Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn's Disease Patients on Ustekinumab.

Autor: Chaparro M; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, 28006 Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain., Baston-Rey I; Complejo Hospitalario Universitario de Santiago, 15706 Santiago de Compostela, Spain., Fernández Salgado E; Complejo Hospitalario de Pontevedra, 36164 Pontevedra, Spain., González García J; Hospital Público Comarcal la Inmaculada, 04600 Almería, Spain., Ramos L; Hospital Universitario de Canarias, 38320 Tenerife, Spain., Diz-Lois Palomares MT; Hospital Universitario A Coruña, 15006 A Coruña, Spain., Argüelles-Arias F; Hospital Universitario Virgen Macarena, 41009 Seville, Spain.; Facultad de Medicina, Universidad de Sevilla, 41009 Seville, Spain., Iglesias Flores E; Hospital Universitario Reina Sofía, 14004 Córdoba, Spain., Cabello M; Hospital Universitario Virgen de Valme, 41014 Seville, Spain., Rubio Iturria S; Complejo Hospitalario de Navarra, 31008 Pamplona, Spain., Núñez Ortiz A; Hospital Universitario Virgen del Rocío, 41013 Seville, Spain., Charro M; Hospital de Barbastro, 22300 Barbastro, Spain., Ginard D; Hospital Universitario Son Espases, 07120 Palma, Spain., Dueñas Sadornil C; Hospital San Pedro de Alcántara, 10003 Cáceres, Spain., Merino Ochoa O; Hospital Universitario Cruces, 48903 Barakaldo, Spain., Busquets D; Hospital Universitari de Girona Doctor Josep Trueta, 17007 Girona, Spain., Iyo E; Hospital Comarcal de Inca, 07300 Inca, Spain., Gutiérrez Casbas A; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.; Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain., Ramírez de la Piscina P; Hospital Universitario de Araba-Txagorritxu, 01004 Vitoria-Gasteiz, Spain., Boscá-Watts MM; Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain., Arroyo M; Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain., García MJ; Hospital Universitario Marqués de Valdecilla, IDIVAL, 39008 Santander, Spain., Hinojosa E; Hospital de Manises, 46940 Manises, Spain., Gordillo J; Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Martínez Montiel P; Hospital Universitario 12 de Octubre, 28041 Madrid, Spain., Velayos Jiménez B; Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain., Quílez Ivorra C; Hospital Marina Baixa, 03570 Villajoyosa, Spain., Vázquez Morón JM; Hospital Universitario Juan Ramón Jiménez, 21002 Huelva, Spain., Huguet JM; Hospital General Universitario de Valencia, 46014 Valencia, Spain., González-Lama Y; Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain., Muñagorri Santos AI; Hospital Universitario de Donostia, 20014 Donostia-San Sebastián, Spain., Amo VM; Hospital Regional de Málaga, 29010 Málaga, Spain., Martín Arranz MD; Hospital Universitario de La Paz, 28046 Madrid, Spain.; Instituto de Investigación Sanitaria del Hospital La Paz (IdiPaz), 28046 Madrid, Spain., Bermejo F; Instituto de Investigación Sanitaria del Hospital La Paz (IdiPaz), 28046 Madrid, Spain.; Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain., Martínez Cadilla J; Hospital Alvaro Cunqueiro, 36213 Vigo, Spain., Rubín de Célix C; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, 28006 Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain., Fradejas Salazar P; Hospital Virgen de la Concha, 49022 Zamora, Spain., López San Román A; Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain., Jiménez N; Hospital General Universitario de Elche, 03203 Elche, Spain., García-López S; Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain., Figuerola A; Hospital General Universitario de Castellón, 12004 Castellón de la Plana, Spain., Jiménez I; Hospital Universitario de Galdakao-Usansolo, 48960 Galdakao, Spain., Martínez Cerezo FJ; Hospital Universitario Sant Joan de Reus, 43204 Reus, Spain., Taxonera C; Hospital Clínico Universitario San Carlos, Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], 28040 Madrid, Spain., Varela P; Hospital Universitario de Cabueñes, 33203 Gijón, Spain., de Francisco R; Hospital Universitario Central de Asturias, Instituto de Investigación Biosanitaria del Principado de Asturias [ISPA], 33011 Oviedo, Spain., Monfort D; Consorci Sanitari de Terrassa, 08227 Terrassa, Spain., Molina Arriero G; Complejo Hospitalario Universitario de Ferrol, 15405 Ferrol, Spain., Hernández-Camba A; Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain., García Alonso FJ; Hospital Universitario Rio Hortega, 47012 Valladolid, Spain., Van Domselaar M; Hospital Universitario de Torrejón, 28850 Torrejón de Ardoz, Spain., Pajares-Villarroya R; Hospital Universitario Infanta Sofía, 28702 San Sebastián de los Reyes, Spain., Núñez A; Hospital Clínico Universitario de Salamanca, 37007 Salamanca, Spain., Rodríguez Moranta F; Hospital Universitario Bellvitge, 08907 L'Hospitalet de Llobregat, Spain., Marín-Jiménez I; Hospital Universitario Gregorio Marañón, 28009 Madrid, Spain., Robles Alonso V; Hospital Universitario Vall d'Hebrón, 08035 Barcelona, Spain., Martín Rodríguez MDM; Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain., Camo-Monterde P; Hospital Universitario San Jorge, 22004 Huesca, Spain., García Tercero I; Hospital General Universitario Santa Lucía, 30202 Cartagena, Spain., Navarro-Llavat M; Hospital de Sant Joan Despí Moisès Broggi, 08970 Sant Joan Despí, Spain., García LA; Hospital Universitario de Burgos, 09006 Burgos, Spain., Hervías Cruz D; Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain., Kloss S; Janssen, EMEA, 2340 Beerse, Belgium., Passey A; Janssen, EMEA, 2340 Beerse, Belgium., Novella C; Janssen Medical Department, Paseo Doce Estrellas, 5-7, 28042 Madrid, Spain., Vispo E; Janssen Medical Department, Paseo Doce Estrellas, 5-7, 28042 Madrid, Spain., Barreiro-de Acosta M; Complejo Hospitalario Universitario de Santiago, 15706 Santiago de Compostela, Spain., Gisbert JP; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, 28006 Madrid, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Aug 03; Vol. 11 (15). Date of Electronic Publication: 2022 Aug 03.
DOI: 10.3390/jcm11154518
Abstrakt: Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index ≤ 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission.
Databáze: MEDLINE
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