P319. Combining anti-inflammatory treatment with antiviral treatment in severe cytomegalovirus-positive ulcerative colitis does not affect colectomy rate: a retrospective European multicentre study
Bibliographic record
Abstract
Background: In patients with Crohn's disease (CD), intestinal complications requiring intestinal surgery occur during their clinical course.Although preventive effect of anti-tumour necrosis factor alpha (anti-TNF) therapy against postoperative recurrence in CD has been well discussed, its preventive effect against initial intestinal resection (IIR) remains uncertain.We aimed to investigate whether anti-TNF therapy decreases the risk of IIR after the diagnosis of CD.Methods: We retrospectively investigated clinical course of 247 patients who were diagnosed as CD at our institution during 1973-2014.Amongst them, 14 patients who required IIR within a 1 year, and 30 patients who were primarily nonresponsive or intolerant to anti-TNF therapy were excluded from the analysis.The remaining 203 subjects were then classified into TNF and non-TNF groups, according to the use of anti-TNF therapy during their clinical course.Clinical characteristics and medical treatments other than anti-TNF therapy were compared between the 2 groups.With the multivariate analysis using Cox proportional hazard model, the risk of IIR was compared between TNF group and non-TNF group.We further assessed the effect of anti-TNF therapy against IIR amongst 100 patients with inflammatory CD.Results: There were 89 patients in the TNF group and 114 patients in the non-TNF group.Colitis type (19% vs 9%; p = 0.034) and inflammatory CD (71% vs 33%; p < 0.0001) were more frequent in the TNF group than in the non-TNF group, whereas previous history of intestinal resection before the diagnosis (15% vs 30%; p = 0.012) was less frequent in the TNF group.As for medical treatments, immunosuppressant was more frequently applied in the TNF group than in the non-TNF group (43% vs 25%; p = 0.011), whereas nutritional therapy of elemental diet or low residue diet was more frequently used in the latter than in the former (76% vs 60%; p = 0.014).During a mean of 91 months follow-up period, 74 patients required IIR.Multivariate analysis demonstrated that anti-TNF therapy was a significant factor associated with the decrease in the risk of IIR (hazard ratio) [HR]; 0.361, 95% confidence interval [CI]; 0.176-0.688).In 100 patients with inflammatory CD, anti-TNF therapy was a significant factor associated with the decrease in the risk (HR; 0.313, 95%CI; 0.084-0.985).Conclusions: Anti-TNF therapy may contribute to the reduction in the risk of intestinal resection after the initial diagnosis of CD.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| 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".