THE ROLE OF INTEGRATED GASTRO-RHEUMATOLOGICAL CARE IN IBD-ASSOCIATED SPONDYLOARTHRITIS IN ACHIEVING JOINT–GUT REMISSION: FOUR-YEAR OUTCOMES FROM THE REAL-WORLD SPIB COHORT
Bibliographic record
Abstract
BACKGROUND: Spondyloarthritis associated with inflammatory bowel disease (Spa-IBD) often requires a customised multidisciplinary approach. The aim of this study was to evaluate long-term outcomes of a cohort of SpA-IBD patients with a multidisciplinary management. METHODS: Consecutive patients with SpA-IBD were assessed at our multidisciplinary Gastro-Rheumatological Clinic and enrolled in the SPIB (SpA in Inflammatory Bowel Disease) cohort. The primary endpoint was the proportion of patients achieving remission in both intestinal and articular domains at four years. Secondary outcomes included the cohort's baseline clinical features, progressive improvement in disease activity scores, treatment patterns, and predictors of remission. RESULTS: The cohort includes 159 patients (58% Crohn's disease, 42% ulcerative colitis). At baseline, 56% of patients were diagnosed with axial SpA-IBD, and 44% with peripheral SpA-IBD. At baseline, 0.6% of patients were in combined intestinal and articular remission, and this proportion gradually increased to 5.7% at six months and 26.3% at four years. Clinical outcomes at 4 years included improvements in TJC (Δ-3.8), SJC (Δ-1.0), LEI score (Δ-0.3), DAPSA remission status (+36.0%), ASDAS inactive disease status (+38.0%), and remission status for CDAI (+19.3%) and pMayo (+26.2%) scores. At 2 years, bDMARD therapy increased by 36%, while corticosteroid use decreased by 35%. In multivariable analysis, male gender predicted remission during follow-up (OR 2.80, 95% CI 1.21-6.76), whereas axial disease (OR 0.41, 0.17-0.96) and enthesitis (OR 0.26, 0.11-0.59) were negative predictors. CONCLUSIONS: The long-term results of the SPIB cohort highlight the value of close collaboration between rheumatologists and gastroenterologists in the application of joint-gut remission strategies.
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".