistically significant reductions in CRP within 4 weeks among patients with moderate to severe CD. Similar decreases in CRP were observed among patients with moderate CD. Disclosure: Dr. S Ghosh - Advisory Board: Abbott, Centocor, Merck, Pfizer, Shire; Honoraria for Lecturing in Educational Events: Abbott, Merck, Shire; Research Support: Abbott, Merck. Drs. EQ Wu & AG Bensimon - Employee: Analysis Group, under contract with Abbott. Drs. PM Mulani, M Yang, & J Chao - Employee and Stockholder: Abbott.
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 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 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 ».