P377 Proportion of IBD patients with suboptimal control in daily clinical practice – real-world evidence from the IBD Podcast study
Bibliographic record
Abstract
Abstract Background Crohn’s disease (CD) and ulcerative Colitis (UC) are inflammatory bowel diseases (IBD) characterized by chronic inflammation of the digestive tract. Increasing evidence highlights the unmet need, the burden of disease, the progressive nature of the disease and subsequent intestinal damage, limited efficacy of current treatments and suboptimal disease management1-3. The IBD-PODCAST study aimed to estimate the proportion of patients with Crohn’s disease (CD) and ulcerative colitis (UC) with suboptimal disease control based on STRIDE-II4 criteria in a real-world setting across 10 countries. Methods A non-interventional, cross-sectional (with a limited retrospective component), multi-center, multi-country study was conducted in 2185 patients across 103 sites in Austria (n=111), Belgium (n=132), Canada (n=163), Germany (n=438), Greece (n=157), Italy (n=220), Portugal (n=130), Spain (n=396) Turkey (n=240) and UK (n=198). Criteria for suboptimal control were largely based on STRIDE-II4 and modified by an expert panel (Table 1) in order to evaluate disease control in this cross-sectional study. Results 2185 patients (CD: n=1108, UC n=1077) with a mean age (SD) of 44.0 (14.8) years and mean disease duration (SD) of 12.4 (9.2) years were included (52.2% male). Ileal CD was present in 39.1% of patients and 35.3% of UC patients had extensive colitis. Among patients with CD and UC, 77.3% and 65.3% respectively, were on targeted immunomodulators (biologics or small molecule drugs) and, according to STRIDE-II4 -based therapeutic windows, 85.6% of CD and 85.4% of UC patients were assigned to the long-term (LT) treatment phase. At index point, suboptimal control at index was detected in 52.2% of patients with CD and 44.3% of patients with UC with relative consistency across countries. Impaired quality of life (QoL), clinically-significant EIMs, steroid overuse and signs of active inflammation in UC and CD, and fistulas in CD contributed most to the identification of suboptimal disease control in LT patients. More than one criterion indicating suboptimal control was seen in 37% of patients. Treatment optimization opportunities were observed in 49% of CD and 61% of UC patients on advanced therapy. Conclusion This study presents a high percentage of suboptimally-controlled IBD patients in a large multinational real-world cohort suggesting a large disease burden in IBD patients, a high unmet medical need and continuous requirements to improve standard of care in IBD. Future analysis should focus on monitoring and response to suboptimal control, and specific analysis of QoL in these patients.
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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 | 0.006 | 0.029 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".