Does Disease Activity After Induction Treatment With Biologics Predict Short-Term Outcome in Crohn’s Disease and Ulcerative Colitis?

2022 ◽  
Author(s):  
Michael Due Larsen ◽  
Bente Mertz Nørgård ◽  
Jens Kjeldsen
Keyword(s):  
Disease Activity ◽  
Induction Therapy ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Biologic Therapy ◽  
C Reactive Protein ◽  
Short Term ◽  
Term Outcome ◽  
Reactive Protein ◽  
Short Term Outcome

Abstract Background Secondary loss of response to biological therapy is a challenge when treating Crohn’s disease (CD) and ulcerative colitis (UC). Currently, no single marker has been found to be valid as a prognostic indicator of response to biologic therapy in patients with CD and UC. In this study, we aimed to assess whether disease activity after 14 weeks of biologic therapy has a prognostic impact on surgery and steroid-free remission during 6 months following completion of induction therapy. Methods In an unselected cohort study based on data from 4 national Danish health registries, we identified 493 patients with UC and 620 patients with CD who completed induction therapy with biologics from 2016 to 2019. Following induction therapy with biologics, we defined disease activity based on C-reactive protein and clinical scores of disease activity. The composite endpoint, “not being well treated,” included surgery or use of corticosteroid within 6 months following induction therapy. Results In patients with UC with disease activity following induction therapy, the adjusted odds ratio for surgery or steroid treatment during 6 months of follow-up was 3.9 (95% CI, 1.6-9.3) compared with patients without disease activity, and in patients with CD, the adjusted odds ratio was 3.6 (95% CI, 1.7-7.6). Conclusions A positive treatment response to biologic treatment after induction therapy (measured by C-reactive protein and clinical scores) predicts a better short-term outcome in patients with CD and UC.

Vitamin D deficiency is associated with acute ischemic stroke, C-reactive protein, and short-term outcome

2016 ◽  
Vol 32 (2) ◽  
pp. 493-502 ◽  
Author(s):  
Daniela Frizon Alfieri ◽  
Márcio Francisco Lehmann ◽  
Sayonara Rangel Oliveira ◽  
Tamires Flauzino ◽  
Francieli Delongui ◽  
...  
Keyword(s):  
Vitamin D ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Vitamin D Deficiency ◽  
C Reactive Protein ◽  
Short Term ◽  
Term Outcome ◽  
Reactive Protein ◽  
Short Term Outcome

scholarly journals Relationship between white blood cell count at admission and short term outcome in patients with acute cerebral infarction

2011 ◽  
Vol 34 (4) ◽  
pp. 249 ◽  
Author(s):  
Yanbo Peng ◽  
Dali Wang ◽  
Jiang Zhang ◽  
Xinhong Xue ◽  
Zhuo Wang ◽  
...  
Keyword(s):  
Blood Cell ◽  
Cerebral Infarction ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Acute Cerebral Infarction ◽  
Hospital Death ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Wbc Count

Purpose: We studied the association between admission white blood cell (WBC) count and short term outcome in patients with acute cerebral infarction. Methods: 2808 patients with acute cerebral infarction were included in the study. WBC count and other variables were collected within the first 24 hours of admission. Clinical outcomes (death or dependency) were evaluated by neurologists during hospitalization. The associations between WBC count and in-hospital death or dependency at discharge were analyzed using a multiple logistic model. Result: Multivariate-adjusted odds ratio (95% confidence intervals) of dependency associated with patients with WBC of 10.0-10.9×109/L, 11.0-11.9×109/L, ≥12.0×109/L were 1.46(0. 87-2. 45), 6.21(3. 70-10. 42) and 7.01(4. 53-10. 87), respectively, when compared with patients with admission WBC counts < 10.0x109/L. Multivariate-adjusted odds ratio (95% confidence intervals) of death associated with WBC 10.0-10.9×109/L, 11.0-11.9×109/L and ≥12.0×109/L were 2.098(0. 96-4. 58), 4.79(2. 24-10. 22) and 5.59(3. 14-9. 98), respectively. Conclusion: Increased WBC count at admission was significantly and positively associated with in-hospital death or dependency at discharge among patients with acute cerebral infarction.

scholarly journals Inflammatory biomarkers are associated with aetiology and predict outcomes in community-acquired pneumonia: results of a 5-year follow-up cohort study

2019 ◽  
Vol 5 (1) ◽  
pp. 00014-2019 ◽  
Author(s):  
William W. Siljan ◽  
Jan C. Holter ◽  
Annika E. Michelsen ◽  
Ståle H. Nymo ◽  
Trine Lauritzen ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Short Term ◽  
Term Outcome ◽  
Reactive Protein ◽  
Short Term Outcome ◽  
Bacterial Aetiology ◽  
All Cause Mortality

