A42 UNDERUSE OF IRON THERAPY UPON DISCHARGE FOR ANEMIC PATIENTS WITH ACUTE GASTROINTESTINAL BLEEDING
Bibliographic record
Abstract
Crohn’s disease (CD) is a chronic inflammatory condition of the intestinal tract. There are various treatments available for CD, including a recently developed treatment – ustekinumab (Stelara®). The objective of this network meta-analysis (NMA) was to assess the comparative efficacy of ustekinumab and vedolizumab in the maintenance of clinical response and remission, after 1 year of treatment. A systematic literature search was performed to identify RCTs published in English comparing biologic therapies for patients with moderate-to-severe CD. Key outcomes of interest were clinical response (CD activity index [CDAI] reduction of 100 points; CDAI-100) and remission (CDAI<150), during maintenance treatment. A Treatment Sequence Bayesian NMA was conducted in order to account for re-randomization after induction of patients based on different clinical definitions (CDAI-70/100 response), the lack of similarity of the common comparator (placebo) in maintenance due to different induction treatment, and the full treatment pathway from induction. A total of thirteen RCTs were identified. Overall, ustekinumab 90 mg q8w was associated with statistically significant maintenance of clinical response (OR [95% CrI]: 1.66 [1.05; 2.62]) and clinical remission (OR 1.74 [1.05; 2.88]) relative to vedolizumab 300 mg q8w. Additionally, ustekinumab 90 mg q12w was associated with statistically significant maintenance of clinical response (OR [95% CrI]: 1.60 [1.01; 2.54]) relative to vedolizumab 300mg q8w. Findings for failed conventional and failed anti-tumor necrosis factor sub-populations are similar to those in the overall population but were not statistically significant, likely due to small sample sizes. The results of the current NMA suggest that ustekinumab is associated with the highest likelihood of maintaining response or remission at 1 year compared with vedolizumab. Results should be interpreted with caution due to methodological limitations; however, the treatment sequence analysis may be the most methodologically sound analysis to derive estimates of comparative efficacy in CD in the absence of head-to-head evidence. Results of Treatment Sequence Analysis in Overall Population UST: ustekinumab; CrI: Credible Interval; Pr: Bayesian Probability; VDZ: vedolizumab Janssen Inc.
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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 | 0.011 | 0.044 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.017 |
| Bibliometrics | 0.001 | 0.002 |
| 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) | 0.007 | 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".