Comparison of outcomes of cyclosporine A and infliximab for steroid‐refractory acute severe ulcerative colitis
Bibliographic record
Abstract
To the Editor,We read with interest the article by Eun Mi Song et al. comparing the outcomes of CsA and IFX as rescue therapy among patients with SR-ASUC in a large, well-defined cohort of Korean UC patients.1 The author found that the rates of treatment failure and colectomy at 3 months were not significantly different between the CsA and the IFX treatment groups among Korean patients with SR-ASUC.Because their findings are different to previous studies, we have performed a systematic review and meta-analysis of available studies evaluating the short-term and long-term efficacy of IFX of CsA in SR-ASUC.Fourteen studies which fulfilled inclusion criteria were included in the meta-analysis.There are 11 non-randomized studies and three RCTs.The diagnostic criteria of ASUC used in these studies were the Truelove and Witts criteria, Montreal severity score, the Mayo, and the Lichtiger scores.Eleven studies (two RCTs and nine non-randomized studies) reported therapeutic response rate and included 470 patients who received IFX and 536 patients who received CsA.The pooled OR for therapeutic response rate among two RCTs was 1.31 (95% CI 0.78-2.21,P = 0.922, I 2 = 0%) (Fig. 1).The pooled response rate in RCTs is 46.4% for those receiving IFX and 39.8% for those receiving CsA.Among non-randomized studies, significantly higher therapeutic response rate was seen with IFX treatment, with a pooled OR of 2.46 (95% CI 1.87-3.25,P = 0.873, I 2 = 0%) (Fig. 1).The pooled response rate in non-randomized studies is 73.5% in the group receiving IFX and 51.2% in the CsA group.Ten studies (two RCTs and eight non-randomized studies) reported 3-month colectomy rates and included 518 patients who received IFX and 768 patients who received CsA.The pooled OR for 3-month colectomy rates among two RCTs was 0.95 (95% CI 0.60-1.50,P = 0.476, I 2 = 0%).Among non-randomized studies, no statistically significant difference could be detected between the two groups in 3-month colectomy rate, with a pooled OR of 0.58 (95% CI 0.29-1.17,P = 0.01, I 2 = 62.2%).Figure 1 Forest plot of all studies reporting treatment response.
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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 | 0.014 | 0.045 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.010 | 0.015 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| 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".