P187 Clinical follow-up of patients with Crohn's disease treated with ustekinumab in our hospital
Bibliographic record
Abstract
Major advances of knowledge in the immunology and pathophysiology of the intestinal inflammatory processes have helped to identify novel molecular targets for drugs and potential new therapeutic approaches fot the treatment of Inflammatory Bowel Intestinal (IBD), one of those target is Anti-Interleukin pathway. Currently, highlighting ustekinumab for moderate–severe Crohn’s disease (CD) and previous anti-TNF failure. The aim of our study was to evaluate, according to clinical practice, the characteristics and evolution of CD in patients receiving Ustekinumab in our hospital. This is an observational and prospective study about a cohort of patients with long-standing CD and failures to other biologic drugs, in treatment with Ustekinumab from November 2017 to November 2018. We assessed characteristics of the disease in each patient, based on the Montreal Classification, activity scores (CDAI and Harvey–Bradshaw) and clinical patients’ evolution at 12 and 24 weeks after the beginning of Ustekinumab. We included 23 patients with CD, 43.5% (10/23) were men with an average age of 41.9 ± 11.3 years. In 65.2% (15/23) the location was ileocolic (L3), 21.7% (5/23) presented ileal involvement (L1), and 8.7% (2/23) colonic location (L2). The disease had an inflammatory behaviour (B1) in 39.1% (9/23), fistulizing (B3) in 34.8% (8/23), and the remaining 26.1% (6/23) presented a stenosing behaviour (B2) (Table 1). Table 1. Demographic characteristics Perianal involvement was present in 52.2% (12/23) of patients and 30.4% (7/23) had extraintestinal manifestations. The most common reported were polyarthralgias, followed by dermatological involvement. In the first visit, the CDAI average score of 176 and the Harvey–Bradshaw index of 10.6. At the second visit (at 12 weeks) both showed a decrease to 88.5 points and 6 points, respectively. The third visit (at 24 weeks) was completed by 11 patients, maintaining all of them clinical remission, with a CDAI average score of 46.5 and Harvey–Bradshaw index of 4 (Table 2). Table 2. Disease activity indices Treatment with ustekinumab seems to be an effective alternative in patients with advanced CD and previous anti-TNF or vedolizumab failure, warranting further evaluation with a larger cohort and a longer term follow-up.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".