P646 Histological remission in patients with moderate-to-severe ulcerative colitis undergoing biological therapy: a single-centre experience
Bibliographic record
Abstract
Histological remission (HR) is emerging as a new treatment target in patients with ulcerative colitis (UC). Biological drugs, as anti-tumour necrosis factor (TNF) agents and anti-integrins, represent the best choice for treating patients with moderate to severe disease. However, ‘real-life’ data about their efficacy in achieving this goal are limited. The aim of the study was to evaluate the efficacy of biological drugs to achieve histological remission in UC patients. We enrolled in a retrospective observational study adult patients with moderate-to-severe UC referring between 2014 and 2018 to IBD Unit (Negrar Hospital), both naïve and experienced to a previous Anti-TNF. We performed endoscopic (by Mayo Endoscopic Subscore, MES) and histological (Nancy Histological Index, NHI, a recent validated score) at baseline (before starting biological therapy) and at Week 48 (control time). Histological remission was defined as NHI < 2. The worst colonic segment was used for the assessment of disease activity. Fisher exact test was used for the statistical analysis (a p-value of <0.05 was considered statistically significant). Sixty-one patients were included. At baseline median MES was 2.6 (2–3), median NHI was 3.5 (2–4). Twenty-eight patients were treated with Infliximab (IFX), 10 with Adalimumab (ADA), 20 with Golimumab (GOL), 3 with Vedolizumab (VDZ), all according to conventional regimen. At Week 48, 26.2% (16/61) of patients achieved histological remission; the subgroup analysis showed that 21.4% (6/28) of patients treated with IFX, 60% (6/10) of patients treated with ADA and 20% (4/20) of patients treated with GOL achieved histological remission. All 3 patients treated with VDZ still showed histologically active disease at control time (NHI ≥ 2). There were no significant differences among drugs (p = 0.082). 42.6% (26/61) of patients achieved endoscopic remission (MES 0 or 1). All patients achieving histological remission were also in endoscopic remission; of these, 62.5% (10/16) had a MES=0. Median MES and NHI significantly improved at Week 48 (1.8 and 2.7, respectively; p < 0.001). There were no differences between naïve and experienced patients (p = 0.703). All anti-TNF agents are able to achieve histological remission in patients with moderate-to-severe UC. For considerations about VDZ more data are required.
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 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 | 0.000 |
| 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 | 0.000 | 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".