FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4381125429> ?p ?o ?g. }

• W4381125429 abstract "<h3>Introduction</h3> It has been hard to demonstrate if early immunosuppression alters resection rates for Crohn’s disease (CD). We studied a population-based cohort from Cardiff to evaluate the impact of both anti-TNF therapy and thiopurines on the natural history of CD, including surgical resection rates. <h3>Methods</h3> This was a retrospective population-based cohort study of all patients diagnosed with CD whilst resident in Cardiff and nearby towns over 12 years 2005–2016. The primary outcome was the impact of therapy on the time to first resection surgery up to 5 years for patients receiving early sustained use (ESU): drug started within one year of diagnosis and continued at least 3 months, versus never use (NU). A propensity score (PS) was calculated. Inverse probability of treatment weighting (IPTW) based on the PS was used so that confounders (baseline Montreal classification, smoking, steroid use, serum albumin) was similar in both the treated and untreated groups. To address immortal time bias (ITB) if an outcome occurs after diagnosis but before the start of therapy, then this time segment is attributed to the untreated group. Therefore, <i>n</i> represents time segments, not individual patients, in statistical analyses. <h3>Results</h3> 419 CD cases were studied. With IPTW there was a significant reduction in risk of surgical resection with ESU anti-TNF vs NU (p=0.0026,<i> n</i>=460 (57 ESU vs 403 NU segments), hazard ratio (HR) 0.28, 95% confidence interval (CI) 0.12 to 0.62) but not with ESU thiopurine vs NU (p=0.39, <i>n</i>=545, HR 0.82, 95% CI 0.52 to 1.29). 138/419 patients received any anti-TNF therapy prior to resection, while 57 had ESU. Probability of avoiding surgery in ESU vs NU at 1 year (98% v 83%), 2 years (95% vs 80%), and 5 years (91% vs 75%). See figure 1. After 5 years the resection rates converged with wider CIs. <h3>Conclusions</h3> Strengths of our study include the individual patient detail conferred from hospital record data collection, contributing to a PS and IPTW to account for confounders, and removal of ITB. ITB artificially protracts treatment arm survival, therefore its removal portrays a more accurate comparison. With this, we demonstrate a significant reduction in surgical resection rates at 5 years in ESU anti-TNF therapy vs NU. Larger numbers are needed to analyse benefits beyond 5 years." @default.
• W4381125429 created "2023-06-19" @default.
• W4381125429 creator A5014008532 @default.
• W4381125429 creator A5014785887 @default.
• W4381125429 creator A5066665023 @default.
• W4381125429 creator A5083810122 @default.
• W4381125429 creator A5086646843 @default.
• W4381125429 creator A5088289778 @default.
• W4381125429 date "2023-06-01" @default.
• W4381125429 modified "2023-09-27" @default.
• W4381125429 title "P64 The impact of anti-TNF and thiopurine therapy on the natural history of Crohn’s disease: a population-based study" @default.
• W4381125429 doi "https://doi.org/10.1136/gutjnl-2023-bsg.136" @default.
• W4381125429 hasPublicationYear "2023" @default.
• W4381125429 type Work @default.
• W4381125429 citedByCount "0" @default.
• W4381125429 crossrefType "proceedings-article" @default.
• W4381125429 hasAuthorship W4381125429A5014008532 @default.
• W4381125429 hasAuthorship W4381125429A5014785887 @default.
• W4381125429 hasAuthorship W4381125429A5066665023 @default.
• W4381125429 hasAuthorship W4381125429A5083810122 @default.
• W4381125429 hasAuthorship W4381125429A5086646843 @default.
• W4381125429 hasAuthorship W4381125429A5088289778 @default.
• W4381125429 hasConcept C126322002 @default.
• W4381125429 hasConcept C141071460 @default.
• W4381125429 hasConcept C163276114 @default.
• W4381125429 hasConcept C167135981 @default.
• W4381125429 hasConcept C207103383 @default.
• W4381125429 hasConcept C2778260677 @default.
• W4381125429 hasConcept C2779134260 @default.
• W4381125429 hasConcept C2779280984 @default.
• W4381125429 hasConcept C2908647359 @default.
• W4381125429 hasConcept C44249647 @default.
• W4381125429 hasConcept C70917649 @default.
• W4381125429 hasConcept C71924100 @default.
• W4381125429 hasConcept C72563966 @default.
• W4381125429 hasConcept C77350462 @default.
• W4381125429 hasConcept C99454951 @default.
• W4381125429 hasConceptScore W4381125429C126322002 @default.
• W4381125429 hasConceptScore W4381125429C141071460 @default.
• W4381125429 hasConceptScore W4381125429C163276114 @default.
• W4381125429 hasConceptScore W4381125429C167135981 @default.
• W4381125429 hasConceptScore W4381125429C207103383 @default.
• W4381125429 hasConceptScore W4381125429C2778260677 @default.
• W4381125429 hasConceptScore W4381125429C2779134260 @default.
• W4381125429 hasConceptScore W4381125429C2779280984 @default.
• W4381125429 hasConceptScore W4381125429C2908647359 @default.
• W4381125429 hasConceptScore W4381125429C44249647 @default.
• W4381125429 hasConceptScore W4381125429C70917649 @default.
• W4381125429 hasConceptScore W4381125429C71924100 @default.
• W4381125429 hasConceptScore W4381125429C72563966 @default.
• W4381125429 hasConceptScore W4381125429C77350462 @default.
• W4381125429 hasConceptScore W4381125429C99454951 @default.
• W4381125429 hasLocation W43811254291 @default.
• W4381125429 hasOpenAccess W4381125429 @default.
• W4381125429 hasPrimaryLocation W43811254291 @default.
• W4381125429 hasRelatedWork W1966970634 @default.
• W4381125429 hasRelatedWork W1974842107 @default.
• W4381125429 hasRelatedWork W2079433673 @default.
• W4381125429 hasRelatedWork W2098571791 @default.
• W4381125429 hasRelatedWork W2144546373 @default.
• W4381125429 hasRelatedWork W2152018063 @default.
• W4381125429 hasRelatedWork W2166867133 @default.
• W4381125429 hasRelatedWork W2912221073 @default.
• W4381125429 hasRelatedWork W4310596618 @default.
• W4381125429 hasRelatedWork W4384497977 @default.
• W4381125429 isParatext "false" @default.
• W4381125429 isRetracted "false" @default.
• W4381125429 workType "article" @default.