P234 Changing natural history in IBD – steroid-free remission and surgery in two cohorts (≤2009 and > 2009) – an interplay between disease pattern, biologics and adherence
Bibliographic record
Abstract
With the more frequent use of Biologics (BIO) a change in disease outcome for both, Crohn’s disease (CD) and ulcerative colitis (UC), is expected but studies yield conflicting results. The aim of the present single centre study was to investigate changes of therapeutic approach, patients’ adherence, and disease outcomes, i.e. steroid-free remission and surgery rates, in two IBD cohorts. we retrospectively assessed demographic (age, gender, smoking status) and disease-related data (disease, age at diagnosis, Montreal classification of IBD, disease pattern (DP)(1: onset and subsequent mild course, 2: relapsing, 3: chronic active disease), type and start of therapy, surgery rates, steroid free remission at 1 and 2 years after taking in charge, and patients’ adherence) of patients followed at our IBD-UNIT. The patients were divided into two cohorts those taken over ≤ year 2009 and those taken over after year 2009). cohort 1: 129 UC, 154 CD; cohort 2: 200 UC, 170 CD. In cohort 2, compared with cohort 1, there was a significant increase in steroid-free remission at year 1 (p < 0.008) and 2 (p < 0.041) in CD and in UC (p < 0.022 and 0.048, respectively)(Figure 1). Steroid-free remission after 1 and 2 years after taking in charge of the patients. In CD, there was a significant reduction in surgery rates (19% vs. 11%, p < 0.006). UC colectomies were very low in both cohorts. While the use of immunomodulators (IMM) was comparable in both cohorts, BIO were earlier employed in cohort 2 (log-rank: p < 0.0001). By multivariate analysis, steroid free remission at 1 year was associated with DP-1 (p = 0.047) and adherence (p = 0.03), whereas steroid free remission at year 2 was associated with BIO use (p = 0.000) and DP-1 (p = 0.048). Adherence was associated with the use of IMM (p = 012), BIO (p = 0.000), and DP-1 (p = 0.01). adherence, BIO, and disease pattern were associated with steroid-free remission at year 1 and 2. Reaching early benefit may influence patients’ confidence and, thus, adherence. This in turn leads to better long-term results at least in patients with milder disease patterns.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".