BackgroundBiomarkers may facilitate clinical decisions in order to guide antimicrobial treatment and prediction of prognosis in community-acquired pneumonia (CAP). We measured serum C-reactive protein, procalcitonin (PCT) and calprotectin levels, and plasma pentraxin 3 (PTX3) and presepsin levels, along with whole-blood white cell counts, at three time-points, and examined their association with microbial aetiology and adverse clinical outcomes in CAP.MethodsBlood samples were obtained at hospital admission, clinical stabilisation and 6-week follow-up from 267 hospitalised adults with CAP. Adverse short-term outcome was defined as intensive care unit admission and 30-day mortality. Long-term outcome was evaluated as 5-year all-cause mortality.ResultsPeak levels of all biomarkers were seen at hospital admission. Increased admission levels of C-reactive protein, PCT and calprotectin were associated with bacterial aetiology of CAP, while increased admission levels of PCT, PTX3 and presepsin were associated with adverse short-term outcome. In univariate and multivariate regression models, white blood cells and calprotectin at 6-week follow-up were predictors of 5-year all-cause mortality.ConclusionsCalprotectin emerges as both a potential early marker of bacterial aetiology and a predictor for 5-year all-cause mortality in CAP, whereas PCT, PTX3 and presepsin may predict short-term outcome.

scholarly journals Hemophagocytic Lymphohistiocytosis: Prevalence, Risk Factors, Outcome, and Outcome-related Factors in Adult Idiopathic Inflammatory Myopathies

2019 ◽  
Vol 47 (10) ◽  
pp. 1532-1540 ◽  
Author(s):  
Junyu Liang ◽  
Danyi Xu ◽  
Chuanyin Sun ◽  
Weiqian Chen ◽  
Heng Cao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Activity ◽  
Case Control Study ◽  
Case Control ◽  
Short Term ◽  
Related Factors ◽  
Term Outcome ◽  
Factors Influencing ◽  
Short Term Outcome ◽  
Control Study

Objective.To clarify the prevalence, risk factors, outcome, and outcome-related factors of hemophagocytic lymphohistiocytosis (HLH) in patients with dermatomyositis (DM), polymyositis (PM), or clinically amyopathic dermatomyositis (CADM).Methods.Data of patients with DM, PM, or CADM who were admitted to the First Affiliated Hospital of Zhejiang University from February 2011 to February 2019 were retrospectively collected. Patients diagnosed with HLH constituted the case group. A 1:4 case-control study was performed to identify risk factors for HLH in patients with DM, PM, or CADM through comparison, univariate, and multivariate logistic regression analysis. Intragroup comparison was made among patients with HLH to identify factors influencing unfavorable short-term outcome.Results.HLH was a rare (4.2%) but fatal (77.8%) complication in patients with DM, PM, or CADM. The retrospective case-control study revealed that higher on-admission disease activity (p = 0.008), acute exacerbation of interstitial lung disease (AE-ILD, p = 0.002), and infection (p = 0.002) were risk factors for complication of HLH in patients with DM, PM, or CADM. The following intragroup comparison showed that higher on-admission disease activity (p = 0.035) and diagnosis of CADM (p = 0.039) might influence the short-term outcome of patients with HLH. However, no risk factor was identified after false discovery rate correction.Conclusion.In this study, secondary HLH was a fatal complication, with higher on-admission disease activity, AE-ILD, and infection working as risk factors. The underlying role of infection and autoimmune abnormality in HLH in connective tissue disease was subsequently noted. Clinical factors influencing the short-term outcome of patients with secondary HLH require further study.

INDUCTION THERAPY WITH POLYCLONAL ATG IMPROVES LONG-TERM BUT NOT SHORT-TERM OUTCOME OF CADAVER RENAL ALLOGRAFTS

1998 ◽  
Vol 65 (Supplement) ◽  
pp. 143
Author(s):  
P Reinke ◽  
E Glöckler ◽  
J Kaden ◽  
B Schönberger ◽  
W D Döcke ◽  
...  
Keyword(s):  
Induction Therapy ◽  
Short Term ◽  
Term Outcome ◽  
Renal Allografts ◽  
Short Term Outcome

scholarly journals INDUCTION THERAPY WITH POLYCLONAL ATG IMPROVES LONG-TERM BUT NOT SHORT-TERM OUTCOME OF CADAVER RENAL ALLOGRAFTS

