How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.1/19827 |
Resumo: | 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 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. |
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How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective studyBiomarkersCalprotectinCrohn's diseaseInfliximabBackgroundTimely 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.Portuguese Group of Studies in Inflammatory Bowel Disease (GEDII)John Wiley & SonsSapientiaMagro, FernandoEstevinho, Maria ManuelaCatalano, GaiaPatita, MartaArroja, BrunoLago, PaulaRosa, IsadoraSousa, Helena TavaresMinistro, PaulaMocanu, IrinaVieira, AnaCastela, JoanaMoleiro, JoanaRoseira, JoanaCancela, EugéniaSousa, PaulaPortela, FranciscoCorreia, LuísMoreira, PaulaSantiago, MafaldaDias, SandraAfonso, JoanaDanese, SilvioPeyrin‐Biroulet, LaurentDias, Cláudia Camila2023-07-13T14:21:07Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.1/19827eng2050-640610.1002/ueg2.12420info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-24T10:32:22Zoai:sapientia.ualg.pt:10400.1/19827Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:09:23.058324Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study |
title |
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study |
spellingShingle |
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study Magro, Fernando Biomarkers Calprotectin Crohn's disease Infliximab |
title_short |
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study |
title_full |
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study |
title_fullStr |
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study |
title_full_unstemmed |
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study |
title_sort |
How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?—A prospective study |
author |
Magro, Fernando |
author_facet |
Magro, Fernando Estevinho, Maria Manuela Catalano, Gaia Patita, Marta Arroja, Bruno Lago, Paula Rosa, Isadora Sousa, Helena Tavares Ministro, Paula Mocanu, Irina Vieira, Ana Castela, Joana Moleiro, Joana Roseira, Joana Cancela, Eugénia Sousa, Paula Portela, Francisco Correia, Luís Moreira, Paula Santiago, Mafalda Dias, Sandra Afonso, Joana Danese, Silvio Peyrin‐Biroulet, Laurent Dias, Cláudia Camila |
author_role |
author |
author2 |
Estevinho, Maria Manuela Catalano, Gaia Patita, Marta Arroja, Bruno Lago, Paula Rosa, Isadora Sousa, Helena Tavares Ministro, Paula Mocanu, Irina Vieira, Ana Castela, Joana Moleiro, Joana Roseira, Joana Cancela, Eugénia Sousa, Paula Portela, Francisco Correia, Luís Moreira, Paula Santiago, Mafalda Dias, Sandra Afonso, Joana Danese, Silvio Peyrin‐Biroulet, Laurent Dias, Cláudia Camila |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Sapientia |
dc.contributor.author.fl_str_mv |
Magro, Fernando Estevinho, Maria Manuela Catalano, Gaia Patita, Marta Arroja, Bruno Lago, Paula Rosa, Isadora Sousa, Helena Tavares Ministro, Paula Mocanu, Irina Vieira, Ana Castela, Joana Moleiro, Joana Roseira, Joana Cancela, Eugénia Sousa, Paula Portela, Francisco Correia, Luís Moreira, Paula Santiago, Mafalda Dias, Sandra Afonso, Joana Danese, Silvio Peyrin‐Biroulet, Laurent Dias, Cláudia Camila |
dc.subject.por.fl_str_mv |
Biomarkers Calprotectin Crohn's disease Infliximab |
topic |
Biomarkers Calprotectin Crohn's disease Infliximab |
description |
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 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. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-07-13T14:21:07Z 2023 2023-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.1/19827 |
url |
http://hdl.handle.net/10400.1/19827 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
2050-6406 10.1002/ueg2.12420 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
John Wiley & Sons |
publisher.none.fl_str_mv |
John Wiley & Sons |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799133341433200640 |