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S978 A Nationwide Comparison of Risankizumab-rzaa, Vedolizumab, and Adalimumab on Infection and Neuromusculoskeletal Adverse Events in Crohn’s Disease Patients: A Pharmacovigilance Investigation

2023· article· en· W4387751107 on OpenAlexaff
Yash P. Ashara, Clive J. Miranda, Murad H. Ali, Gregory D. Gudleski, Bhavtosh Dedania

Bibliographic record

VenueThe American Journal of Gastroenterology · 2023
Typearticle
Languageen
FieldBiochemistry, Genetics and Molecular Biology
TopicInflammatory Bowel Disease
Canadian institutionsBrandon University
Fundersnot available
KeywordsMedicineVedolizumabAdalimumabAdverse Event Reporting SystemAdverse effectInternal medicineOdds ratioCrohn's diseasePharmacovigilanceInflammatory bowel diseaseConfidence intervalDisease

Abstract

fetched live from OpenAlex

Introduction: Crohn’s disease (CD) is chronic inflammation of the gut mucosa due to dysregulated immune responses. Biologics, a novel therapy revolutionized CD management. However, these medications have not been without adverse reactions, and comprehensive patient education is thereby imperative when starting it. In this study, we investigate the adverse events associated with the biologic agents risankizumab-rzaa, adalimumab, and vedolizumab in a nationwide cohort of CD patients. Methods: The US Food and Drug Administration’s Adverse Event Reports System (FAERS) was queried for risankizumab-rzaa, vedolizumab and adalimumab in CD on February 5, 2023. Patient demographics were recorded along with rates of infection and neuromusculoskeletal adverse reactions on these drugs. Analysis was performed using reported odds ratios (ROR) with 95% confidence interval (CI) and statistical significance P < 0.05. Results: A dataset of 93,056 reported adverse event cases of CD patients treated with risankizumab-rzaa, vedolizumab and adalimumab until December 31, 2022, was extracted from the FAERS database. 34,647 (37.2%) patients were male. Patients on vedolizumab were 1.56 times more likely to be hospitalized than those on adalimumab [95% CI 1.50-1.58, P < 0.05]. Whereas patients on risankizumab-rzaa were significantly 44% less likely to be hospitalized than those on adalimumab [95% CI 0.40-0.77, P < 0.05]. The risk of contracting an infection was 1.35 times higher for patients on vedolizumab than those on adalimumab [95% CI 1.31-1.40, P < 0.001]. Notably the risk for nervous system disorders was almost twice as high for patients on risankizumab than those on adalimumab [OR 1.97, 95% CI 1.57-2.47, P < 0.001]. Incorporating musculoskeletal adverse events, patients on risankizumab had 1.69 times a risk of developing a neuromusculoskeletal disorder over those patients on adalimumab [95% CI 1.46-1.97, P < 0.001]. There was no statistical significance between rates of neuromusculoskeletal adverse reactions between patients on vedolizumab and those on adalimumab. Incorporating gender and age did not yield any statistical significance (Figure 1). Conclusion: Patients with Crohn’s disease on risankizumab-rzaa had significantly higher rates of neuromusculoskeletal adverse events but less hospitalization than patients with CD being treated with adalimumab while patients with CD on vedolizumab have significantly higher rates of infections and hospitalization than patients with CD on adalimumab.Figure 1.: A) Risk Ratio of Reported Events in Risankizumab-rzaa vs Adalimumab in Crohn’s Disease; B) Risk Ratio of Reported Events in Vedolizumab vs Adalimumab in Crohn’s Disease.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.007
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.004
Threshold uncertainty score0.015

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0030.007
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.002
Bibliometrics0.0010.002
Science and technology studies0.0000.000
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0040.000

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.

Opus teacher head0.008
GPT teacher head0.271
Teacher spread0.262 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2023
Admission routes1
Has abstractyes

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