Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2022; 28(23): 2582-2596
Published online Jun 21, 2022. doi: 10.3748/wjg.v28.i23.2582
Infliximab trough level combined with inflammatory biomarkers predict long-term endoscopic outcomes in Crohn’s disease under infliximab therapy
Wan-Ting Cao, Rong Huang, Shan Liu, Yi-Hong Fan, Mao-Sheng Xu, Yi Xu, Hui Ni
Wan-Ting Cao, Rong Huang, Yi-Hong Fan, Yi Xu, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Key Laboratory of Gastrointestinal Diseases Pathophysiology, Hangzhou 310006, Zhejiang Province, China
Shan Liu, Department of Clinical Evaluation Center, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Mao-Sheng Xu, Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Hui Ni, Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Author contributions: Fan YH designed the research; Cao WT performed the research; Cao WT and Liu S analyzed the data; Cao WT, Huang R, Ni H and Xu MS wrote the paper; Xu Y supervised the paper; All authors have read and approve the final manuscript.
Supported by National Natural Science Foundation of China, No. 81473506 and No. 81971600; Zhejiang TCM Science and Technology Project, No. 2019ZA056, No. 2021ZA057 and No. 2016ZA077.
Institutional review board statement: This study was reviewed and approved by the ethics committee of the First Affiliated Hospital of Zhejiang Chinese Medical University, No. 2021-KL-024-02.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Some or all data, models, or code generated or used during the study are available from the corresponding author by request. People could contact the corresponding author to get the data which is not used for commercial purposes.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Hong Fan, MD, Associate Professor, Chief Doctor, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Key Laboratory of Gastrointestinal Diseases Pathophysiology, No. 54 Youdian Road, Shangcheng District, Hangzhou 310006, Zhejiang Province, China. yhfansjr@163.com
Received: October 30, 2021
Peer-review started: October 30, 2021
First decision: March 11, 2022
Revised: March 25, 2022
Accepted: May 7, 2022
Article in press: May 7, 2022
Published online: June 21, 2022
Processing time: 229 Days and 3.9 Hours
Core Tip

Core Tip: Previous investigations, contraposing Crohn’s disease patients under infliximab (IFX) maintenance therapy, have indicated that higher IFX trough levels (ITLs) were associated with sustained drug response and clinical remission in inflammatory bowel disease patients, while lower ITLs were linked to secondary unresponsiveness of IFX. Currently, endoscopic remission or mucosal healing has been considered the main goal of biological therapy. Our study manifested that Crohn’s disease patients with higher levels of IFX blood concentration and lower levels of inflammatory biomarkers tended to have a better long-term endoscopic prognosis. Combining ITL, fecal calprotectin and C-reactive protein monitoring was helpful for the timely adjustment of IFX treatment strategy.