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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Drugs for Treatment of Ulcerative Colitis in IBD01:29

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Algorithmic Identification of Treatment-Emergent Adverse Events From Clinical Notes Using Large Language Models: A

Anna L Silverman1,2, Madhumita Sushil3, Balu Bhasuran3

  • 1Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Phoenix, Arizona, USA.

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Large language models (LLMs) like UCSF-BERT show promise for improving drug safety surveillance. This new clinical LLM achieved superior accuracy in detecting serious adverse events from outpatient notes.

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Area of Science:

  • Pharmacovigilance and Drug Safety
  • Clinical Natural Language Processing
  • Artificial Intelligence in Healthcare

Background:

  • Outpatient clinical notes contain valuable drug safety data but are underutilized due to text mining limitations.
  • Existing text mining methods struggle with accurate adverse event (AE) detection.
  • Large language models (LLMs) show potential for natural language processing tasks but require evaluation for AE detection.

Purpose of the Study:

  • To adapt and evaluate a clinical LLM, UCSF-BERT, for detecting serious adverse events (SAEs) in inflammatory bowel disease (IBD) patients.
  • To compare the performance of UCSF-BERT against other language models for AE detection in clinical notes.
  • To assess the utility of LLMs in enhancing pharmacovigilance.

Main Methods:

  • Annotated 928 outpatient IBD notes for SAE-associated hospitalizations following non-steroid immunosuppressant use.
  • Adapted UCSF-BERT, a clinical LLM, for SAE detection.
  • Compared UCSF-BERT with eight other candidate language models.

Main Results:

  • UCSF-BERT achieved the highest numerical performance (accuracy 88-92%, macro F1 61-68%), outperforming previous models by 5-10%.
  • UCSF-BERT demonstrated significant superiority (P < 0.01) in identifying hospitalization events linked to medication use.
  • Failure of intended efficacy was the most common SAE identified.

Conclusions:

  • LLMs, specifically UCSF-BERT, offer numerically superior accuracy for SAE detection from clinical notes compared to prior methods.
  • These findings highlight the potential of LLMs to significantly enhance pharmacovigilance efforts.
  • Further research with multicenter data and advanced architectures is warranted to optimize this methodology.