ArticleIntestinal research2022
Biomarker dynamics during infliximab salvage for acute severe ulcerative colitis: C-reactive protein (CRP)-lymphocyte ratio and CRP-albumin ratio are useful in predicting colectomy.
Article in Intestinal research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Predictors for colectomy in patients with acute severe ulcerative colitis: a systematic review and meta-analysis.BMJ open gastroenterology · 2024Pooled it
- Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease.Nutrients · 2023Pooled it
- Association Between the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index and Tissue-Confirmed Cytomegalovirus Colitis in Patients with Active Ulcerative Colitis.Diagnostics (Basel, Switzerland) · 2026Article
- Article
- Association between the C-reactive protein to albumin ratio and unplanned readmission in ulcerative colitis: insights from a cohort study.Frontiers in medicine · 2026Article
- In Acute Severe Ulcerative Colitis Patients Who Receive Rescue Therapy, Prior Maintenance Therapy and Day 3 C-Reactive Protein After Rescue Therapy Are Associated With 12-Month Colectomy Risk.Inflammatory bowel diseases · 2024Article
- Defining management strategies for acute severe ulcerative colitis using predictive models: a simulation-modeling study.Intestinal research · 2024Article
- Predicting Outcome after Acute Severe Ulcerative Colitis: A Contemporary Review and Areas for Future Research.Journal of clinical medicine · 2024Review
- Clinical utility of C-reactive protein-to-albumin ratio in the management of patients with inflammatory bowel disease.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Medical treatment selection and outcomes for hospitalized patients with severe ulcerative colitis as defined by the Japanese criteria.Journal of gastroenterology · 2024Article
- Article
- Unresolved challenges in acute severe ulcerative colitis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Article
- Which biomarkers best reflect the degree of inflammation in Crohn's disease?Intestinal research · 2024Article
- Article
- Ischemia-modified albumin: a novel blood marker of endoscopic mucosal healing in inflammatory bowel disease.Intestinal research · 2024Article
- Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms.Inflammatory intestinal diseases · 2023Article
- Exploring the diagnostic and prognostic value of the C-reactive protein/lymphocyte ratio for dilated cardiomyopathy based on a real-world study.Scientific reports · 2023Article
- Clinical significance of the C-reactive protein-to-bilirubin ratio in patients with ulcerative colitis.Frontiers in medicine · 2023Article
- C-Reactive Protein/Albumin Ratio at Diagnosis of Pediatric Inflammatory Bowel Disease: A Retrospective Multi-Center Study.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Clinical outcomes and predictors of response for adalimumab in patients with moderately to severely active ulcerative colitis: a KASID prospective multicenter cohort study.Intestinal research · 2022Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsThe residual risk of colectomy after infliximab salvage in steroid-refractory acute severe ulcerative colitis (ASUC) is required to inform the need for subsequent maintenance biologic therapy. The aim of this study was to determine the dynamic response of common serum biomarkers to infliximab salvage and assess their utility in predicting subsequent colectomy.
methodsA retrospective single-center cohort study was conducted on all patients who received infliximab salvage for steroid-refractory ASUC between January 1, 2010, and July 31, 2019. Biomarkers were assessed on admission and days 1 and 3 post infliximab, and included C-reactive protein (CRP)-albumin-ratio (CAR), CRP-lymphocyte-ratio (CLR), platelet-lymphocyte-ratio (PLR) and neutrophil-lymphocyte-ratio (NLR).
resultsOf 94 patients (median age, 35 years; 67% of male), 20% required colectomy at 12 months. Biomarkers on day 3 post-infliximab best differentiated nonresponders, who had higher CRP, lower albumin and lower lymphocyte count (each P< 0.05). Day 3 predictive performance (area under the curve) for 12-month colectomy was best for CAR (0.871) and CLR (0.874), which were similar to Lindgren (0.829; P> 0.05) but superior to Mayo (0.726), partial Mayo (0.719), PLR (0.719), Ho index (0.714), NLR (0.675), Travis score (0.657) and endoscopic Mayo (0.609) (each P< 0.05). A day 3 CAR cutoff of 0.47 mg/g had 79% sensitivity, 80% specificity, 94% negative predictive value (NPV) to predict colectomy; while a day 3 CLR cutoff of 6.0 mg/109 had 84% sensitivity, 84% specificity, 96% NPV.
conclusionsCAR and CLR measured on day 3 post infliximab salvage for steroid-refractory ASUC represent simple and routinely performed biomarkers that appear to be strong predictors of colectomy. Prospective studies are required to confirm the utility of these predictive scores.
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