P0731 Analysis of the short-term efficacy and risk factors of ustekinumab combined with surgical intervention in the management of perianal fistulizing Crohn's Disease: a single center real-world result
Notice bibliographique
Résumé
Abstract Background The aim of this study was to evaluate the short-term clinical efficacy and identify potential risk factors for Ustekinumab (UST) in conjunction with surgical intervention among patients diagnosed with perianal fistulizing Crohn's Disease (pfCD), utilizing MRI healing as the gold standard. Methods The study was conducted retrospectively from July 2021 to July 2024, including all patients diagnosed with pfCD who underwent surgical intervention combined with UST treatment and completed a 24-week follow-up. The clinical data of patients and perianal fistula characteristics, were collected. The primary efficacy evaluation indicator is the clinical healing rate and MRI healing rate after treatment. The secondary efficacy indicators included the CDAI, PDAI, CRP, ESR, and FC. Additionally, the SES-CD and Van Assche score were utilized, along with Wexner incontinent score, to evaluate effectiveness prior to treatment and at 24 weeks post-treatment. The independent risk factors induced MRI healing after treatment were determined through multivariate analysis using binary logistic regression analysis. Results A total of 66 patients were included in this study. According to the Montreal classification, group A1, A2 and A3 consisted of 3 patients (4.5%), 59 patients (89.4%), and 4 patients (6.1%) respectively. In terms of disease location, 26 patients (39.4%) were classified as L1, 9 patients (13.6%) as L2, and 31 patients (47.0%) as L3. Additionally, 50 patients (75.8%) presented with B1 while the remaining 16 patients (24.2%) had B2. Four patients (6.1%) presented with simple anal fistulas, while complex anal fistulas were observed in 62 cases (93.9%). At 24-week follow-up, the clinical healing rate was 95.5% (63/66) with an average healing time of 8.58 ± 4.27 weeks. The MRI healing rate demonstrated a significant outcome of 68.2% (45/66). Additionally, there was a notable reduction in patients' CDAI and PDAI scores, as well as CRP, ESR, FC concentrations, Van Assche scores, SES-CD and Wexner scores at 24-week compared to baseline levels (p < 0.001). The multivariate logistic regression analysis revealed that the presence of perianal abscess (OR = 0.05, 95%CI: 0.004~0.052, p = 0.014) and a high baseline Van Assche score (OR = 0.48, 95%CI: 0.252~0.901, p = 0.023) were identified as independent risk factors for MRI healing in patients with pfCD. Meanwhile, no instances of anal function problems were reported during the follow-up period. Conclusion The combination of UST and surgical intervention demonstrates favorable short-term clinical efficacy and safety in the management of patients with pfCD. Notably, the presence of perianal abscess and a high Van Assche score independently contribute to the risk of incomplete MRI healing.
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 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 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) | 0,002 | 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 ».