P920 Efficacy and Drug Adherence Rates of Anti TNF Drugs in patients with Crohn's Disease: A Single Tertiary IBD Center Cohort
Bibliographic record
Abstract
Abstract Background In the last 2 decades, the introduction of biological therapies has been a significant milestone in the management of inflammatory bowel diseases. Despite the recent emergence of new biological therapies and small molecules, Anti-TNF agents still play a crucial role in treatment and still being used as first line biologic treatments rather than anti-integrins and anti-cytokines in quite a number of countries.Although many studies have been conducted previously to compare the efficacy of these drugs, there is still not a clear conclusion. In this study, we aimed to compare the persistence of infliximab (IFX) to adalimumab (ADA) in the treatment of Crohn's at a tertiary IBD center. Methods This was a retrospective cohort analysis of patients with Crohn's disease either received adalimumab or infliximab as a first line biologic treatment. A total of 411 patients were included to this analysis. Demographic information such as gender, age, montreal classification, smoking and prior medications were noted from patients electronic medical records. Weighted Kaplan-Meier and Cox models were used to assess the outcomes. Results Out of the 411 patients included in the study, 165 had used infliximab, and 246 had used adalimumab as a first-line treatment. Age and gender of the patients in both groups did not differ from each other statistically. 87% of the patients treated with adalimumab and 84% of the patients treated with infliximab were thiopurine experienced. Montreal classification differed between two groups (in IFX group, 60% of the patients had either sticturing or penetrating behaviour where as in ADA group, only 46% of the patients had either sticturing or penetrating behaviour, p<0.05). In ADA group, only 48% of the patients were receiving concomitant azathioprine treatment where as in IFX group, 60% of the patients were receiving concomitant azathioprine treatment. Primary non-response rates were not different between IFX and ADA group, 4.5% vs 4.6% respectively. In addition, clinical response rates after first year were 73.8% and 72.8% respectively. Drug persistency rates of adalimumab and infliximab in moderate to severe ulcerative colitis patients were not statistically different from each other (Figure 1). Conclusion In conclusion, it seems that there is no difference in drug persistence rates and in efficacy rates of the medications between infiximab and adalimumab treated moderate to severe Crohn's disease patients. Although disease character and concomitant treatment presence differ between two groups, these differences did not show any significant effect.
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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 | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".