Naomi S Sakai, Andrew A Plumb, Norin Ahmed, Kashfia Chowdhury, Yakup Kilic, Maira Hameed, Anisha Patel, Anisha Bhagwanani, Emma Helbren, Rachel Hyland, Gauraang Bhatnagar, Harbir Sidhu, Hannah Lambie, James M Franklin, Maryam Mohsin, Elen Thomson, Darren Boone, Damian Tolan, Safi Rahman, Nik Ding, Gordon W Moran, Stuart Bloom, Ailsa Hart, Alex Menys, Simon Travis, Steve Halligan, Stuart A Taylor
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引用次数: 0
Abstract
Objectives: Altered body fat and muscle mass in Crohn's disease (CD) have been linked to adverse disease course and outcomes. Prediction of treatment response or remission (RoR) of small bowel CD (SBCD) to biologic therapy remains challenging. We aimed to establish the prognostic value of body composition parameters measured using MR enterography (MRE) for RoR at 1 year in patients with SBCD commencing biologic therapy.
Methods: Participants were identified from those recruited to a prospective, multicentre study investigating the predictive ability of motility MRI for 1 year RoR in patients starting biologic therapy for active SBCD (MOTILITY trial). Myopenia, skeletal muscle:fat and visceral:subcutaneous fat were measured from baseline MRE. RoR at 1 year was judged using a composite of clinical and morphological MRE parameters. We compared the likelihood of RoR in patients with and without myopenia or low skeletal muscle:fat using logistic regression models.
Results: Ninety-six participants were included (mean age 38.2 years; 40 (42%) female). There were 34 (35%) responders. There was no significant difference in RoR at 1 year between those patients with and without skeletal muscle myopenia (OR: 0.85, 95% CI: 0.27, 2.66, p-value: 0.78), or those with or without low skeletal muscle:fat (OR: 0.71, 95% CI: 0.19, 2.71, p-value: 0.62).
Conclusions: Body composition parameters demonstrated no value for predicting therapeutic RoR in patients commencing biologic therapy for SBCD.
Critical relevance statement: Prediction of response to biologic therapy in small bowel Crohn's disease (SBCD) remains challenging. Body composition parameters cannot predict biologic therapeutic response or remission for SBCD reliably.
Key points: Altered body fat and muscle mass in Crohn's disease have been linked to adverse outcomes. Prediction of response to biologic therapy in small bowel CD (SBCD) would be useful for treatment optimisation. Body composition parameters measured using MRI cannot reliably predict biological therapeutic response or remission for SBCD.
期刊介绍:
Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere!
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