S2726 Five Crohn’s Disease Patients Treated With Vedolizumab for Pyoderma Gangrenosum
Pourquoi ce travail est dans la base
Une base qui oublie comment elle a trouvé un travail ne peut pas être vérifiée. Voici les voies qui ont admis celui-ci.
Notice bibliographique
Résumé
Introduction: Management of pyoderma gangrenosum (PG) is complex due to limited data from extensive studies to guide treatment options. Vedolizumab (VDZ) is a promising new biologic that has shown benefit in treating PG based on case reports. We performed a retrospective chart review to investigate the role of VDZ for the treatment of Ulcerative Colitis (UC) or Crohn’s Disease (CD) associated PG. Case Description/Methods: Using the McKesson billing database, we identified patients with UC or CD-associated PG treated with VDZ between January 1, 2016, and December 31, 2019, at Baystate Medical Center, a 715-bed teaching hospital in western Massachusetts. Sixty-two charts came up in the search and were reviewed manually. Five met our inclusion criteria, and a chart review of these patients’ clinical histories was performed with patient characteristics recorded in Table. Case #1 was a 38-year-old woman with colonic CD diagnosed at age 30, status post subtotal colectomy with end ileostomy, complicated by arthralgias and severe PG of her face, legs, and peristoma, who was followed for CD and recurrent PG. She was steroid dependent for nearly the entire duration of her disease, unable to wean below 20 mg daily prednisone without her PG flaring. Adalimumab, infliximab, sulfasalazine failed to control her PG. She was started on VDZ, and after her fourth induction dose, her PG lesions were in complete resolution / remission. After three months of maintenance infusions, she was tapered to 5 mg daily prednisone. Three years later, her PG remains in remission with VDZ (Figure). Case #5 was a 47-year-old man with colonic CD, diagnosed at age 30, complicated by anorectal stricture and fistulization, status post multiple seton placements and left hemicolectomy with Colo vesical fistula repair and a right transverse colostomy, who had peristomal PG that did not improve with adalimumab for eight months and mesalamine. He was started on VDZ, and at his four-month follow-up, he reported complete resolution of his peristomal PG. He has remained on VDZ therapy for the last five years with no recurrence of PG reported. Discussion: In conclusion, 2 out of 5 of our CD patients with PG responded favorably to VDZ. Our case series suggests that VDZ can be an effective treatment for refractory PG in CD patients; however, given the paucity of data, larger studies are needed.Figure 1.: Case 1’s peristomal pyoderma gangrenosum in remission after approximately one year of vedolizumab therapy. Table 1. - Patient characteristics Case #1 Case #2 Case #3 Case #4 Case #5 Age 38 65 33 44 47 Sex Female Male Female Female Male BMI 49.8 36.1 27.8 34.9 24.4 IBD type CD CD CD CD CD Montreal Classification A2 L2 B3 A2 L2 B2 A2 L2 B3p A2 L3 B3p A2 L2 B3p Duration of IBD 8 years Unknown 10 years 26 years 17 years Associated medical conditions Morbid obesity, obstructive sleep apnea, iron deficiency anemia, thyroid nodule Varicose veins Depression, hypertension, hyperilpidemia, psoriasis, irritable bowel syndrome Type 2 diabetes Insomnia, alcohol use Other extra intestinal manifestations Arthralgias None Arthralgias None None PG site(s) Face, peristomal, legs Peristomal Legs Breasts, perineum, labia Peristomal Failed biologic therapy Adalimumab, infliximab Adalimumab Infliximab, adalimumab, ustekinumab, certolizumab pegol Adalimumab, infliximab, certolizumab pegol Infliximab, adalimumab PG response to VDZ Improved Not improved Not improved Not improved Improved
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.
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| 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 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 découle