Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s disease
Abstract Background Enteric fistula is one of the penetrating features in Crohn’s disease (CD). This study aimed to clarify the prognostic factors for the efficacy of infliximab (IFX) treatment in luminal fistulizing CD patients. Methods We retrospectively included 26 cases diagnosed with luminal fi...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-023-02676-9 |
| _version_ | 1827983926751133696 |
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| author | Ye Ma Runfeng Zhang Wei Liu Yinghao Sun Jingnan Li Hong Yang Hong Lv Yue Li Bei Tan Xiyu Sun Jiaming Qian Ji Li |
| author_facet | Ye Ma Runfeng Zhang Wei Liu Yinghao Sun Jingnan Li Hong Yang Hong Lv Yue Li Bei Tan Xiyu Sun Jiaming Qian Ji Li |
| author_sort | Ye Ma |
| collection | DOAJ |
| description | Abstract Background Enteric fistula is one of the penetrating features in Crohn’s disease (CD). This study aimed to clarify the prognostic factors for the efficacy of infliximab (IFX) treatment in luminal fistulizing CD patients. Methods We retrospectively included 26 cases diagnosed with luminal fistulizing CD hospitalized in our medical center from 2013 to 2021. The primary outcome of our research was defined as death from all causes and undergoing of any relevant abdominal surgery. Kaplan–Meier survival curves were used to describe overall survival. Univariate and multivariate analyses were used to identify prognostic factors. A predictive model was constructed using Cox proportional hazard model. Results The median follow-up time was 17.5 months (range 6–124 months). The 1- and 2-year surgery-free survival rates were 68.1% and 63.2%, respectively. In the univariate analysis, the efficacy of IFX treatment at 6 months after initiation (P < 0.001, HR 0.23, 95% CI 0.01–0.72) and the existence of complex fistula (P = 0.047, HR 4.11, 95% CI 1.01–16.71) was found significantly related to the overall surgery-free survival, while disease activity at baseline (P = 0.099) also showed predictive potential. The multivariate analysis showed that efficacy at 6 months (P = 0.010) was an independent prognostic factor. The C-index of the model for surgery-free survival was 0.923 (P < 0.001), indicating an acceptable predictive effect. Conclusion Prognostic model including the existence of complex fistula, disease activity at baseline and efficacy of IFX at 6 months may be useful to predict long-term outcome of luminal fistulizing CD patients. |
| first_indexed | 2024-04-09T22:53:56Z |
| format | Article |
| id | doaj.art-799e06a6b4264e0c9e51e694193c7141 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-09T22:53:56Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-799e06a6b4264e0c9e51e694193c71412023-03-22T11:22:54ZengBMCBMC Gastroenterology1471-230X2023-03-012311910.1186/s12876-023-02676-9Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s diseaseYe Ma0Runfeng Zhang1Wei Liu2Yinghao Sun3Jingnan Li4Hong Yang5Hong Lv6Yue Li7Bei Tan8Xiyu Sun9Jiaming Qian10Ji Li11Department of Gastroenterology, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalDepartment of Radiology, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalDepartment of General Surgery, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalDepartment of Gastroenterology, Peking Union Medical College HospitalAbstract Background Enteric fistula is one of the penetrating features in Crohn’s disease (CD). This study aimed to clarify the prognostic factors for the efficacy of infliximab (IFX) treatment in luminal fistulizing CD patients. Methods We retrospectively included 26 cases diagnosed with luminal fistulizing CD hospitalized in our medical center from 2013 to 2021. The primary outcome of our research was defined as death from all causes and undergoing of any relevant abdominal surgery. Kaplan–Meier survival curves were used to describe overall survival. Univariate and multivariate analyses were used to identify prognostic factors. A predictive model was constructed using Cox proportional hazard model. Results The median follow-up time was 17.5 months (range 6–124 months). The 1- and 2-year surgery-free survival rates were 68.1% and 63.2%, respectively. In the univariate analysis, the efficacy of IFX treatment at 6 months after initiation (P < 0.001, HR 0.23, 95% CI 0.01–0.72) and the existence of complex fistula (P = 0.047, HR 4.11, 95% CI 1.01–16.71) was found significantly related to the overall surgery-free survival, while disease activity at baseline (P = 0.099) also showed predictive potential. The multivariate analysis showed that efficacy at 6 months (P = 0.010) was an independent prognostic factor. The C-index of the model for surgery-free survival was 0.923 (P < 0.001), indicating an acceptable predictive effect. Conclusion Prognostic model including the existence of complex fistula, disease activity at baseline and efficacy of IFX at 6 months may be useful to predict long-term outcome of luminal fistulizing CD patients.https://doi.org/10.1186/s12876-023-02676-9Crohn’s diseaseFistulaInfliximabPrognostic factorsEfficacy |
| spellingShingle | Ye Ma Runfeng Zhang Wei Liu Yinghao Sun Jingnan Li Hong Yang Hong Lv Yue Li Bei Tan Xiyu Sun Jiaming Qian Ji Li Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s disease BMC Gastroenterology Crohn’s disease Fistula Infliximab Prognostic factors Efficacy |
| title | Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s disease |
| title_full | Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s disease |
| title_fullStr | Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s disease |
| title_full_unstemmed | Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s disease |
| title_short | Prognostic factors for the efficacy of infliximab in patients with luminal fistulizing Crohn’s disease |
| title_sort | prognostic factors for the efficacy of infliximab in patients with luminal fistulizing crohn s disease |
| topic | Crohn’s disease Fistula Infliximab Prognostic factors Efficacy |
| url | https://doi.org/10.1186/s12876-023-02676-9 |
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