P373 Primary sclerosing cholangitis associated with inflammatory bowel disease: clinical characteristics of patients from reference centers in Brazil
Bibliographic record
Abstract
Abstract Background Inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC) are closely associated pathological entities that, when present in combination, create a phenotypically different disease, referred to as PSC-IBD. The occurrence of PSC complicating IBD seems to vary depending on the studied population. The aim of this study was to describe the clinical profile of patients with PSC-IBD in reference centers in Brazil. Methods Descriptive cross-sectional study in 7 tertiary centers. Patients with PSC and IBD were identified. Data were collected from patients' charts. The following variables were studied: age, age at diagnosis of IBD and PSC, type of IBD, Montreal classification, medications used, occurrence of colorectal cancer and dysplasia, colectomy and liver complications. The study was approved by the ethics and research committee. Results Ninety-three patients were included. The mean age of the patients was 43,8 years (range 17 to 73). 63 patients were male (67.7%). UC was more frequent 74.2% (N=69). The mean age at diagnosis of IBD and PSC was 31.4 years (range 6 to 67) and 35.6 years (range 8 to 72), respectively. The diagnosis of PSC preceded that of IBD in only 15 (16.1%) cases. Among patients with UC, the majority (61/69) had extensive colitis (88.4%), and 47.8% (33/69) had already used at least one biological therapy. Only 9 (13%) patients with UC required colectomy. Regarding CD, colon involvement occurred in 21 (87.5%) patients and 20 (83.3%) needed to use at least one biologic. Just 3 CD patients (12.5%) had isolated disease in the small intestine. In our study, liver cirrhosis occurred in 20 (21,5%) cases of the studied population, and 13 (14%) patients required liver transplantation. Fourteen (15,1%) IBD patients had dysplasia or colorectal cancer (CRC). Use of biological therapy was more frequent in patients with CD than in those with UC (83.3% vs 47.8%; p=0.002). There was a trend towards a higher occurrence of CRC in the UC population (p=0.08). Conclusion In our studied PSC-IBD population, UC was more common than CD. Furthermore, we observed that in this subgroup of IBD with PSC, UC presented a more severe phenotype, with a superior occurrence of extensive colitis and need for biological therapy. In CD, most patients have colonic involvement. Interestingly, we observed a greater need to use at least one biologic in CD patients (p=0.002), as well as the need to use multiple biologics compared to UC patients (p=0.009). Additionally, there was a trend towards greater occurrence of CRC in UC patients. The rates of occurrence of dysplasia and liver cirrhosis in our casuistic emphasize the demand for more intensive follow-up in patients with IBD and PSC.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".