P0973 Early infliximab use is associated with less disease progression in luminal Crohn’s disease: a real-world tertiary centre experience
Bibliographic record
Abstract
Abstract Background The PROFILE study demonstrated clear benefits of early advanced therapy in luminal Crohn’s disease (CD) in the trial setting. We retrospectively evaluated the relationship between timing of onset of infliximab as first advanced therapy and disease outcomes in a real-world single centre cohort at Oxford University Hospitals NHS Trust. Methods A pharmacy database was searched to identify patients who received infliximab as first advanced therapy in CD. Electronic patient records (Cerner) were searched to capture the following: demographics, Montreal classification, timing of onset of infliximab, biochemical, endoscopic and radiological parameters. The primary outcome was persistence on therapy. Secondary outcomes were survival without surgery or hospitalisation, progression of disease phenotype and steroid use. Data was analysed using GraphPad Prism. Results 247 patients prescribed infliximab as first advanced therapy were identified (F:M = 112:135). Median duration (IQR) from diagnoses to first infliximab dose was 2.83 (0.25 – 10.02) years. 117 patients had inflammatory luminal disease at therapy onset (Montreal B1P0), with median first therapy from diagnosis of 2.67 (0.25 – 9.91) years. When reviewing all cases, and those with exclusively inflammatory luminal disease, persistence on therapy, survival without surgery and survival without hospitalisation did not vary with time to first advanced therapy (p>0.05 all comparisons, figure 1). However, in patients with luminal inflammatory CD who started therapy within 2 years of disease onset there was less disease progression, defined as extension in location, behaviour or new perianal disease (2/52 vs 10/65 chi sq 4.18 p=0.04), and a trend towards less systemic corticosteroid use (4/52 vs 13/65 chi sq 3.53 p=0.06). Conclusion Early infliximab therapy in luminal CD is associated with less disease progression and less use of systemic corticosteroids. The lack of variation in other outcomes may be due to historical case selection for advanced therapies. References Noor NM et al. PROFILE. Gastro Lancet Hep 2024 Figure 1: Persistence on therapy, surgery and hospitalisation free survival, categorised by duration from diagnosis until first infliximab dose. *luminal = Montreal B1P0
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 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) | 0.003 | 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".