P0784 Independent association between baseline simple endoscopic score for Crohn’s disease and C-reactive protein with Crohn’s disease-related complications: An analysis of the Randomized Evaluation of an Algorithm for Crohn’s Treatment – Study 2 (REACT2)
Notice bibliographique
Résumé
Abstract Background Endoscopic improvement in the validated Simple Endoscopic Score for Crohn’s disease (SES-CD) is associated with better long-term outcomes in CD; however, a relationship with CD-related complications is not clear. Elevated biomarkers, such as C-reactive protein (CRP) also are associated with adverse long-term outcomes. We assessed the relationship between baseline (BL) SES-CD score, elevated CRP, and CD-related complications and identified the threshold for SES-CD score associated with an increased risk of complications. Methods Pooled data from REACT2 (NCT01698307) was analysed. SES-CD at BL was categorized as inactive disease (0–2), mild (3–6), moderate (7–16) and severe disease (>16). Elevated BL CRP was defined as >5mg/L. CD-related complications (ie, hospitalisation, surgery, medications-related, and non-surgical CD events) were assessed from BL through 24 months. Exposure-adjusted incidence (EAI) of CD-related complications was analysed as incidence rates. Adjusted analyses compared time to the first occurrence of CD-related complication, with Cox proportional hazard regression used to adjust for clustering effects and key patient characteristics. The BL SES-CD threshold that was associated with complications was determined using receiver operating curve (ROC) approach. Results Of 502 patients (pts) reporting BL SES-CD, 21.9% had inactive disease, 32.7% had mild disease and 45.4% had moderate-to-severe disease. A greater proportion of pts in the moderate-to-severe group (50.0%) had ≥1 CD-related complication vs those with inactive disease (32.0%; P=.0004). More pts with moderate-to-severe disease (20.6%) had CD-related hospitalizations vs those with inactive disease (5.8%; P=.0002). The EAI rate of CD-related complications was higher with moderate-to-severe vs inactive disease (0.4347 vs 0.2239; P=.0003). The adjusted risk of CD-related complications was higher in moderate-to-severe SES-CD vs inactive disease (HR=1.72; P=.0058). The ROC approach suggested SES-CD ≥7 was associated with CD-related complications. The proportion of pts with ≥1 CD-related complication was higher in those with elevated CRP at BL (48.6%) vs not (34.6%; P<.0001). Similar trends were observed for CD-related hospitalization. The adjusted risk of CD -related complications was higher among pts with elevated CRP vs not (HR=1.48; P=.0016); results were similar for CD-related hospitalizations (HR=1.75; P=.0013). Conclusion Elevated SES-CD and CRP are independently associated with a higher risk of complications in pts with CD. These findings point to the importance of controlling mucosal healing and inflammation to reduce risk of complications.
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 | 0,009 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,007 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 ».