Effectiveness of biologics for endoscopic healing in patients with isolated proximal small bowel Crohn’s disease

Table 1 Baseline clinical features, n (%)

Variables	All patients (n = 110)
Male	88 (80.0)
Age, years, median (IQR)	33 (25-39)
Disease duration, years, median (IQR)	1.1 (0.4-2.5)
Smoking history	18 (16.4)
Disease behavior
Bl: Inflammatory	30 (27.3)
B2: Stricturing	62 (56.4)
B3: Penetrating	18 (16.4)
Perianal disease	65 (59.1)
HBI, median (IQR)	7 (5-7)
HBI > 4	94 (85.5)
CRP, mg/L, median (IQR)	2.1 (0.6-8.9)
Albumin, g/L, median (IQR)	39 (36-42)
Hemoglobin, g/L, median (IQR)	129 (112-139)
Prior biologic exposure	33 (30.0)
Current biologic therapy
Infliximab	64 (58.2)
Ustekinumab	28 (25.5)
Vedolizumab	18 (16.4)
Concomitant treatment
Steroids	3 (2.7)
Immunomodulator	34 (30.9)
Baseline BAE evaluation
Modified SES-CD, median (IQR)	8 (6-9)
Bowel segment with active disease1
Jejunum	39 (35.5)
Proximal ileum	103 (93.6)
Very large ulcers (> 2.0 cm)
Jejunum	11/39 (28.2)
Proximal ileum	35/103 (34.0)
Dose optimization	7 (6.4)

¹Bowel segment with active disease was defined as having a segmental modified simple endoscopic score for Crohn’s disease ≥ 3, accompanied by any size ulcer.

IQR: Interquartile range; HBI: Harvey-Bradshaw Index; CRP: C-reactive protein; BAE: Balloon-assisted enteroscopy; SES-CD: Simple endoscopic score for Crohn’s disease.

Table 2 Risk for failure to achieve complete endoscopic healing after one-year biologic therapy

Variables	Univariate analysis			Multivariate analysis
	OR	95%CI	P value	aOR	95%CI	P value
Male	1.863	0.500-6.944	0.354
Age > 40	0.457	0.097-2.161	0.323
Disease duration > 2 years	0.578	0.207-1.612	0.295
Active smoker	0.423	0.090-1.988	0.276
B2/3 behavior	0.191	0.066-0.559	< 0.001	0.261	0.087-0.778	0.016
Perianal involvement	0.434	0.156-1.207	0.434
Prior biologic exposure	0.078	0.010-0.607	0.015	0.080	0.010-0.674	0.020
Immunomodulator use	0.271	0.075-0.985	0.047	0.448	0.108-1.860	0.269
Moderate-to-severe endoscopic disease1	3.617	1.396-9.374	0.008	0.277	0.093-0.829	0.022
Prior intestinal resection	0.350	0.042-2.886	0.329
Dose optimization	1.630	0.186-14.256	0.659
Type of biological therapies (IFX reference)
Vedolizumab	0.139	0.017-1.123	0.064
Ustekinumab	0.533	0.277-1.027	0.060

¹Moderate-to-severe endoscopic disease was defined as the modified simple endoscopic score for Crohn’s disease ≥ 7.

OR: Odds ratio; IFX: Infliximab; aOR: Adjusted odds ratio.