P0716 Comparison of vedolizumab and ustekinumab treatment persistence in anti-TNF experienced perianal Crohn’s Disease patients: A Single Center Experience
Bibliographic record
Abstract
Abstract Background Perianal Crohn’s disease (CD) is a particularly challenging and debilitating complication of Crohn’s disease. This can lead to significant morbidity, including chronic pain, and recurrent infections, all of which severely impact a patient’s quality of life. Biologic therapies, particularly tumor necrosis factor (TNF) inhibitors, such as infliximab and adalimumab, have become central to the management of this condition due to their ability to target key inflammatory pathways driving both intestinal and extra-intestinal disease. In addition to Anti-TNF agents, other biologics such as integrin inhibitors (e.g., vedolizumab) and interleukin inhibitors (e.g., ustekinumab) have shown promise in treating refractory or complex perianal Crohn’s disease. In this study, we aimed to compare the persistence rates of vedolizumab and ustekinumab in anti-TNF experienced perianal Crohn’s disease patients. Methods This was a single center, retrospective cohort analysis of Anti-TNF treatment experienced Crohn’s disease patients either received vedolizumab or ustekinumab as a treatment. A total of 176 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 176 Crohn’s disease patients, 128 patients had perianal Crohn’s disease. 41.5% of the patients were female, where as 33.7% of the patients had extraintestinal manifestations and 41.7% of the patients had fistulizing disease. EIM was less frequent in fistulizing disease (26% vs. 39.2%, p<0.05), concomitant azathioprine use was more frquent in fistulizing disease (58.9% vs. 34.3%, p<0.05) and fistulizing disease patients were predominantly male (67.3% vs 32.7%, p<0.05). Use of vedolizumab and ustekinumab did not different in fistulizing disease. In general cohort, the persistence rate was higher in ustekinumab treated group (Figure 1) where as in fistulizing disease group there was no statistically difference in persistence rate between two treatment arm (Figure 2). Conclusion To conclude, there is a shorter drug persistence rate in fistulizing Crohns disease when compared to non-fistulizing Crohn’s disease even with concomitant azathioprine use. While there was a longer drug persistence rate in the ustekinumab arm compared to the vedolizumab arm in the overall group, no significant difference was observed between both treatment arms in the fistulizing subgroup. Figure : 1 Figure 2:
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".