P0716 Comparison of vedolizumab and ustekinumab treatment persistence in anti-TNF experienced perianal Crohn’s Disease patients: A Single Center Experience
Notice bibliographique
Résumé
Abstract Background Perianal Crohn’s disease (CD) is a particularly challenging and debilitating complication of Crohn’s disease. This can lead to significant morbidity, including chronic pain, and recurrent infections, all of which severely impact a patient’s quality of life. Biologic therapies, particularly tumor necrosis factor (TNF) inhibitors, such as infliximab and adalimumab, have become central to the management of this condition due to their ability to target key inflammatory pathways driving both intestinal and extra-intestinal disease. In addition to Anti-TNF agents, other biologics such as integrin inhibitors (e.g., vedolizumab) and interleukin inhibitors (e.g., ustekinumab) have shown promise in treating refractory or complex perianal Crohn’s disease. In this study, we aimed to compare the persistence rates of vedolizumab and ustekinumab in anti-TNF experienced perianal Crohn’s disease patients. Methods This was a single center, retrospective cohort analysis of Anti-TNF treatment experienced Crohn’s disease patients either received vedolizumab or ustekinumab as a treatment. A total of 176 patients were included to this analysis. Demographic information such as gender, age, Montreal classification, smoking and prior medications were noted from patients electronic medical records. Weighted Kaplan-Meier and Cox models were used to assess the outcomes. Results Out of 176 Crohn’s disease patients, 128 patients had perianal Crohn’s disease. 41.5% of the patients were female, where as 33.7% of the patients had extraintestinal manifestations and 41.7% of the patients had fistulizing disease. EIM was less frequent in fistulizing disease (26% vs. 39.2%, p<0.05), concomitant azathioprine use was more frquent in fistulizing disease (58.9% vs. 34.3%, p<0.05) and fistulizing disease patients were predominantly male (67.3% vs 32.7%, p<0.05). Use of vedolizumab and ustekinumab did not different in fistulizing disease. In general cohort, the persistence rate was higher in ustekinumab treated group (Figure 1) where as in fistulizing disease group there was no statistically difference in persistence rate between two treatment arm (Figure 2). Conclusion To conclude, there is a shorter drug persistence rate in fistulizing Crohns disease when compared to non-fistulizing Crohn’s disease even with concomitant azathioprine use. While there was a longer drug persistence rate in the ustekinumab arm compared to the vedolizumab arm in the overall group, no significant difference was observed between both treatment arms in the fistulizing subgroup. Figure : 1 Figure 2:
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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 | 0,000 | 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) | 0,001 | 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 ».