S1146 Inflammatory Bowel Disease (IBD)-Associated Peripheral Arthritis is Not Associated With Objective Markers of Luminal IBD Disease Activity - Results From the CHASE Cohort
Notice bibliographique
Résumé
Introduction: Inflammatory bowel disease (IBD)-associated peripheral spondyloarthritis (IBD-pSpA) is common but remains understudied. Although the type I vs type II classification, which categorizes patients based upon number and size of involved joints, is commonly accepted by gastroenterologists, this schema is neither widely accepted within the rheumatology literature nor prospectively validated. The aim of this study was to assess the association between clinical presentation of IBD-pSpA and IBD activity. Methods: We prospectively recruited patients with IBD-pSpA, defined by previously established consensus criteria (incorporating presence of swollen/tender joints on physical exam), from 6 sites across the United States. The relationship of clinical presentation of IBD-pSpA (number and type of involved peripheral joints as proposed by the type I vs type II classification schema) with objective markers of disease activity was assessed. Unadjusted univariate logistic regression analysis was performed to assess association between joint distribution and disease activity. R software was used. A significance level of 0.05 was assumed for all tests. Results: One hundred 6 patients (61% female, 70% Crohn’s disease (CD)) were included (see Table 1 for summary statistics). Within a month of enrollment, 24% had results available for fecal calprotectin and 53% for C-reactive protein (CRP). Within 3 months of enrollment, 18% had IBD-related imaging. The most recent endoscopy results were available in 96% of patients, with median time from endoscopy to enrollment 0.8 years (interquartile range 0.3-1.60). There was no statistically significant association between pattern of joint distribution and elevated fecal calprotectin ( >150 μg/g), active IBD on imaging, or active CD endoscopically. There was a statistically significant association between knee involvement and elevated CRP (odds ratio [OR], 4.3; 95% CI, 1.18–21.0; P =0.04) and active ulcerative colitis (UC) endoscopically (OR, 5.9; 95% CI, 1.16– 37.0; P =0.04). Conclusion: Contrary to the type I vs type II classification, in this prospective study, the pattern of joint involvement in IBD-pSpA was not associated with IBD activity. Knee involvement was associated with elevated CRP and endoscopic activity in patients with UC. Table 1. - Summary Descriptive Statistics Variable All Age at Enrollment, Median [25th 75th] 46.7 [31.8; 56.9] Sex, N (%) Male Female 65 (61.3) IBD Diagnosis, N (%) Ulcerative Colitis 31 (29.5) Crohn’s Disease 74 (70.5) Patient Report of Joint Pain, N (%) 105 (99.1) Patient report of Joint Stiffness, N (%) 82 (79.6) Number of Tender/Swollen Joints, N (%) < 5 joints 51 (49.5) >=5 joints 52 (50.5) Location of Joints Hand(s) 72 (67.9) Elbow(s) 21 (19.8) Shoulder(s) 27 (25.5) Hips(s) 29 (27.4) Knee(s) 56 (52.8) Ankles(s) 18 (17.0) Foot/Feet 27 (25.5) Current Medications, N (%) Prednisone 17 (16) Budesonide 1 (0.9) Balsalazide 1 (0.9) Mesalamine 6 (5.7) Sulfasalazine 8 (7.6) Azathioprine 5 (4.7) 6-Mercaptopurine 4 (3.8) Methotrexate (oral) 12 (11.3) Methotrexate (subcutaneous) 4 (3.77) Infliximab / Biosimilar 16 (15.1) Adalimumab / Biosimilar 8 (7.6) Golimumab 1 (0.9) Certolizumab 3 (2.8) Vedolizumab 22 (20.8) Ustekinumab 21 (19.8) Upadacitinib 7 (6.6) Risankizumab 6 (5.7) Objective Assessment of IBD Disease Activity Fecal calprotectin Total: 25 (24.3)Elevated 10 (40) CRP Total: 56 (53.3)Elevated: 16 (28.6) Imaging Total: 18 (18.2)Active: 11 (61.1) Endoscopy Total 101 (96.2), CD: 73 (73), UC: 27 (27)Active UC: 13 (48.1)Active CD: 32 (43.8) Caption: IBD = inflammatory bowel disease, CRP = C reactive protein.
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) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 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 ».