{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T01:54:12Z","timestamp":1794621252852,"version":"4.9.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Portuguese Inflammatory Bowel Disease Group"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>This study explored the relationship between fecal calprotectin (FCAL) and C-reactive protein (CRP) trajectory classes and composite outcomes (COs) in Crohn\u2019s disease (CD) patients under infliximab (IFX). COs reflected disease progression, including surgery, hospitalizations, new fistulas, abscesses, strictures, and treatment escalation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The DIRECT study was a multicenter, prospective investigation (2016\u20132019), including moderate\u2013severe CD patients on IFX. Latent class mixed models were used to identify subgroups based on longitudinal FCAL and CRP trajectories.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>FCAL trajectory analysis identified four clusters; CRP analysis revealed three. Patients in the U-shaped FCAL trajectory (Class 1) were more likely to achieve the global CO [odds ratio (OR) 3.263, 95% confidence interval (CI) 1.050\u201310.144, P\u2009=\u2009.041] and the CO without symptoms and IFX adjustments compared to those in the subthreshold decline (Class 4) (OR 9.639, 95% CI 1.147\u201381.025, P\u2009=\u2009.037). In CRP trajectories, patients in the upward trend (Class C) had a higher odds of achieving the global CO compared to the flat trajectory (Class B) (OR 2.171, 95% CI 1.059\u20134.449, P\u2009=\u2009.034). In multivariable regression models, class membership improved composite outcome discrimination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients under IFX therapy with near or above-threshold FCAL levels or a history of high CRP were more likely to experience adverse outcomes. Regression analyses demonstrated that class membership provided additional prognostic value beyond baseline variables alone. These findings highlight the clinical relevance of trajectory-based monitoring for optimizing treatment strategies and underscore the importance of controlling inflammation early to prevent disease progression in CD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf120","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T23:52:27Z","timestamp":1755042747000},"source":"Crossref","is-referenced-by-count":4,"title":["Longitudinal profiles of fecal calprotectin and C-reactive protein in relation to outcomes in Crohn\u2019s disease patients on infliximab"],"prefix":"10.1093","volume":"19","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,","place":["Portugal"]},{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o Hospital University Centre , Porto,","place":["Portugal"]},{"name":"Health Research Innovation RISE-HEALTH, Center for Health Technology and Services Research (CINTESIS) , Porto,","place":["Portugal"]},{"name":"Unidade de Farmacologia Cl\u00ednica, S\u00e3o Jo\u00e3o Hospital University Centre , Porto,","place":["Portugal"]},{"name":"Portuguese Inflammatory Bowel Disease Group (GEDII) ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Domingues","sequence":"additional","affiliation":[{"name":"Portuguese Inflammatory Bowel Disease Group (GEDII) ,","place":["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,","place":["Portugal"]},{"name":"Department of Gastroenterology, Unidade Local de Sa\u00fade Gaia e Espinho , Vila Nova de Gaia,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Patita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Unidade Local de Sa\u00fade de Almada Seixal , Almada,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5634-4870","authenticated-orcid":false,"given":"Bruno","family":"Arroja","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Unidade Local de Sa\u00fade de Braga , Braga,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Lago","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Porto Hospital University Centre , 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