{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:27:48Z","timestamp":1793212068155,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Timely stratification of Crohn's disease (CD) is essential for patients' management. The use of noninvasive accurate biomarkers is key to monitor treatment and to pursue mucosal healing, the ultimate treatment endpoint in CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to evaluate the performance of readily available biomarkers and develop risk matrices to predict CD progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 289 CD patients receiving infliximab (IFX) maintenance therapy for 2\u00a0years was collected; those patients were included in DIRECT, a prospective multicenter observational study. Disease progression was evaluated using two composite outcomes incorporating clinical and drug\u2010related factors, the first including IFX dose and\/or frequency adjustments. Univariate and multivariable logistic regressions were used to calculate the odds ratios (OR) and to develop risk matrices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The isolated presence of anemia at least once during follow\u2010up was a significant predictor of disease progression (OR 2.436 and 3.396 [<jats:italic>p<\/jats:italic>\u00a0\u2264\u00a00.001] for composite outcomes 1 and 2, respectively) regardless of confounding factors. Isolated highly elevated C\u2010reactive protein (CRP; &gt;10.0\u00a0mg\/L) and fecal calprotectin (FC; &gt;500.0\u00a0\u03bcg\/g) in at least one visit were also significant predictors, while milder elevations (3.1\u201310.0\u00a0mg\/L and 250.1\u2013500.0\u00a0\u03bcg\/g) were only relevant when detected in at least two visits (consecutive or not). The combination of biomarkers in risk matrices had good ability to predict progression; patients simultaneously presenting anemia, highly elevated CRP and FC at least once had 42%\u201363% probability of achieving the composite outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combined evaluation of hemoglobin, CRP, and FC in at least one time point and their incorporation into risk matrices seems to be the optimal strategy for CD management, as data from additional visits did not meaningfully influence the predictions and may delay decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12420","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T11:10:05Z","timestamp":1686827405000},"page":"531-541","source":"Crossref","is-referenced-by-count":16,"title":["How many biomarker measurements are needed to predict prognosis in Crohn's disease patients under infliximab?\u2014A prospective study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2634-9668","authenticated-orcid":false,"given":"Fernando","family":"Magro","sequence":"first","affiliation":[{"name":"Department of Biomedicine Unit of Pharmacology and Therapeutics Faculty of Medicine University of Porto  Porto Portugal"},{"name":"Department of Gastroenterology S\u00e3o Jo\u00e3o Hospital University Centre  Porto Portugal"},{"name":"Center for Health Technology and Services Research (CINTESIS)  Porto Portugal"},{"name":"Unidade de Farmacologia Cl\u00ednica S\u00e3o Jo\u00e3o Hospital University Centre  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7171-0139","authenticated-orcid":false,"given":"Maria Manuela","family":"Estevinho","sequence":"additional","affiliation":[{"name":"Department of Biomedicine Unit of Pharmacology and Therapeutics Faculty of Medicine University of Porto  Porto 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Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-5987","authenticated-orcid":false,"given":"Isadora","family":"Rosa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology IPOLFG, EPE  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6626-205X","authenticated-orcid":false,"given":"Helena","family":"Tavares de Sousa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Algarve Hospital University Centre \u2010 Portim\u00e3o Unit  Portim\u00e3o Portugal"},{"name":"ABC \u2013 Algarve Biomedical Center University of Algarve  Faro Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Ministro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Viseu\u2010Tondela Hospital Centre  Viseu 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