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Record W2586830390 · doi:10.1093/ecco-jcc/jjx002.626

P502 Ulcerative colitis patients on vedolizumab lacking response at induction phase continue to improve over the first 6 months of treatment

2017· article· en· W2586830390 on OpenAlexaff
Petros Zezos, Boyko Kabakchiev, Adam V. Weizman, G C Nguyen, Neeraj Narula, Kenneth Croitoru, A.H. Steinhart, Mark S. Silverberg

Bibliographic record

VenueJournal of Crohn s and Colitis · 2017
Typearticle
Languageen
FieldMedicine
TopicMicroscopic Colitis
Canadian institutionsLunenfeld-Tanenbaum Research InstituteUniversity of TorontoMount Sinai Hospital
Fundersnot available
KeywordsVedolizumabMedicineUlcerative colitisInternal medicineHazard ratioProportional hazards modelUnivariate analysisAdverse effectGastroenterologyDiscontinuationMultivariate analysisSurgeryConfidence intervalDisease

Abstract

fetched live from OpenAlex

Background: Vedolizumab, a gut-selective anti-integrin inhibitor, is a biologic agent indicated for ulcerative colitis (UC) treatment. We retrospectively assessed the real-world efficacy and safety of vedolizumab as induction and maintenance therapy in UC patients. Methods: Adult UC patients followed at a tertiary IBD center and treated with vedolizumab were included. All patients received infusions at 0, 2, and 6 weeks and then every 8 weeks. Six-month cumulative rates of clinical remission (CR, partial Mayo score≤2) and steroid-free clinical remission (SFCR) were assessed with Kaplan-Meier survival analyses. Univariate and multivariable Cox proportional hazard (PH) analyses were performed to identify among baseline variables independent predictors of clinical remission. Hospitalizations, surgeries and adverse events were recorded. Results: Fifty-seven patients were analyzed (Table 1). At 2 months, CR and SFCR were 37% and 30%. At 6 months, the cumulative rates of CR and SFCR were 49% and 44% (Table 1, Fig. 1). Among patients who were not in CR after 3 infusions (n=36) the probability of remission with continuation of vedolizumab was 25% (9/36) at 6 months. Pairwise analyses showed significant improvement in median partial Mayo scores and median CRP levels over the 6-month period compared to baseline (Fig. 1). Cox PH analysis revealed a 3-fold increase in the probability of clinical remission at 6 months among patients with baseline CRP levels less than 5mg/L (univariate analysis, hazard ratio [HR]: 2.55, 95% CI: 1.17–5.57, p=0.019; multivariate analysis, HR: 2.72, 95% CI: 1.24–5.97, p=0.012) and mild baseline disease (univariate analysis, HR: 2.48, 95% CI: 1.2–5.54, p=0.026; multivariate analysis, HR: 2.86, 95% CI: 1.27–6.44, p=0.011) compared with those who did not (Fig. 1). Cumulative rates of colectomy were 5%, 9%, and 14% at 2, 4 and 6 months respectively. The most common side effect was headache. Figure 1. Clinical remission rates in UC patients on conitnuous vedolizumab for 6 months. Conclusions: In our study, 35% of UC patients, most of whom were unresponsive to anti-TNFs, achieved CR after induction and 50% were in CR at six months with vedolizumab maintenance treatment. We did not observe severe adverse events. Our data would indicate that a significant proportion of patients who had not achieved response at 2 months may go on to achieve CR by 6 months of continued therapy.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.003
Threshold uncertainty score0.009

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0030.001

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.

Opus teacher head0.019
GPT teacher head0.316
Teacher spread0.297 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

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Citations2
Published2017
Admission routes1
Has abstractyes

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