P1070 Comaparison of Effectiveness and Perisitence Anti-TNF drugs on Perianal Fistulizing Crohn’s Disease: A Single Tertiary IBD Referral Center Experience
Bibliographic record
Abstract
Abstract Background Perianal Crohn’s disease (CD) is a debilitating and often challenging manifestation of Crohn’s disease that involves the formation of fistulas, abscesses, and other inflammatory lesions around the anus and perineal area. It is associated with significant morbidity, including pain, recurrent infections, and impairment of daily activities. Treatment of perianal CD is complex, requiring a multidisciplinary approach to control disease activity, promote healing, and preserve anal function. Anti-TNF (tumor necrosis factor) biologic agents, such as infliximab and adalimumab, have become a mainstay in the management of perianal Crohn’s disease. However, there is still a debate which anti-TNF agents acts better than other in this subset of patients. Here in this study, we aimed to evaluate the compare the efficacy and persistence of two Anti-TNF agents in perianal Crohn’s disease. Methods This was a single center, retrospective cohort analysis of patients with Crohn’s disease either received adalimumab or infliximab as a first line biologic treatment. A total of 396 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 446 Crohn’s disease patients, 128 patients had perianal Crohn’s disease. Gender, smoking, extraintestinal manifestations presence and family history were not different between patients with and without perianal disease. However, in perianal disease group there was more concomitant immunomodulator use than in patients with no perianal involvement (61.5% vs 49.4%, p<0.05). Anti-TNF drug persistence was significantly higher in patients without perianal involvement when compared to patients with with perianal involvement (Figure 1). There was no significant difference in drug persistence rates in perianal Crohn’s disease between infliximab and adalimumab treatment (Figure 2). The concomitant use of immunomodulator drugs did not make any impact. Conclusion In Crohn’s disease patients, anti-TNF medication persistence rates was observed to be significantly lower in those with perianal involvement. However, which anti-TNF agent was chosen as first line biologic did not change medication persistence rates. Concomitant thiopurine use did not make any impact on the results.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".