S1266 Evaluating the Continued Use of 5-Aminosalicylates in Crohn's Disease: Insights From A Single-Center Study
Bibliographic record
Abstract
Introduction: The management of Crohn's disease (CD) has evolved significantly, with the American College of Gastroenterology's 2018 guidelines recommending against the use of 5-aminosalicylates (5-ASA) due to their limited efficacy against placebo. Despite these updated recommendations, a substantial number of Crohn's disease patients continue to be prescribed 5-ASA’s. This study aims to assess the prevalence of 5-ASA use among Crohn's disease patients and evaluate adherence to current therapeutic guidelines. Understanding these prescribing patterns is crucial for optimizing patient outcomes. Methods: We identified patients, ages 18-70, who were diagnosed with CD that visited our gastroenterology clinic from 2020-2023. Their electronic medical records were analyzed for current and past pharmacologic therapies, prescription fill history, and prescriber information. Results were calculated using simple mathematics. Results: We identified 150 patients in this study, 27 patients (20.3%) were not taking pharmacologic therapy due to quiescent disease activity, 93 patients (69.9%) were on biologic therapies, and 2 patients (1.5%) were on chronic prednisone therapy due to biologic refusal. Eleven patients (8.3%) were taking 5-ASA’s, with the most common being mesalamine (Figure 1). All of the active prescriptions for 5-ASA’s were through primary care offices. Conclusion: In conclusion, our study highlights a significant issue in the management of Crohn's disease, with a notable number of patients continuing on 5-ASA’s despite updated guidelines. Previous larger studies in Canada have suggested that as much as one third of CD patients continue to be prescribed 5-ASA's. The persistence of these prescriptions, particularly among patients lost to follow-up, underscores the need for improved monitoring and adherence to current therapeutic recommendations. By addressing these gaps, we aim to enhance the quality of care and improve outcomes for our patients with CD.Figure 1.: Pie chart demonstrating the treatment modalities of the CD patients in our study.
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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 | 0.004 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 | 0.001 | 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".