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Albumin-Based Indices and Hematologic Ratios as Predictors of Short-Term Response to Anti-TNF Therapy in Crohn’s Disease: A Single-Center Retrospective Study
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DOI：10.3390/life16071126.png)
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Abstract
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Background Biological agents such as infliximab [IFX] and adalimumab [ADA] are employed in the treatment of severe Crohn’s disease [CD], especially in cases refractory to conventional therapies. This study assessed the predictive value of simple serum-based markers in terms of early response to anti-tumor necrosis factor [anti-TNF] biologics. Methods:A total of 55 adult patients who had undergone 57 individual courses of either IFX or ADA at the Department of Gastroenterology of the Medical University of Łódź were retrospectively evaluated: 33 males and 22 females, aged 18–70 years. Serum parameters were assessed upon initiation of biological therapy and at the 14th week treatment response assessment juncture. Results: A total of 50 of the 57 (87.7%) assessed courses presented with treatment response upon week 14. Intergroup comparison revealed a statistically significant discrepancy in albumin concentration between the responder and non-responder groups: 38.4 g/L (35–41) vs. 28.4 g/L (26.7–30.1) (p < 0.05). Similar results were observed upon division of the total group in regard to prior biological agent exposure—bionaïves and biopositives. Further receiver operating characteristic [ROC] analysis revealed either strong or excellent discriminatory performance in regard to early response in the total and biopositive groups of mean albumin concentration (AUC: 0.93, p < 0.05; 1.0, p < 0.05), CRP–albumin–lymphocyte [CALLY] (AUC: 0.81, p < 0.05; 0.88, p < 0.05), CRP/albumin ratio (AUC: 0.83, p < 0.05; 0.88, p < 0.05), and mean platelet volume [MPV] and red blood cell distribution width [RDW] in the bionaïve group (AUC: 0.87, p < 0.05) (AUC: 0.88, p < 0.05), respectively. Conclusions: Simple, readily available serum-derived markers appear promising in assessing the likelihood of early anti-TNF response in CD patients. Albumin and albumin-derived parameters especially demonstrated considerable potential in this regard.
Keywords:
Crohn’s disease
infliximab
adalimumab
early response prediction
albumin
CALLY
CRP/albumin ratio
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