P0237 Opportunity for action in Spanish IBD patients with Sub-optimal Disease Control: Subanalysis of IBD-PODCAST Study
Notice bibliographique
Résumé
Abstract Background Timely, effective management of inflammatory bowel diseases (IBD) is crucial to achieve sustained clinical remission, and prevent bowel damage and disease progression and complications, as demonstrated by the PROFILE trial and reinforced by ECCO guidelines on therapeutics of Crohn’s disease (CD)1. Endoscopic activity and consecutive elevated fecal calprotectin values are predictive of worse IBD outcomes2,3. Methods The IBD-PODCAST was a non-interventional, cross-sectional, multicounty study, including 396 patients from 14 Spanish hospitals, recruited from February to June 20224. The objective was to determine the percentage of CD and ulcerative colitis (UC) patients with sub-optimal disease control (SDC) in a real-world setting, according to STRIDE-II criteria refined by experts. SDC in 53% of CD and 41% of UC Spanish patients was previously reported4. The aim of this analysis was to evaluate the proportion of these patients with sustained abnormal parameters, and the treatment pattern in patients with SDC. Results A total of 104 CD and 83 UC patients with SDC were analyzed. Data on sustained abnormal parameters over 12 months is summarized in Table 1. Among CD patients reporting abdominal pain, 23% experienced this symptom for a duration exceeding 12 months; and 7% of UC patients experiencing rectal bleeding reported this symptom over 12 months. Positively, sustained use of prednisolone at ≥10 mg/day was not reported for longer than 12 months. However, percentages of sustained abnormal parameters were higher for outcomes related to intermediate and long-term targets from STRIDE II. Fecal calprotectin remained above 250 μg/g for more than 12 months in 35% of CD and 26% of UC patients with elevated levels. Endoscopic findings were maintained over 12 months in 29% of CD patients and 18% of UC patients with any endoscopic finding. Additionally, clinicians reported sustained SDC for 18% of CD patients, and 30% UC patients among the overall group with clinician-reported SDC. Over 35% of IBD patients with self-assessed SDC reported this condition for longer than 12 months. Remarkably, more than 70% of patients with SDC were either naïve to targeted immunomodulators (TIMs) or were treated with them as first-line therapy (Figure 1), indicating scope for further management. Conclusion Although the cohort of Spanish patients with SDC had limited exposure to TIMs, up to one third of patients presented sustained abnormal parameters for over 12 months. These results highlight the opportunity for early intervention with effective treatment in IBD, considering the advancements in therapeutic options in the last three years. References 1.Gordon H, Minozzi S, Kopylov U, et al. ECCO Guidelines on Therapeutics in Crohn's Disease: Medical Treatment. J Crohns Colitis 2024: jjae091. 2.Kim KO. Endoscopic activity in inflammatory bowel disease: clinical significance and application in practice. Clin Endosc 2022;55(4):480-488. 3.Pathirana WPNGW, Paul Chubb SA, Gillet MJ, Vasikaran SD. Faecal calprotectin. Clin Biochem Rev 2018;39(3):77-90. 4.Vega P, Huguet JM, Gómez E, et al. IBD-PODCAST Spain: A Close Look at Current Daily Clinical Practice in IBD Management. Dig Dis Sci 2024;69(3):749-765.
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 | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| 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 ».