MRI assessment of body composition for prediction of therapeutic response to biologic agents in patients with Crohn's disease.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-03-19 DOI:10.1186/s13244-025-01930-w

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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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.

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克罗恩病患者体成分MRI评估预测生物制剂治疗反应

目的：克罗恩病（CD）患者体脂肪和肌肉质量的改变与不良病程和结果有关。预测小肠CD （SBCD）对生物治疗的治疗反应或缓解（RoR）仍然具有挑战性。我们的目的是建立用MR肠造影（MRE）测量的体成分参数对开始生物治疗的SBCD患者1年RoR的预后价值。方法：参与者是从一项前瞻性、多中心研究中招募的，该研究旨在调查运动MRI对开始生物治疗活动性SBCD患者1年RoR的预测能力（运动试验）。从基线MRE开始测量肌萎缩、骨骼肌脂肪和内脏皮下脂肪。使用临床和形态学MRE参数综合判断1年的RoR。我们使用logistic回归模型比较了有和没有肌萎缩症或低骨骼肌脂肪的患者发生RoR的可能性。结果：纳入96例受试者(平均年龄38.2岁；40名（42%）女性)。有34例（35%）应答者。1年的RoR在有和没有骨骼肌肌萎缩的患者（OR: 0.85, 95% CI: 0.27, 2.66， p值：0.78）和有或没有低骨骼肌脂肪的患者（OR: 0.71, 95% CI: 0.19, 2.71， p值：0.62）之间没有显著差异。结论：体成分参数对开始生物治疗的SBCD患者的治疗性RoR没有预测价值。关键相关性声明：预测小肠克罗恩病（SBCD）对生物治疗的反应仍然具有挑战性。体成分参数不能可靠地预测SBCD的生物治疗反应或缓解。重点：克罗恩病患者体内脂肪和肌肉质量的改变与不良后果有关。预测生物治疗对小肠CD （SBCD）的反应将有助于治疗优化。使用MRI测量的身体成分参数不能可靠地预测SBCD的生物治疗反应或缓解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

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! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.