1998 ◽  
Vol 65 (12) ◽  
pp. S67
Author(s):  
P Reinke ◽  
E Gl??ckler ◽  
J Kaden ◽  
B Sch??nberger ◽  
W D D??cke ◽  
...  
Keyword(s):  
Induction Therapy ◽  
Short Term ◽  
Term Outcome ◽  
Renal Allografts ◽  
Short Term Outcome

scholarly journals Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

2016 ◽  
Vol 47 (1) ◽  
pp. 23-33 ◽  
Author(s):  
J. F. Hayes ◽  
G. M. Khandaker ◽  
J. Anderson ◽  
D. Mackay ◽  
S. Zammit ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Young Adulthood ◽  
Interleukin 6 ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Inflammatory Marker ◽  
Birth Cohort Study ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Increased Risk

BackgroundThere are no existing longitudinal studies of inflammatory markers and atopic disorders in childhood and risk of hypomanic symptoms in adulthood. This study examined if childhood: (1) serum interleukin-6 (IL-6) and C-reactive protein (CRP); and (2) asthma and/or eczema are associated with features of hypomania in young adulthood.MethodParticipants in the Avon Longitudinal Study of Parents and Children, a prospective general population UK birth cohort, had non-fasting blood samples for IL-6 and CRP measurement at the age of 9 years (n = 4645), and parents answered a question about doctor-diagnosed atopic illness before the age of 10 years (n = 7809). These participants completed the Hypomania Checklist at age 22 years (n = 3361).ResultsAfter adjusting for age, sex, ethnicity, socio-economic status, past psychological and behavioural problems, body mass index and maternal postnatal depression, participants in the top third of IL-6 values at 9 years, compared with the bottom third, had an increased risk of hypomanic symptoms by age 22 years [adjusted odds ratio 1.77, 95% confidence interval (CI) 1.10–2.85, p < 0.001]. Higher IL-6 levels in childhood were associated with adult hypomania features in a dose–response fashion. After further adjustment for depression at the age of 18 years this association remained (adjusted odds ratio 1.70, 95% CI 1.03–2.81, p = 0.038). There was no evidence of an association of hypomanic symptoms with CRP levels, asthma or eczema in childhood.ConclusionsHigher levels of systemic inflammatory marker IL-6 in childhood were associated with hypomanic symptoms in young adulthood, suggesting that inflammation may play a role in the pathophysiology of mania. Inflammatory pathways may be suitable targets for the prevention and intervention for bipolar disorder.

scholarly journals Association of C-Reactive Protein Level and Short Term Clinical Outcome among Spontaneous Intracerebral Haemorrhage Patients

2018 ◽  
Vol 3 (2) ◽  
pp. 89-93
Author(s):  
Md Mamnur Rashid ◽  
Chandra Shekhar Bala ◽  
MS Jahirul Hoque Choudhury ◽  
Mohammad Selim Shahi ◽  
Md Merazul Islam Shaikh ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Functional Outcome ◽  
Intracerebral Haemorrhage ◽  
C Reactive Protein ◽  
Short Term ◽  
Poor Functional Outcome ◽  
Term Outcome ◽  
Reactive Protein ◽  
Group I ◽  
Spontaneous Intracerebral Haemorrhage

Background: C-reactive protein is a biomarker among the spontaneous intracerebral haemorrhage patients.Objective: The purpose of this present study was to see the association of CRP level with the short term clinical outcome among spontaneous intracerebral haemorrhage patients.Methodology: This prospective cohort study was conducted in the Department of Neurology at Dhaka Medical College and Hospital, Dhaka, Bangladesh from July 2012 to June 2014 for a period of two (02) years. Patients presented with first ever spontaneous intracerebral haemorrhage with the age group of more than or equal to 18 years with both sexes and hospital admission within 48 hours of onset were included for this study. Admission plasma CRP was measured and study population were divided into group I (plasma CRP≥6 mg/L) and group II (plasma CRP<6 mg/L). The patients were observed daily till 1 week after admission with special attention to vital parameters and clinical outcome which were mortality, functional outcome and early neurological worsening. Finally findings were analyzed and clinical outcome were compared in patient with different level of admission plasma CRP.Result: Early neurological worsening at the end of first week was 37(38%) patients. Poor functional outcome (GOS 2-3) at the end of first week was found in 51(52%) patients. Overall mortality within that period was 16(17%) patients. Elevated CRP level was associated with higher proportion of GCS score < 9 at day seven. Early neurological worsening and poor functional outcome (GOS2-3) was also found more in these patients.Conclusion: High admission plasma CRP level may be associated with higher proportions of poor short term outcome (GOS 2-3), early neurological worsening at the end of the first week after onset and mortality within this period in the patients with spontaneous intracerebral haemorrhage.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 89-93

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