P473 Contrasting the use of 5-ASA in patients with Ulcerative Colitis and Crohn's Disease: A cross-sectional analysis at a tertiary care IBD clinic
Bibliographic record
Abstract
5-ASA is a mainstay of initial induction and maintenance therapy in patients with ulcerative colitis (UC). Although often used in patients with Crohn’s disease (CD), its clinical efficacy in this condition is uncertain. An upcoming Canadian multi centre randomised controlled trial will assess the non-inferiority of 5-ASA withdrawal vs. continuation in CD (STATIC Trial NCT03261206). The aim of this study was to determine the prevalence of 5-ASA use in patients with CD and contrast it with its use in UC in a tertiary care setting. All patients seen at a single site IBD clinic at London Health Sciences Centre, Victoria Hospital, between January and June 2016 were reviewed. Patients were only included if they had a definite diagnosis of UC or CD. Patients with indeterminate colitis were excluded. If patients were seen on multiple occasions during the study period, characterisation of their medication profile was derived from their last visit. Chi-squared analysis was used for comparison of proportions. A total of 575 patients were included in the analysis. Of these, 389 (67.7%) had a diagnosis of CD and 186 (32.3%) had a diagnosis of UC. 274 of 575 (47.6%) patients were on biologics (36.3% on anti-TNF, 7.1% on vedolizumab, 4.2% on ustekinumab). 189 of 575 (32.9%) patients were on immunomodulators (12.9% on methotrexate, 20% on azathioprine). 50/575 (8.7%) patients were on corticosteroids at their last visit. Five of 575 (0.9%) patients were on investigational agents. One hundred and seventy-five of 575 (30.4%) patients were on 5-ASA. When broken-down according to diagnosis, 134 of 186 (72.0%) of patients with UC were taking oral and/or rectal. 5-ASA while 41/389 (10.5%) of CD patients were taking this class of medication (p <0.001). When used as monotherapy, 77 of 134 (57.5%) of UC patients were using 5-ASA as monotherapy while 23 of 41 (56.1%) of CD patients were using 5-ASA as their only treatment (p = 0.877). 5-ASA is much more commonly used in UC than CD. However, when used as monotherapy the proportion of patients on 5-ASA alone does not appear to vary between the two conditions. The upcoming STATIC trial will add new evidence to determine whether this ongoing use of 5-ASA in CD is efficacious.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".