Early Change of Serum Albumin Predict Clinical and Endoscopic Outcomes in Patients with Ulcerative Colitis Starting Anti-TNF Treatment
- Authors
- Lee, Sun-Ho; Walshe, Margaret; Oh, Eun Hye; Hwang, Sung Wook; Park, Sang Hyoung; Yang, Dong-Hoon; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun; Greener, Tomer; Weizman, Adam, V; Silverberg, Mark S.; Ye, Byong Duk
- Issue Date
- Aug-2021
- Publisher
- OXFORD UNIV PRESS INC
- Keywords
- ulcerative colitis; anti-TNF; serum albumin
- Citation
- INFLAMMATORY BOWEL DISEASES, v.27, no.9, pp.1452 - 1461
- Indexed
- SCIE
SCOPUS
- Journal Title
- INFLAMMATORY BOWEL DISEASES
- Volume
- 27
- Number
- 9
- Start Page
- 1452
- End Page
- 1461
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/190354
- DOI
- 10.1093/ibd/izaa309
- ISSN
- 1078-0998
- Abstract
- Background: Up to 60% of patients with ulcerative colitis (UC) ultimately fail anti-tumor necrosis factor (TNF) treatment. We aimed to investigate early predictive markers of clinical and endoscopic outcomes in patients with UC who were anti-TNF-naive commencing anti-TNF treatment, with particular focus on changes in albumin and C-reactive protein levels in the first 2 weeks of treatment.
Methods: We retrospectively investigated 210 patients with UC who started infliximab or adalimumab between 2009 and 2016 (male, 62.4%; median age at diagnosis, 37.9 years [interquartile range, 25.5-48.9 years]; median follow-up duration, 3.3 years [1.9-5.0 years]). Logistic and Cox proportional-hazards regressions were performed to identify variables associated with primary nonresponse (PNR), endoscopic outcomes, time-to-colectomy, and anti-TNF failure.
Results: Forty-one patients (19.5%) experienced PNR; week 0/week 2 ratio serum albumin was associated with PNR (adjusted odds ratio [aOR], 1.8; 95% confidence interval [CI], 1.1 2.9, per interquartile range increase). Week 0/week 2 ratio albumin was also associated with endoscopic response (aOR, 0.28; 95% CI, 0.31-0.82) and endoscopic remission (aOR, 0.61; 95% CI, 0.39-0.96) at weeks 8 to 14, time-to-colectomy (adjusted hazard ratio, 2.12; 95% CI, 1.29-3.49) and time-to-anti-TNF failure (adjusted hazard ratio, 1.54; 95% CI, 1.22-1.96), regardless of age, disease severity, or in-patient status. Association with time-to-colectomy and anti-TNF failure was externally validated in an independent cohort of inpatients with UC starting infliximab.
Conclusions: Change in serum albumin within the first 2 weeks of anti-TNF treatment is predictive of PNR, endoscopic outcomes, time-tocolectomy, and anti-TNF failure in patients with UC. Timely access to this biomarker enables early identification of patients with UC at risk of anti-TNF failure and may guide early optimization of anti-TNF treatment to improve disease outcomes.
- Files in This Item
-
Go to Link
- Appears in
Collections - 서울 의과대학 > 서울 내과학교실 > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/190354)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.