A111 INFLIXIMAB FOR INDUCTION OF REMISSION IN CROHN’S DISEASE
Bibliographic record
Abstract
Crohn’s disease (CD) is a chronic idiopathic disease characterized by transmural inflammation of the gastrointestinal tract. To evaluate the efficacy and safety of infliximab (IFX) for induction of remission in CD. MEDLINE, EMBASE, the Cochrane Library were searched from database inception to August 2016. Randomized controlled trials (RCTs) comparing IFX to placebo or an active treatment for induction of remission in CD were eligible for inclusion. Data were analyzed on an intention-to-treat basis. The risk ratio (RR) and corresponding 95% confidence interval (CI) were calculated for dichotomous outcomes. The primary outcome was failure to enter clinical remission. Methodological quality was assessed using the Cochrane risk of bias tool. GRADE was used to assess the overall quality of the evidence for the primary outcome. Five RCTs (total 956 patients) were included. All of the studies were judged to be at low risk of bias. Targan 1997 compared patients receiving a single 5, 10 or 20 mg/kg IFX infusion to placebo. At week 4, 67% (56/83) of IFX patients failed to enter remission (defined as a Crohn’s Disease Activity Index <150) compared to 96% (24/25) of placebo patients (RR 0.70, 95% CI 0.59–0.83; moderate quality evidence). Lemann 2006 compared IFX 5 mg/kg to placebo. All patients received azathioprine (AZA) or 6-mercaptopurine. At week 24, the failure to enter corticosteroid-free clinical remission rate was lower in the IFX group (46%; 26/57) compared to placebo (73%; 41/56) (RR 0.62, 95% CI 0.45–86; moderate quality evidence). Colombel 2010 compared IFX 5 mg/kg monotherapy, AZA monotherapy, and a combination of these drugs. At week 26, 56% (94/169) of IFX patients failed to enter corticosteroid-free clinical remission compared to 70% (119/170) of AZA patients (0.79, 95% CI 0.67–0.94; moderate quality evidence). D’Haens 2008 compared patients receiving IFX 5 mg/kg and early immunosuppressive therapy with AZA to patients receiving conventional therapy. At week 26, 40% (26/65) of the IFX group failed to enter clinical remission compared to 64% (41/64) of the conventional therapy group (RR 0.62, 95% CI 0.44–0.89; moderate quality evidence). Present 1999 did not report remission or response rates but did include safety data. A pooled analysis and results from Colombel 2010 and D’Haens revealed no statistically significant difference in serious adverse events for IFX vs. placebo, IFX vs. AZA or IFX plus AZA vs. conventional therapy, respectively. Moderate quality evidence from a limited number of RCTs indicates that IFX is effective for induction of remission in CD. None
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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 | 0.009 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.007 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.018 | 0.001 |
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".