Validation and update of a prediction model for risk of relapse after cessation of anti-TNF treatment in Crohn's disease
| العنوان: | Validation and update of a prediction model for risk of relapse after cessation of anti-TNF treatment in Crohn's disease |
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| المؤلفون: | Huinink, S.T., Jong, D.C. de, Nieboer, D., Thomassen, D., Steyerberg, E.W., Dijkgraaf, M.G.W., Bodelier, A.G.L., West, R.L., Romkens, T.E.H., Hoentjen, F., Mallant, R.C., Tuyl, B.A.C. van, Mares, W.G.N., Wolfhagen, F.H.J., Dijkstra, G., Reijnders, J.G.P., Boer, N.K. de, Tan, A.C.I.T.L., Boeckel, P.G.A. van, Tack, G.J., Asseldonk, D.P. van, D'Haens, G.R.A.M., Woude, C.J. van der, Duijvestein, M., Vries, A.C. de |
| المساهمون: | Groningen Institute for Organ Transplantation (GIOT), Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Translational Immunology Groningen (TRIGR), Gastroenterology and Hepatology, Graduate School, Epidemiology and Data Science, APH - Methodology, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and hepatology, Gastroenterology & Hepatology, Public Health, Surgery |
| المصدر: | European journal of gastroenterology & hepatology, 34(10), 983-992. Lippincott Williams and Wilkins European Journal of Gastroenterology & Hepatology, 34, 983-992 European journal of gastroenterology & hepatology, 34(10), 983-992. Lippincott Williams & Wilkins European Journal of Gastroenterology & Hepatology, 34, 10, pp. 983-992 European Journal of Gastroenterology & Hepatology, 34(10), 983-992. LIPPINCOTT WILLIAMS & WILKINS ten Bokkel Huinink, S, de Jong, D C, Nieboer, D, Thomassen, D, Steyerberg, E W, Dijkgraaf, M G W, Bodelier, A G L, West, R L, Römkens, T E H, Hoentjen, F, Mallant, R C, van Tuyl, B A C, Mares, W G N, Wolfhagen, F H J, Dijkstra, G, Reijnders, J G P, de Boer, N K, Tan, A C I T L, van Boeckel, P G A, Tack, G J, van Asseldonk, D P, D'Haens, G R A M, van der Woude, C J, Duijvestein, M & de Vries, A C 2022, ' Validation and update of a prediction model for risk of relapse after cessation of anti-TNF treatment in Crohn's disease ', European journal of gastroenterology & hepatology, vol. 34, no. 10, pp. 983-992 . https://doi.org/10.1097/MEG.0000000000002403 |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | anti-TNF therapy, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Risk Assessment, All institutes and research themes of the Radboud University Medical Center, Crohn Disease, Recurrence, Humans, METAANALYSIS, Retrospective Studies, Models, Statistical, Hepatology, FACTOR-ALPHA THERAPY, Gastroenterology, Reproducibility of Results, REMISSION, prediction, EFFICACY, BREAST-CANCER RISK, Crohn's disease, MAINTENANCE, cessation, Withholding Treatment, SAFETY, ANTITUMOR NECROSIS FACTOR, Tumor Necrosis Factor Inhibitors, WITHDRAWAL, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5], INFLAMMATORY-BOWEL-DISEASE |
| الوصف: | BACKGROUND: Anti-tumor necrosis factor (TNF) therapy is effective for the treatment of Crohn's disease. Cessation may be considered in patients with a low risk of relapse. We aimed to externally validate and update our previously developed prediction model to estimate the risk of relapse after cessation of anti-TNF therapy. METHODS: We performed a retrospective cohort study in 17 Dutch hospitals. Crohn's disease patients in clinical, biochemical or endoscopic remission were included after anti-TNF cessation. Primary outcome was a relapse necessitating treatment. Discrimination and calibration of the previously developed model were assessed. After external validation, the model was updated. The performance of the updated prediction model was assessed in internal-external validation and by using decision curve analysis. RESULTS: 486 patients were included with a median follow-up of 1.7 years. Relapse rates were 35 and 54% after 1 and 2 years. At external validation, the discriminative ability of the prediction model was equal to that found at the development of the model [c-statistic 0.58 (95% confidence interval (CI) 0.54-0.62)], though the model was not well-calibrated on our cohort [calibration slope: 0.52 (0.28-0.76)]. After an update, a c-statistic of 0.60 (0.58-0.63) and calibration slope of 0.89 (0.69-1.09) were reported in internal-external validation. CONCLUSION: Our previously developed and updated prediction model for the risk of relapse after cessation of anti-TNF in Crohn's disease shows reasonable performance. The use of the model may support clinical decision-making to optimize patient selection in whom anti-TNF can be withdrawn. Clinical validation is ongoing in a prospective randomized trial. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0954-691X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::48a17de86d4eacf6d66f3e5e97f5bb99 https://hdl.handle.net/1887/3564559 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....48a17de86d4eacf6d66f3e5e97f5bb99 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 0954691X |
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