scholarly journals P254 Factors that may predict the need for infliximab optimization in Crohn’s disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S292-S292
Author(s):  
C Flores ◽  
R Petry ◽  
C Bortolin Fonseca ◽  
L Dos Santos Harlacher
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Laboratory ◽  
Serum Levels ◽  
Therapeutic Drug ◽  
C Reactive Protein ◽  
Porto Alegre ◽  
Reactive Protein ◽  
Endoscopic Characteristics ◽  
Worse Prognosis

Abstract Background Biological therapy has revolutionized treatment of Crohn’s Disease (CD), increasing the rate of disease remission. Despite this, a significant percentage of patients present partial response or loss of response over time. These patients need optimization of therapy, whether by increasing the dosage or reducing the interval between infusions. The main objective of this study was to identify possible factors related to the need to optimize the dose of infliximab (IFX) in patients with CD. This finding can facilitate the early identification of the need for therapeutic optimization, reducing the risks of unfavorable evolution and decreasing costs related to the disease. Methods Retrospective and prospective maintained database of CD patients under IFX treatment being followed up in the Infusion Center at the Day Hospital of the Hospital de Clínicas de Porto Alegre, Brazil, from 2009 to 2018. Epidemiological, clinical, laboratory and endoscopic characteristics that correlate with worse prognosis of CD were evaluated. The main goal of the study was to identify possible factors related to the need for (IFX) optimization. Results 121 patients were evaluated. Of these, 58 (47,93%) needed the optimization of the IFX dosage. The only variables that had significant statistical difference between the groups with or without need for optimization were anemia (p=0.019) and C reactive protein (CRP) which were persistently elevated in week 14 (p=0.039). After the adjustment with the multivariate model, only the elevated CRP during week 14 was still statistically significant, with a 119% greater risk of optimizing treatment when compared to those of normal CRP. Conclusion Among the factors studied, only the maintenance of higher CRP during week 14 was associated to the need for optimization of the IFX dose. This finding agrees with the literature that describes week 14 as an ideal moment for evaluating the serum levels of immunobiologics as a predictor of sustained response. Thus, in the absence of therapeutic drug monitoring, we could look at persistently high CRP as a marker of the need for therapeutic optimization. This finding needs to be confirmed in prospective studies.

Serum levels of C-reactive protein in Crohn's disease and ulcerative colitis

1982 ◽  
Vol 12 (4) ◽  
pp. 351-359 ◽  
Author(s):  
E. A. FAGAN ◽  
R. F. DYCK ◽  
P. N. MATON ◽  
H. J. F. HODGSON ◽  
V. S. CHADWICK ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Serum Levels ◽  
C Reactive Protein ◽  
Reactive Protein

C-Reactive Protein as a Predictor of Relapse in Asymptomatic Patients with Crohn's Disease

1983 ◽  
Vol 28 (1) ◽  
pp. 26-29 ◽  
Author(s):  
C. André ◽  
L. Descos ◽  
J. Vignal ◽  
J. Gillon
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Acute Phase Proteins ◽  
Activity Index ◽  
Clinical Status ◽  
Disease Activity Index ◽  
Serum Levels ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Asymptomatic Patients

Comparison of the Crohn's Disease Activity Index (CDAI) with serum levels of the acute phase proteins during a 4-year study period of 50 patients with Crohn's disease has shown the serum C-reactive protein (CRP) to be a sensitive indicator of clinical status. Five patients are described in whom raised CRP levels reliably predicted relapse at a time when the patients were asymptomatic and the CDAI was normal. Measurement of serum CRP by radial immunodiffusion is cheap and simple, and if performed frequently in the follow-up of patients with Crohn's disease it may permit earlier, and therefore possibly more effective, treatment of relapse.

Combined evaluation of fecal calprotectin and C-reactive protein as a therapeutic target in the management of patients with Crohn's disease

2021 ◽  
Vol 44 (2) ◽  
pp. 87-95
Author(s):  
Francisco Guilherme Cancela Penna ◽  
Rodrigo Macedo Rosa ◽  
Fernando H. Pereira ◽  
Pedro Ferrari Sales Cunha ◽  
Stella Cristina S. Sousa ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Therapeutic Target ◽  
Fecal Calprotectin ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Combined Evaluation

Correlation between levels of C-reactive protein and clinical activity in Crohn's disease

2007 ◽  
Vol 39 (11) ◽  
pp. 1006-1010 ◽  
Author(s):  
S. Karoui ◽  
S. Ouerdiane ◽  
M. Serghini ◽  
T. Jomni ◽  
L. Kallel ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Activity ◽  
C Reactive Protein ◽  
Reactive Protein

Plasma Arachidonic Acid-Rich Phospholipids in Crohn's Disease: Response to Treatment

1996 ◽  
Vol 91 (4) ◽  
pp. 509-512 ◽  
Author(s):  
Stephen P. Pereira ◽  
Theresa B. Cassell ◽  
Jeffrey L Engelman ◽  
Gordon E. Sladen ◽  
Gerard M. Murphy ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Polyunsaturated Fatty Acids ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Polyunsaturated Phosphatidylcholine

1. Increased concentrations of plasma polyunsaturated fatty acids have been implicated in the pathogenesis of Crohn's disease. However, it is not known whether there are corresponding changes in circulating phospholipids - the major source of fatty acids in the plasma. 2. Fasting plasma samples were obtained from 17 control subjects and 13 patients with active Crohn's disease [Simple Index of Crohn's Disease Activity (SICDA) >6] before, and 2 and 8 weeks after, treatment with either a peptide diet or oral prednisolone. 3. Before treatment, the Crohn's disease patients had mildly active disease (SICDA 9.9 ± 0.8, erythrocyte sedimentation rate 26.4 ± 6.5 mm/h, serum C-reactive protein 2.8 ± 0.4 mg/l). The proportions of the polyunsaturated phosphatidylcholine species, 16:0–20:4 (10.0 ± 0.7%) and 16:0–22:6 (7.1 ± 0.8%), were both significantly higher than those in healthy controls (7.6 ± 0.5%, P < 0.01 and 5.3 ± 0.5%, P < 0.05 respectively). 4. After 2 weeks treatment, the SICDA in the Crohn's disease patients decreased to 3.2 ± 0.6 (P < 0.0001 compared with the pretreatment value), and there were corresponding falls in the erythrocyte sedimentation rate (to 12.6 ± 2.7 mm/h, P < 0.05) and C-reactive protein concentration (to 1.7 ± 0.3 mg/l, P < 0.05)—these improvements being maintained at 8 weeks. There was also a fall to normal values in 16:0–20:4 (to 7.7 ± 0.6%, P < 0.01 compared with the pretreatment value) and in 16:0–22:6 (to 5.7 ± 0.5%, P not significant), by week 8. 5. The proportions of polyunsaturated phosphatidylcholine molecular species were increased in the plasma of patients with active Crohn's disease, but fell to normal levels during disease remission. These observations are consistent with the theory that, in active Crohn's disease, the mucosal phospholipids containing polyunsaturated fatty acids are increased, contribute to eicosanoid synthesis and ‘spill’ into the plasma.

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