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Objective: Drug sustainability (DS), a surrogate marker for drug efficacy, is important, especially when aiming for precision medicine. However, it lacks reliable prediction methods.
Aims: To develop and externally validate a web-based artificial intelligence(AI)-derived tool for predicting DS of infliximab and vedolizumab in patients with moderate-to-severe Ulcerative Colitis (UC).
Methods: Data from three Israeli centers included infliximab or vedolizumab patients treated for >54 weeks. Sustainability meant no corticosteroids, hospitalizations or surgeries. Machine learning techniques predicted >54-week and overall DS using baseline clinical data.
Results: The model was developed using data from 246 patients from Rabin Medical Center and externally validated on 67 patients from Rambam Health Care Campus and Sheba Medical Center. No significant difference in DS was observed across the datasets. Most patients were biologic-naïve and primarily treated with vedolizumab. The model performed well, with an area under the ROC curve of 0.86, and showed good accuracy (65.5 %-76.9 %) across the test sets.
Conclusions: The study introduces a novel, AI-based tool for predicting >54-week DS of infliximab and vedolizumab in moderate-to-severe UC, using baseline parameters. This can aid clinical decision-making in the framework of precision medicine, promising to optimize disease management while maintaining physician autonomy.
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http://dx.doi.org/10.1016/j.dld.2024.06.008 | DOI Listing |
Clin J Gastroenterol
September 2025
Department of Gastroenterology, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
The patient, a woman in her 40 s, was diagnosed with Crohn's disease (CD) of the small and large intestine, for which she had been treated for 30 years. The disease activity was difficult to control with infliximab. She underwent multiple surgical procedures, including partial resection of the small intestine and colostomy.
View Article and Find Full Text PDFAliment Pharmacol Ther
July 2025
Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Combining two advanced therapies may improve outcomes in Crohn's disease (CD) refractory to monotherapy. We conducted a descriptive case series of 27 patients with CD who initiated combination therapy with upadacitinib and infliximab (n = 1), risankizumab (n = 17), ustekinumab (n = 3) or vedolizumab (n = 6). At 12 weeks, 24 achieved clinical response and 9 achieved steroid-free remission.
View Article and Find Full Text PDFCase Rep Gastroenterol
March 2025
Department of Gastroenterology and Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Introduction: The medical treatment of refractory collagenous colitis with a concomitant symptomatic lymphocytic disorder of the upper gastrointestinal tract is very challenging with scarce evidence.
Case Presentation: We present a 61-year-old female patient with a long-standing highly refractory collagenous colitis with a concomitant symptomatic lymphocytic disorder with villous atrophy and intraepithelial lymphocytes of the upper gastrointestinal tract causing severe watery diarrhoea with severe hypokalemia and recurrent episodes of prerenal kidney injuries requiring several hospital admissions. Celiac serology as well as genetic analyses (HLA-DQ2/DQ8) were negative, and other common etiologies of intraepithelial lymphocytosis and villous atrophy were ruled out.
Pharmacol Rep
August 2025
Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, 88100, Italy.
Background: The use of immune-modifying biological agents has markedly changed the clinical course and the management of inflammatory bowel diseases (IBDs). Active post-marketing surveillance programs are essential for the early recognition of both expected and unexpected adverse events (AEs), providing a powerful tool for better defining the safety profiles of biologics in a real-world setting.
Methods: Patients diagnosed with IBDs and treated with biologic drugs at two gastroenterology units in Calabria, Italy, were monitored during the period from 2023 to 2024.
Front Immunol
August 2025
Department of Gastroenterology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Background: Inflammatory bowel disease (IBD) presents unpredictable therapeutic responses and complex immune dysregulation. Current precision medicine approaches lack robust molecular tools integrating transcriptomic signatures with immune dynamics for personalized treatment guidance.
Methods: We performed multi-omics analyses of GEO datasets using machine learning algorithms (LASSO/Random Forest) to derive a four-gene signature.