P-116 Infliximab and Adalimumab are Equally Effective in Prevention of Postoperative Endoscopic Recurrence in Crohnʼs Disease
Bibliographic record
Abstract
Anti-TNF therapy plays an important role in prevention of endoscopic recurrence in Crohn´s disease (CD) patients submitted to surgical resections. Prospective studies had demonstrated the significant efficacy of this agents as compared to conventional treatment with thiopurines and 5-ASA. There is lack of data comparing directly the efficacy of Infliximab (IFX) and Adalimumab (ADA) in this setting. The aim of this study was to compare the rates of endoscopic recurrence after ileocolectomies for CD between patients that were treated with IFX and ADA. Multicenter retrospective observational study, with CD patients that were submitted to ileocecal resections, were treated with anti-TNF therapy after the procedures and had endoscopic follow-up to analyze recurrence. Studied variables: demographic data, Montreal classification, surgical characteristics, pre and postoperative medication and recurrence according to the Rutgeerts score. Endoscopic recurrence was defined as Rutgeerts score i2 to i-4. Patients were classified in 2 groups according to the type of anti-TNF used (IFX or ADA). Endoscopic recurrence rates on the first postoperative colonoscopy were analyzed and compared between the groups. Statistical analysis: student t test or Mann-Whitney analysis were used for quantitative variables and Fischer test was used for qualitative variables, with P < 0.05 considered significant. From an initial cohort of 85 patients, from 4 referral centres, 56 patients with anti-TNF therapy after the ileocecal resections were included, 28 on IFX and 28 on ADA group. The groups were completely homogeneous in all variables analyzed, including demographic data, Montreal Classification, CD duration at surgery, pre and postoperative medication and all surgical aspects. Median time for the first colonoscopy after the operations was 12.8 months (3–120). Endoscopic recurrence was detected in 9/28 patients on the IFX group (32,14%) and 8/28 patients on the ADA group (28,57%), with P = 1.000. There was no significant difference between the type of anti-TNF agent used after ileocecal resection for CD in terms of endoscopic recurrence. IFA and ADA seem to be equally effective in this setting. Prospective randomized head-to-head trials are still needed to better define the role of each agent in the postoperative prevention of recurrence.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.001 | 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".