P223 C-reactive protein improvement after vedolizumab induction phase is associated with remission after 6 months of treatment in ulcerative colitis patients
Bibliographic record
Abstract
Background: Vedolizumab, a gut-selective anti-integrin inhibitor is a biologic agent indicated for ulcerative colitis (UC) treatment. We retrospectively investigated whether improvement of serum C-reactive protein (CRP) levels, after the first 3 infusions of vedolizumab (induction phase) predicts responsiveness at 6 months of therapy. Methods: Adult UC patients followed at a tertiary IBD center and treated with vedolizumab were included. Cumulative rates of clinical remission (CR, partial Mayo score ≤2 with a bleeding subscore 0) and steroid-free clinical remission (SFCR) were assessed at 3 and 6 months. Responses were calculated using nonresponder imputation. Mann-Whitney U-test was used for unpaired samples and Wilcoxon signed-rank test for paired samples to analyze for differences in CRP levels between patients in remission and in no remission at 6 months of continuous vedolizumab treatment. Results: Fifty-seven UC patients (Table 1) were analyzed. Two thirds had prior anti-TNF treatment exposure and two thirds had pancolitis. All 57 patients completed 3 vedolizumab infusions by week 6 and 49 completed 5 infusions by week 22. Following 3 infusions, CR and SFCR were 37% (21/57) and 30% (17/57) and at 6 months the cumulative rates of CR and SFCR were 49% (28/57) and 44% (25/57) respectively (Table 1). Patients in remission at 6 months had significantly lower baseline median CRP levels compared to those not in remission (3 versus 12 respectively, p=0.005). Low CRP levels at baseline were not associated with steroid use. Only patients in remission at 6 months had a significant reduction of median CRP levels after 3 vedolizumab infusions as compared to median baseline levels (z=3.225, p=0.001, Figure 1). Nine out 36 patients who were non- responders after the induction phase achieved clinical remission at 6 months. Their (n=9) median CRP levels at baseline and after 3 infusions were significantly lower compared to the non-responders (n=27) (3 versus 13; z=2.028, exact p=0.043 and 2 versus 10, z=2.093, exact p=0.035, respectively). Table 1. Ulcerative colitis patients: baseline characteristics and vedolizumab treatment outcomes Figure 1. Changes in median CRP levels after vedolizumab induction in UC patients. Conclusions: Low baseline CRP levels and further reduction of the levels after the induction phase of vedolizumab treatment are associated with clinical remission at 6 months. A decrease in CRP following vedolizumab induction may be used to predict those patients who will be in clinical remission at 6 months.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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 | 0.001 | 0.001 |
| 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".