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How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study

2023Journal article Open access
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dc.contributor.authorMagro, Fernando
dc.contributor.authorEstevinho, Maria Manuela
dc.contributor.authorCatalano, Gaia
dc.contributor.authorPatita, Marta
dc.contributor.authorArroja, Bruno
dc.contributor.authorLago, Paula
dc.contributor.authorRosa, Isadora
dc.contributor.authorSousa, Helena Tavares
dc.contributor.authorMinistro, Paula
dc.contributor.authorMocanu, Irina
dc.contributor.authorVieira, Ana
dc.contributor.authorCastela, Joana
dc.contributor.authorMoleiro, Joana
dc.contributor.authorRoseira, Joana
dc.contributor.authorCancela, Eugénia
dc.contributor.authorSousa, Paula
dc.contributor.authorPortela, Francisco
dc.contributor.authorCorreia, Luís
dc.contributor.authorMoreira, Paula
dc.contributor.authorSantiago, Mafalda
dc.contributor.authorDias, Sandra
dc.contributor.authorAfonso, Joana
dc.contributor.authorDanese, Silvio
dc.contributor.authorPeyrin‐Biroulet, Laurent
dc.contributor.authorDias, Cláudia Camila
dc.date.accessioned2023-07-13T14:21:07Z
dc.date.available2023-07-13T14:21:07Z
dc.date.issued2023
dc.description.abstractBackgroundTimely stratification of Crohn's disease (CD) is essential for patients' management. The use of noninvasive accurate biomarkers is key to monitor treatment and to pursue mucosal healing, the ultimate treatment endpoint in CD. ObjectiveWe aimed to evaluate the performance of readily available biomarkers and develop risk matrices to predict CD progression. MethodsData from 289 CD patients receiving infliximab (IFX) maintenance therapy for 2 years was collected; those patients were included in DIRECT, a prospective multicenter observational study. Disease progression was evaluated using two composite outcomes incorporating clinical and drug-related factors, the first including IFX dose and/or frequency adjustments. Univariate and multivariable logistic regressions were used to calculate the odds ratios (OR) and to develop risk matrices. ResultsThe isolated presence of anemia at least once during follow-up was a significant predictor of disease progression (OR 2.436 and 3.396 [p <= 0.001] for composite outcomes 1 and 2, respectively) regardless of confounding factors. Isolated highly elevated C-reactive protein (CRP; >10.0 mg/L) and fecal calprotectin (FC; >500.0 mu g/g) in at least one visit were also significant predictors, while milder elevations (3.1-10.0 mg/L and 250.1-500.0 mu g/g) were only relevant when detected in at least two visits (consecutive or not). The combination of biomarkers in risk matrices had good ability to predict progression; patients simultaneously presenting anemia, highly elevated CRP and FC at least once had 42%-63% probability of achieving the composite outcomes. ConclusionThe combined evaluation of hemoglobin, CRP, and FC in at least one time point and their incorporation into risk matrices seems to be the optimal strategy for CD management, as data from additional visits did not meaningfully influence the predictions and may delay decision-making.pt_PT
dc.description.sponsorshipPortuguese Group of Studies in Inflammatory Bowel Disease (GEDII)pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1002/ueg2.12420pt_PT
dc.identifier.issn2050-6406
dc.identifier.urihttp://hdl.handle.net/10400.1/19827
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherJohn Wiley & Sonspt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectBiomarkerspt_PT
dc.subjectCalprotectinpt_PT
dc.subjectCrohn's diseasept_PT
dc.subjectInfliximabpt_PT
dc.titleHow many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage11pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleUnited European Gastroenterology Journalpt_PT
person.familyNameSousa
person.givenNameHelena Tavares
person.identifier.ciencia-idCF1F-1163-1C4A
person.identifier.orcid0000-0002-6626-205X
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication6b1d11dd-486f-4fb3-b41f-02e1cf6a5c2e
relation.isAuthorOfPublication.latestForDiscovery6b1d11dd-486f-4fb3-b41f-02e1cf6a5c2e

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