Copyright
©The Author(s) 2019.
World J Gastroenterol. Apr 14, 2019; 25(14): 1764-1774
Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1764
Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1764
Table 1 Patient’s demographic characteristics (n = 62) n (%)
Patient’s demographic characteristics (n = 62) | |
Female, n (%) | 31 (50) |
Age at inclusion, mean (min-max) | 39 (18-72) |
Disease duration (yr), mean (min-max) | 9 (0-33) |
Location | |
Terminal ileum | 32 (52) |
Colonic | 15 (24) |
Ileocolonic | 15 (24) |
Associated upper involvement | 3 (5) |
Phenotype | |
Inflammatory | 39 (63) |
Stricturing | 14 (22) |
Penetrating | 9 (15) |
Associated structuring + penetrating | 4 (7) |
Perianal disease | 16 (26) |
Current smokers | 19 (31) |
Anti-TNFdrug used | |
Infliximab | 34 (55) |
Adalimumab | 28 (45) |
Prior anti-TNF exposure | 16 (26) |
Immunomodulators at baseline | 53 (86) |
Steroids at baseline | 13 (21) |
Previous CD surgery | 9 (15) |
Table 2 Biological, pharmacokinetic, clinical and endoscopic data at baseline and during follow up
Baseline, n = 62 | Week 14, n = 59 | P value (week 14- baseline) | Week 46, n = 56 | P value (week 46- baseline) | |
CDAI, median (IQR) | 201 (114-236) | 60 (28-94) | P < 0.001 | 53 (26-94) | P < 0.001 |
CDEIS, median (IQR) | 6.7 (5-11.3) | 3.2 (0.8-5) | P < 0.001 | 3.0 (0.2-4.4) | P < 0.001 |
CRP mg/dL, median (IQR) | 0.66 (0,16-1.72) | 0.2 (0.03-0.71) | P = 0.125 | 0.19 (0.03-0.76) | P < 0.05 |
Hemoglobin g/L, median (IQR) | 127 (113-140) | 135 (121-141) | P < 0.05 | 134 (123-143) | P < 0.05 |
Albumin g/L, median (IQR) | 41 (40-43) | 43 (40-45) | P < 0.05 | 43 (40-45) | P < 0.05 |
Serum TNF-alpha pg/mL, median (IQR) | 5.5 (3.3-8) | 20 (11-36) | P < 0.001 | 17 (8.25-30) | P < 0.001 |
Fecal Calprotectin μg/g, median (IQR) | 1044 (685-1800) | 610 (209-1646) | P < 0.05 | 940 (233-1747) | P < 0.05 |
Infliximab μg/mL, median (IQR) | 0 (0-0) | 3.1 (1.2-5.6) | P < 0.001 | 1.8 (1-6.6) | P < 0.001 |
ATIs, % patients (n) | 8 (5/62) | 3 (1/34) | P = 0.327 | 13 (4/32) | P = 0.230 |
Adalimumab μg/mL, median (IQR) | 0 (0-0) | 8.9 (5.6-12) | P < 0.001 | 9.9 (7-12) | P < 0.001 |
ATAs, % patients (n/total) | 10 (6/62) | 0 (0/25) | P = 0.117 | 4.1 (1/24) | P = 0.408 |
Table 3 Sensitivity and specificity of variables at week 14 as predictors of long-term mucosal healing
Variable | Sensitivity | Specificity |
CDEIS < 3 | 69 | 67 |
CDEIS < 4 | 62 | 78 |
80% reduction of CDEIS (baseline to week 14) | 59 | 91 |
Endoscopic response at week 14 | 85 | 66 |
Endoscopic remission at week 14 | 59 | 85 |
Table 4 Diagnostic accuracy of 80% Crohn’s Disease Endoscopic Index of Severity reduction at week 14 for the diagnosis of long-term mucosal healing
Mucosal healing at week 46 | ||||
No | Yes | |||
≥ 80% reduction in CDEIS at week 14 from baseline | No | n (%) | 32 (74.4) | 11(25.6) |
Yes | n (%) | 3 (15.8) | 16 (84.2) |
Table 5 Comparison between 50 and 80% Crohn’s Disease Endoscopic Index of Severity reduction from baseline to week 14 as predictors of long-term mucosal healing
CDEIS reduction | Sensitivity (95%CI) | Specificity (95%CI) | PPV (95%CI) | NPV (95%CI) | LR+ (95%CI) | LR- (95%CI) |
50% | 85 (66%-96%) | 66 (48%-81%) | 66 (54%-76%) | 85 (69%-93%) | 2.5 (1.5-4) | 0.23 (0.09-0.57) |
80% | 59 (39%-77%) | 91 (77%-98%) | 84 (63%-94%) | 74 (65%-82%) | 6.9 (2.24-21) | 0.45 (0.28-0.72) |
- Citation: Alfaro I, Masamunt MC, Planell N, López-García A, Castro J, Gallego M, Barastegui R, Giner A, Vara A, Salas A, Ricart E, Panés J, Ordás I. Endoscopic response to tumor necrosis factor inhibitors predicts long term benefits in Crohn’s disease. World J Gastroenterol 2019; 25(14): 1764-1774
- URL: https://www.wjgnet.com/1007-9327/full/v25/i14/1764.htm
- DOI: https://dx.doi.org/10.3748/wjg.v25.i14.1764