Serum C-reactive protein and albumin are useful biomarkers for tight control management of Crohn's disease in Japan.
Adalimumab
/ administration & dosage
Adult
Biomarkers
/ blood
C-Reactive Protein
/ metabolism
Crohn Disease
/ drug therapy
Female
Hospitalization
/ statistics & numerical data
Humans
Infliximab
/ administration & dosage
Japan
Male
Retrospective Studies
Serum Albumin
/ metabolism
Treatment Outcome
Tumor Necrosis Factor-alpha
/ antagonists & inhibitors
Young Adult
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
16 01 2020
16 01 2020
Historique:
received:
21
08
2019
accepted:
02
01
2020
entrez:
18
1
2020
pubmed:
18
1
2020
medline:
11
11
2020
Statut:
epublish
Résumé
Tight control management of Crohn's disease (CD) based on biomarkers is more effective than conventional clinical management; however, fecal calprotectin is not allowed in Asian and some Western countries. To investigate whether tight control management based on readily available serum biomarkers results in better outcomes, we retrospectively reviewed treatment courses of consecutive Japanese CD patients treated with anti-tumor necrosis factor agents between 2003 and 2018. The association between failure of tight control (C-reactive protein (CRP) ≥ 0.5 mg/dL or albumin (Alb) < 3.8 g/dL at week 8 or 24) and subsequent major adverse outcomes (MAOs; hospitalization related to CD worsening, surgery, and discontinuation due to treatment failure) were analyzed. Among 223 patients followed for >8 weeks, 88 patients experienced MAOs. Multivariate analysis identified penetrating type, CRP ≥ 0.5 mg/dL and Alb < 3.8 g/dL at week 8 as independent risk factors (hazard ratios: 2.16, 2.06, and 2.08, respectively). Among 204 patients followed for >24 weeks, 80 patients experienced MAOs. Penetrating type, CRP ≥ 0.5 mg/dL, and Alb < 3.8 g/dL at week 24 were identified as independent risk factors (2.39, 1.90, and 2.20, respectively). Even in settings without fecal calprotectin, tight control management based on serum CRP and Alb may help avoid MAOs.
Identifiants
pubmed: 31949246
doi: 10.1038/s41598-020-57508-7
pii: 10.1038/s41598-020-57508-7
pmc: PMC6965616
doi:
Substances chimiques
Biomarkers
0
Serum Albumin
0
TNF protein, human
0
Tumor Necrosis Factor-alpha
0
C-Reactive Protein
9007-41-4
Infliximab
B72HH48FLU
Adalimumab
FYS6T7F842
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
511Références
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