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Fecal Calprotectin at Postinduction Is Capable of Predicting Persistent Remission and Endoscopic Healing after 1 Year of Treatment with Infliximab in Pediatric Patients with Crohn’s Disease

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Background/Aims: The recent update on Selecting Therapeutic Targets in Inflammatory Bowel Disease initiative has added a decrease in fecal calprotectin (FC) to an acceptable range as an intermediate target for Crohn’s disease (CD). We aimed to investigate whether postinduction FC could predict future persistent remission (PR) and endoscopic healing (EH) after 1 year of treatment with infliximab (IFX) in pediatric patients with CD. Methods: This multicenter retrospective observational study included pediatric patients with CD who were followed up for at least 1 year after starting IFX. The association of postinduction FC with PR and EH was investigated. Results: A total of 132 patients were included in this study. PR and EH were observed in 71.2% (94/132) and 73.9% (82/111) of the patients, respectively. In multivariate logistic regression analysis, only the postinduction FC level was associated with PR (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.08 to 0.66; p=0.009). The FC levels at initiation of IFX and postinduction were significantly associated with EH (OR, 0.73; 95% CI, 0.53 to 0.99; p=0.044 and OR, 0.20; 95% CI, 0.06 to 0.49; p=0.002, respectively). According to the receiver operating characteristic curve analysis, the optimal cutoff level for postinduction FC associated with PR was 122 mg/kg, and that associated with EH was 377 mg/kg. Conclusions: Postinduction FC was associated with PR and EH after 1 year of treatment with IFX in pediatric patients with CD. Our findings emphasize the importance of FC as an intermediate target in the treat-to-target era.

Abstract

Background/Aims: The recent update on Selecting Therapeutic Targets in Inflammatory Bowel Disease initiative has added a decrease in fecal calprotectin (FC) to an acceptable range as an intermediate target for Crohn’s disease (CD). We aimed to investigate whether postinduction FC could predict future persistent remission (PR) and endoscopic healing (EH) after 1 year of treatment with infliximab (IFX) in pediatric patients with CD. Methods: This multicenter retrospective observational study included pediatric patients with CD who were followed up for at least 1 year after starting IFX. The association of postinduction FC with PR and EH was investigated. Results: A total of 132 patients were included in this study. PR and EH were observed in 71.2% (94/132) and 73.9% (82/111) of the patients, respectively. In multivariate logistic regression analysis, only the postinduction FC level was associated with PR (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.08 to 0.66; p=0.009). The FC levels at initiation of IFX and postinduction were significantly associated with EH (OR, 0.73; 95% CI, 0.53 to 0.99; p=0.044 and OR, 0.20; 95% CI, 0.06 to 0.49; p=0.002, respectively). According to the receiver operating characteristic curve analysis, the optimal cutoff level for postinduction FC associated with PR was 122 mg/kg, and that associated with EH was 377 mg/kg. Conclusions: Postinduction FC was associated with PR and EH after 1 year of treatment with IFX in pediatric patients with CD. Our findings emphasize the importance of FC as an intermediate target in the treat-to-target era.

참고문헌 (42)

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Association between Fecal Calprotectin and Mucosal Healing in Pediatric Patients with Crohn’s Disease Who Have Achieved Sustained Clinical Remission with Anti-Tumor Necrosis Factor Agents이유민, 최병호, Choe Yon Ho, Choi Sujin, Jang Hyo-Jeong, Kang Ben, Kim Eun Sil, Kim Mi Jin, Kim Seung, Koh Hong거트앤리버 소화기연관학회협의회 · Gut and Liver2022 · 제16권 제1호Fecal Calprotectin Assay at an Early Stage of Treatment Can Be Used as a Surrogate Marker to Predict Clinical Remission and Mucosal Healing in Pediatric Crohn’s DiseaseJae Hong Park, Yeoun Joo Lee대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2022 · 제25권 제5호Short-Term Outcome of Infliximab Therapy in Pediatric Crohn’s Disease: A Single-Center Experience김경모, 오석희, 이성희, 정인숙, Dai Jung대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2017 · 제20권 제4호Efficacy of Early Infliximab Treatment for Pediatric Crohn’s Disease: A Three-year Follow-up김미진, 이유민, Sang Hun Baek, Yon Ho Choe, Yoon Lee, Yun Seok Lee대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2012 · 제15권 제4호Clinical Use of Measuring Trough Levels and Antibodies against Infliximab in Patients with Pediatric Inflammatory Bowel Disease이지현, 최소윤, 최윤호, Ben Kang거트앤리버 소화기연관학회협의회 · Gut and Liver2017 · 제11권 제1호Early Biologic Treatment in Pediatric Crohn’s Disease: Catchingthe Therapeutic Window of Opportunity in Early Disease by Treat-to-TargetBen Kang, Yon Ho Choe대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2018 · 제21권 제1호

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