P403. Colectomy is not a cure for ulcerative colitis: A systematic review
Bibliographic record
Abstract
Background: Recently, randomized controlled trials have demonstrated that Adalimumab (ADA) is effective in the induction and maintenance treatment of moderate to severe ulcerative colitis (UC) that did not present sufficient response to conventional therapy, including corticosteroids and immunosuppressants.However, the absolute benefit in terms of clinical practice requires new evidence when used as the first anti-TNF treatment.Our goal is to obtain data on efficacy and safety of ADA in treating patients with active ulcerative colitis who had not previously received another anti-TNF.Methods: Retrospective review of 17 patients older than 18 years diagnosed with UC refractory to conventional treatment, ADAtreated for 1 year, according to product label in real-life situations.Response and clinical remission at 6 months and 1 year was assessed according to partial Mayo index.Results: Seventeen patients (10 men) with a mean age of 49.7 years.Duration of disease 6 years.Montreal classification of UC: Extent -E2 6 patients (35.3%),E3 11 patients (64.7%).Severity -S1 2 patients (11.8%),S2 10 patients (58.8%),S3 5 patients (29.4%).Receiving concomitant immunosuppressive treatment 16 patients, 15 with azathioprine / 6MP (88.2%) and 1 with methotrexate (5.9%).All were treated with induction with ADA at doses of 160/80 mg and maintenance with ADA 40 mg every 2 weeks.Response and remission in 16 (94.1%)and 12 (70.6%)at 6 months and 15 (88.2%) and 14 (82.4%) at 12 months was observed.Eight patients (46.1%) required intensification of treatment.Colonoscopy was performed in 11 patients at 12 months; 7 (63.6%)had mucosal healing.Treatment was suspended in 4 patients (23.5%), 1 of them for loss of efficacy.In 2 patients malignancies were diagnosed, 1 of them showed recurrence of low-grade bladder urothelial carcinoma and another was diagnosed with lung cancer (ex-smoker).Four patients had mild infectious complications.One patient (5.9%) required colectomy due to sustained activity refractory to second anti-TNF treatment with infliximab.Conclusions: ADA has shown efficacy in the treatment of UC as first line anti-TNF in real clinical practice, in adult patients.Response and remission real clinical data with ADA as first line anti-TNF in UC are higher than randomized controlled trials efficacy data of ADA versus placebo.It is important to monitor the development of new neoplasias, mainly if there are risk factors or history of neoplasia. P402 Anal neoplasia in inflammatory bowel disease is associated with HPV and perianal disease
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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 | 0.005 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.006 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".