P0287 Mild Crohn´s Disease is associated with a low, but not negligible, rate of progression, over a 5-year follow-up period
Bibliographic record
Abstract
Abstract Background Currently, most studies aim to identify predictive factors for complicated phenotype in Crohn’s disease (CD). However, it is equally important to identify factors associated with a mild disease course, thereby avoiding unnecessary exposure of patients to the potential risks of medication. Methods This was a retrospective cohort study of incident CD cases between February 2015 and August 2023. Mild CD was defined as: 1) absence or minimal symptoms at diagnosis, 2) absence of deep ulcers on colonoscopy, 3) absence of complications (strictures, fistula, perianal disease), and/or 4) no need for surgery within three months of diagnosis. A composite outcome was defined by the need of steroids, therapeutic escalation, surgery, progression to fistulizing/penetrating disease, or perianal disease. Survival analysis was performed. Results We included 40 patients (55% male; median age of 44 years, IQR [34-56]), with a median follow-up of 63 months, IQR [35–111]. According to Montreal classification the majority were A2 (55%) with terminal ileum involvement (L1 72.5%, of which 80% had <10 cm of ileal involvement, L2 20%, L3 7.5%). At diagnosis, 55% started on 5-ASA, 35% oral budesonide, and 10% did not receive any treatment. The composite outcome occurred in 22.5% of cases (9/40), with a median time until the event of 30 months IQR [6.5-70]: perianal disease in 0.03% (1/40), development of stricturing phenotype in 0.03% (1/40), need for steroids in 17.5% (7/40) and need to escalate therapy also in 17.5% (7/40) patients. Characteristics at baseline were not different between those who developed the composite outcome. Shorter ideal disease showed a trend toward a lower rate of disease progression (16%vs 23%, p=0.09) (table 1). In a multivariate cox regression, none of these variables were independent predictors of the need of corticotherapy, escalation of therapy or the development of the composite outcome. Conclusion Only a minority of patients with mild CD had disease progression, which was generally indolent. No factors associated with worse outcomes were identified in our cohort. Mild CD appears to represent a distinct phenotype that warrants further investigation to better characterize its disease course.
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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) | 0.000 | 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".