P821 HLADQA1-HLADRB1 pre-emptive screening for azathioprine-induced pancreatitis in inflammatory bowel disease: a preliminary report
Bibliographic record
Abstract
Abstract Background Genetic variation in the HLADQA1-HLADRB1*07:01 haplotype is strongly associated with azathioprine (AZA)-induced pancreatitis in inflammatory bowel disease (IBD). We aimed to evaluate the utility of pre-emptive HLA DQA1-HLADRB1*07:01 screening to reduce the risk of AZA-induced pancreatitis in an IBD population. Methods A prospective cohort study is ongoing in IBD patients being considered for AZA therapy who are assigned to pre-treatment HLA DQA1-HLADRB1*07:01 (rs2647087) screening (n = 372 currently recruited) and compared with historical controls who have received AZA standard of care (n = 373). Participants in the pre-emptively screened group found to be variant carriers (AC or CC) are excluded from AZA treatment while wild type carriers (AA) received standard dosing. The incidence of clinically diagnosed pancreatitis (lipase >3 times the upper limit of normal and one of abdominal pain or imaging findings suggestive of pancreatitis) occurring within 3 months in all participants with AZA exposure is being compared between the prospective and historic populations. Results The minor allele frequency of HLADQA1-HLADRB1*07:01 is 29%. To date, 194 participants (AA genotype) in the pre-emptively-screened cohort have received AZA therapy and completed the 3-month follow-up period. An additional 136 individuals with AA genotype are needed to obtain the target sample size (n = 330). Thus far, fewer cases of AZA-induced pancreatitis are seen in the pre-emptively screened population (pre-emptive cohort, 1/194 vs. historical controls, 13/373; odds ratio = 7.01, 95%CI = 0.91–53.98, p = 0.04). Conclusion Pre-emptive HLA DQA1-HLADRB1*07:01 screening may reduce the risk of pancreatitis during AZA treatment in patients with IBD. Completion of this study will help define whether HLA DQA1-HLADRB1*07:01 screening is a clinically-actionable and relevant tool for the safe use of AZA therapy in IBD.
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 | 0.002 |
| 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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| 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".