Observational studyUnited European gastroenterology journal2023
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?-A prospective study.
Observational study in United European gastroenterology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of ustekinumab and tumor necrosis factor antagonists on extraintestinal manifestations of Crohn's disease: a systematic review and meta-analysis.Frontiers in pharmacology · 2026Pooled it
- Interpretable machine learning model predicts the early gastrointestinal dysfunction risk in severely burned patients: a multicenter-based study.International journal of surgery (London, England) · 2026Article
- Magnetic resonance enterography to predict disabling disease in newly diagnosed Crohn's disease: the METRIC-EF multivariable prediction model, multicentre diagnostic inception cohort study.Health technology assessment (Winchester, England) · 2026Article
- Vedolizumab for Crohn's disease: Real-world efficacy through a meta-analytical lens.United European gastroenterology journal · 2025Article
- Prediction of early mucosal healing of Crohn's disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factors.Frontiers in pharmacology · 2025Article
- UEG Journal and Impact on Clinical Practice.United European gastroenterology journal · 2024Article
- Anemia and Iron Deficiency Predict All-Cause Mortality in Patients with Heart Failure and Preserved Ejection Fraction: 6-Year Follow-Up Study.Diagnostics (Basel, Switzerland) · 2024Article
- Biomarkers in inflammatory bowel disease: a practical guide.Therapeutic advances in gastroenterology · 2024Review
- How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?-A prospective study.United European gastroenterology journal · 2023Observational
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Authors and funding
26 authors.
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Abstract
backgroundTimely 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 μg/g) in at least one visit were also significant predictors, while milder elevations (3.1-10.0 mg/L and 250.1-500.0 μg/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.
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