Noninvasive biomarkers as surrogate predictors of clinical and endoscopic remission after infliximab induction in patients with refractory ulcerative colitis

Hassan, Elham Ahmed; Ramadan, Haidi Karam‐Allah; Ismael, Ali; Mohamed, Khaled; El-Attar, Madiha M; Alhelali, Ihab

doi:10.4103/sjg.sjg_599_16

Cited by 16 publications

(1 citation statement)

References 36 publications

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“…Furthermore, higher FCP levels following induction were observed in clinical nonresponders compared to responders in another Crohn's cohort treated with anti-TNFs [46]. Similarly, in ulcerative colitis patients treated with infliximab, FCP results following induction are significantly lower in those achieving mucosal healing compared to those that do not [47]. However, as was evident in the current study, not all patients with unequivocal intestinal inflammatory activity have an elevated FCP.…”

Section: Discussionsupporting

confidence: 58%

Early sonographic response to a new medical therapy is associated with future treatment response or failure in patients with inflammatory bowel disease

Smith

Taylor

Friedman

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Objective Gastrointestinal ultrasound (GIUS) accurately assesses inflammation and is responsive to changes in inflammatory bowel disease. This study aimed to determine the prognostic utility of sonographic response in the first 14 weeks of a newly-instituted therapy with therapeutic response at 46 weeks and to compare its performance with standard clinical assessment tools. Methods Patients with sonographic evidence of inflammation were assessed by GIUS, clinical activity, serum C-reactive protein and faecal calprotectin again 2, 6 and 14 weeks after commencing a new biologic or thiopurine. Treatment failure was defined as undergoing surgery, hospitalisation, escalation of dosage or introduction of new medication over 46-weeks' follow-up. Sonographic response was defined as a decrease in bowel wall thickness and improved vascularity. Results In 31 patients (median age 49 years, 74% Crohn's disease), sonographic response at 14 weeks [OR 19.3, 95% confidence interval (CI), 3.23-101.10; P = 0.0054] and faecal calprotectin (P = 0.018), but no clinical disease activity or C-reactive protein, were predictive of subsequent treatment response. Sonographic response alone was predictive at week 6 (P = 0.016), but not week 2. 16% reduction in bowel wall thickness at 6 weeks (area-under-the-receiver-operator-curve=0.86; P = 0.002; sensitivity 72%, specificity 90%), with similar performance for 10% at 14 weeks, was associated with treatment response. Conclusion Sonographic response as early as 6 weeks after initiation of a new therapy may accurately predict treatment outcomes over 46 weeks and is superior to other markers used to monitor disease activity.

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Section: Discussionsupporting

confidence: 58%

Early sonographic response to a new medical therapy is associated with future treatment response or failure in patients with inflammatory bowel disease

Smith

Taylor

Friedman

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Chronic Active Ulcerative Colitis

Vaughan

Christensen

Rubin³

2019

Biomarkers in Inflammatory Bowel Diseases

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Patient sex does not affect endoscopic outcomes of biologicals in inflammatory bowel disease but is associated with adverse events

Lie

Paulides

Woude

2020

Int J Colorectal Dis

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Purpose Biological therapies are currently the mainstay in the treatment of patients with inflammatory bowel diseases (IBD). Several factors are known to influence the efficacy and tolerability of biologicals, such as CRP levels or previous biological use. Whether patient sex affects the efficacy or tolerability is unclear but would help with better risk and benefit stratification. This systematic review assesses patient sex on the efficacy and tolerability of biological therapies in IBD patients. Methods A systematic literature review was performed using Embase (including MEDLINE), MEDLINE OvidSP, Cochrane Central Register of Controlled Trials, Web of Science and PubMed. The primary outcome was the influence of patient sex on endoscopic outcomes in IBD patients treated with biologicals. The secondary outcome was the influence of patient sex on adverse events. Studies were included in the assessment regardless of study type or setting. Results The search yielded 19,461 citations; after review, 55 studies were included in the study, involving 28,465 patients treated with adalimumab, certolizumab pegol, infliximab, or vedolizumab. There was no significant association between patient sex and endoscopic efficacy in 41 relevant studies. Increased adverse events were associated with female sex in 7 out of 14 relevant studies. Conclusions There is no evidence for a sex difference in endoscopically measured response to biological therapies in IBD patients. However, there is an influence of sex on the occurrence of adverse events.

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Noninvasive biomarkers as surrogate predictors of clinical and endoscopic remission after infliximab induction in patients with refractory ulcerative colitis

Cited by 16 publications

References 36 publications

Early sonographic response to a new medical therapy is associated with future treatment response or failure in patients with inflammatory bowel disease

Early sonographic response to a new medical therapy is associated with future treatment response or failure in patients with inflammatory bowel disease

Chronic Active Ulcerative Colitis

Patient sex does not affect endoscopic outcomes of biologicals in inflammatory bowel disease but is associated with adverse events

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