Linear growth during infliximab therapy: Results of the REACH multicenter study
Bibliographic record
Abstract
Linear growth, a marker of therapeutic success in pediatric Crohn's disease (CD), was evaluated during maintenance infliximab (IFX) therapy in the context of the REACH multicenter, randomized open-label study comparing two dosing regimens. 112 children and adolescents (59% males; mean age 13.3 yrs, range 6-17 yrs) with moderately-to-severely active CD (Pediatric Crohn's Disease Activity Index [PCDAI >30]; mean 41.2, standard deviation 8.3) received a 3-dose induction of IFX 5mg/kg at weeks 0, 2 and 6. At week 10, responders (n = 103 [88%]) were randomized to receive IFX 5mg/kg at regularly scheduled infusions q8 or q12 weeks from week6 through week46 or42, respectively. 54 responders with a baseline bone age <13 yrs (female, n=20) or <14 yrs (male, n=34) were classified as having presumed growth potential (PGP). Their growth parameters (height and height velocity) before and after infliximab therapy (randomized: n=33 q8 week dosing; n=21 q12 week dosing) were analyzed after standardizing for age and gender. At IFX therapy initiation, mean z-scores for height (-1.0; 95% confidence interval [CI], -1.3 to -0.7) increased by a mean of 0.4 (95% CI 0.3 to 0.5). At week 54, 29/54 (54%) were in clinical response (delta PCDAI≥15 and PCDAI≤30), and 24/54 (44%) were in clinical remission (PCDAI≤10). The effects of IFX therapy on height velocity z-scores for various subgroups are presented below. Maintenance IFX therapy is associated with improved linear growth velocity and height centile in pediatric Crohn's patients treated before or in early puberty. Ultimate height in children with moderate-to-severe CD may be less compromised with IFX therapy than with conventional therapies.
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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 | 0.006 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".