title: Magnetic resonance enterographic predictors of one-year outcome in ileal and ileocolonic Crohn's disease treated with anti-tumor necrosis factor antibodies.
abstract: The aim of the study was to assess the role of magnetic resonance enterography (MRE) in predicting one-year efficacy of anti-tumor necrosis factor antibodies--infliximab (IFX), adalimumab (ADA) in Crohn's disease (CD) patients primarily responding to therapy. We performed retrospective analysis among 61 CD patients who had undergone a successful IFX/ADA induction therapy and were treated with maintenance doses. All patients underwent MRE at week 0. We assessed which MRE features were predictive for steroid-free remission at week 52, and which were associated with a secondary loss of response. 44 patients were in steroid-free remission at week 52, 17--were secondary non-responders. The ROC curve showed that bowel thickening with contrast enhancement analyzed together at week 0 were associated with steroid-free remission at week 52 (p = 0.01; AUC 0.67). Bowel stenosis with or without prestenotic dilatation [OR 5.8 (95% CI 1.4-25) and 2.4 (95% CI 1.2 - 5) respectively; p = 0.01] and the presence of intra-abdominal fistulas [OR 1.4 (95% CI 1.1-2); p=0.004] were related to secondary non-response. A high baseline inflammatory activity detected by MRE predicts one-year response in CD after IFX/ADA. In case of bowel stenosis, intra-abdominal fistulas, other therapeutic options should be considered.
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Eder
authors.affiliation: Department of Computer Science and Statistics, Poznan University of Medical Sciences, Dabrowskiego Street 79, 60-529 Poznan, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Michalak
authors.affiliation: Department of General Radiology, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Katulska
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Liliana
authors.initials: L
authors.lastname: Lykowska-Szuber
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Krela-Kazmierczak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Kamila
authors.initials: K
authors.lastname: Stawczyk-Eder
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Klimczak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Szymczak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Linke
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D019540:Area Under Curve; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007082:Ileum / Q000378:metabolism / Q000473:pathology; D000069285:Infliximab / Q000627:therapeutic use*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D000069285:Infliximab; D000068879:Adalimumab