Neutrophil-lymphocyte ratio at 14th week predicts loss of response to 52-week infliximab therapy in patients with Crohn's disease.
10.12122/j.issn.1673-4254.2020.04.01
- VernacularTitle:52周英夫利西疗程中第14周中性粒细胞与淋巴细胞比值可预测克罗恩患者是否对治疗产生失应答
- Author:
Gao QIAN
1
;
Dong HONGXIA
2
;
L I JIN
1
Author Information
1. Department of Gastroenterology, Zhongnan Hospital, Wuhan University, Wuhan 430071, China.
2. Department of Ultrasound, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China.
- Publication Type:Journal Article
- Keywords:
Crohn's disease;
infliximab;
loss of response;
neutrophils-lymphocytes ratio;
predictor
- MeSH:
Crohn Disease;
Gastrointestinal Agents;
Humans;
Infliximab;
Lymphocytes;
Neutrophils;
Retrospective Studies;
Treatment Outcome
- From:
Journal of Southern Medical University
2020;40(4):453-458
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:Loss of response (LOR) has become an important clinical problem in patients with Crohn's disease receiving infliximab (IFX) treatment. Neutrophil-lymphocyte ratio (NLR) has been shown to correlate with the activity of inflammatory bowel disease (IBD), and NLR at the 14th week of IFX therapy potentially allows the prediction of sustained response to IFX in Crohn's patients. The aim of this study was to explore whether NLR at the 14th week of IFX therapy could predict the occurrence of LOR to IFX in Crohn's patients.
METHODS:Between January, 2012 and December, 2016, 54 patients with Crohn's disease underwent a 52-week treatment with IFX and successfully achieved response to the induction treatment in Zhongnan Hospital. We retrospectively examined their medical records and assessed the association between NLR at 14 weeks and LOR during IFX therapy.
RESULTS:Of the 54 patients, 15 (27.8%) showed LOR to IFX during the follow-up. We noted a significant increase in NLR at 14 weeks in the patients with LOR as compared with the patients with sustained response to IFX[3.51 (2.9-6.25) 1.77 (1.23-2.56), =0.00]. Receiver-operating characteristic analysis showed that at the cut-off value of 2.75, NLR at 14 weeks was predictive of LOR within 52 weeks of IFX therapy with a sensitivity of 93.33% and a specificity of 84.62%, and the area under curve (AUC) of NLR was 0.903 (0.731-0.959). Univariate analysis revealed a significant correlation between relapse-free survival and the NLR at 14 weeks (=0.00). Multivariate analysis identified NLR at 14 weeks as an independent prognostic factor for LOR with a hazard ratio of 1.851 (95% :1.096-3.026, =0.021).
CONCLUSIONS:NLR at the 14th week during IFX therapy is a useful predictor for LOR in patients with Crohn's disease.
