S797 Direct and Indirect Effects of Tofacitinib on Work Productivity in Patients With Ulcerative Colitis: A Mediation Analysis Between Work Productivity and the Mayo Score
Notice bibliographique
Résumé
Introduction: Tofacitinib is an oral small molecule JAK inhibitor for the treatment of UC. Tofacitinib induction treatment has been shown to improve work productivity in patients (pts) with UC. However, it is unknown whether improvements in work productivity are fully explained by changes in the Mayo score or if other factors not captured by these changes contribute. Methods: We evaluated the interrelationship between Mayo score components (rectal bleeding [RB], stool frequency [SF], Mayo endoscopic subscore [MES], and Physician Global Assessment [PGA]) and Work Productivity and Activity Impairment-UC (WPAI-UC) components (overall work productivity loss and activity impairment) among pts in the Phase 3, 8-week induction studies that evaluated tofacitinib as induction therapy for UC (OCTAVE Induction 1&2; NCT01465763; NCT01458951). A mediation model used Mayo score components as mediators of the treatment effect on WPAI-UC components as outcomes. The MES was modelled as a predecessor of RB, SF, and PGA components as these are at least partially impacted by endoscopic inflammation. Work productivity loss and activity impairment can be viewed as complementary outcomes covering work and other daily activities, respectively. Analyses used all available pooled data from Week 8 in pts receiving tofacitinib/placebo. Results: There were 484 and 1,073 pts available for analysis in the models assessing work productivity loss and activity impairment, respectively. For the model evaluating work productivity loss, 100% of the impact of tofacitinib was mediated through Mayo score components, with the largest effect mediated by MES and PGA (46.8%; Figure a). For the model evaluating the effect of tofacitinib on activity impairment, 26.3% of the effect was mediated through factors not captured by the Mayo score, and 73.7% was mediated through Mayo score components; the largest effect was via MES and bowel-related symptoms, specifically SF (30.5%; Figure b). Conclusion: This analysis suggests the effects of tofacitinib on work productivity loss in pts with UC were fully mediated by Mayo score components, whereas the effects on activity impairment were only partially mediated by these. Bowel-related symptoms had the largest indirect effects in non-work environments. These findings provide important insights into the interrelationship between Mayo score components and WPAI-UC and may help inform healthcare providers on the impact of UC therapies on pts' work and leisure activities.Figure 1.: Summary of direct and indirect (mediated through Mayo score components) effects of tofacitinib vs placebo on the a) work productivity loss and b) activity impairment WPAI-UC components as a percentage of the total treatment effect. The WPAI-UC is a self-administered six-item questionnaire that generates four metrics: absenteeism (work time missed), presenteeism (impairment whilst working), productivity loss (overall work impairment from the combination of absenteeism and presenteeism), and activity impairment (non-work activity impairment). WPAI-UC component scores are expressed as percentages, with a higher percentage indicating greater impairment and less productivity. The Mayo score measures disease activity by assessing stool frequency, rectal bleeding, endoscopic appearance, and PGA. Total Mayo score ranges from 0 to 12 points (each subscore ranges from 0 to 3), with higher scores indicating more severe disease activity. MES, Mayo endoscopic subscore; PGA, Physician Global Assessment; WPAI-UC, Work Productivity and Activity Impairment-Ulcerative Colitis.
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 | 0,011 | 0,021 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,003 | 0,012 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,024 | 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 ».