INFLIXIMAB AND BONE MINERAL DENSITY IN PEDIATRIC CROHN'S DISEASE
Bibliographic record
Abstract
Introduction: Diminished bone mineral density (BMD) is a recognized complication of Crohn's disease (CD), and has received increasing attention in the past few years. Infliximab (anti-tumor necrosis factor α) treatment is associated with improved bone mineral density. The pathophysiology of bone disease in patients with CD is unclear but may include a direct effect of inflammatory cytokines. Tumor necrosis factor alpha (TNF-α) plays a key role in the pathogenesis of CD inflammation and has been implicated in the pathogenesis of CD related bone disease. Hypothesis: CD related bone disease would be expected to improve following therapy with infliximab. Aim: To study the effect of infliximab on BMD in pediatric patients with CD. Methods: A retrospective case study of all CD pts. <18 years receiving infliximab at our center. BMD studies (lumbar spine study with z- scores) pre infliximab were compared to that post therapy using paired student t-tests. Results: 20 patients receiving infliximab (5-10 mg/kg per dose) were identified. There were 10 male and 10 female, age range 10-18 years, all on immunosuppressive agents prior to initiation of infliximab. Patients received 2-27 (mean = 12) infusions. Disease location was ileocolonic (10), colonic (8), perianal (2), and duodenal (2). The z-score pre infliximab ranged from + 0.2 to − 5 with a mean of −1.6, 65% had z-score <−1. The z-score post infliximab ranged from −0.2 to −2.7 with a mean of −1.2. This represented an increase in BMD of 0.4 (P < 0.01). Conclusions: In patients with CD treatment with infliximab improves BMD. This suggests that TNF-α may play a role in CD induced bone disease and that treatment with infliximab may result in BMD improvement.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".