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The Potential of High-Density Lipoprotein as a Predictive Biomarker for Infliximab Efficacy in Crohn's Disease
Keke Tang1,2, Ziheng Peng1,2, Duo Xu1,2
1Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.
Insights
Baseline high-density lipoprotein (HDL) levels predict infliximab effectiveness in Crohn's disease (CD). Higher HDL is linked to fewer adverse events, suggesting HDL as a predictive biomarker for CD patients.
Area of Science:
- Gastroenterology
- Immunology
- Biomarker Discovery
Background:
- Crohn's disease (CD) management involves biologic therapies like infliximab.
- Predicting treatment response and adverse events in CD patients is crucial for personalized medicine.
Purpose of the Study:
- To determine if baseline serum high-density lipoprotein (HDL) levels can predict infliximab effectiveness in Crohn's disease patients.
- To investigate the association between HDL levels and adverse outcomes during infliximab therapy.
Main Methods:
- Retrospective single-center study of 166 Crohn's disease patients treated with infliximab.
- Evaluation of baseline serum HDL levels and 52-week composite adverse outcomes (clinical activity, treatment changes, surgery, readmission).
Main Results:
- High-density lipoprotein (HDL) levels predicted 52-week adverse events in infliximab-treated CD patients (AUC 0.661, p < 0.05).
- Higher baseline HDL was associated with better nutritional status, lower inflammation, and a significantly lower risk of adverse events (p = 0.0017).
- Baseline HDL was an independent risk factor for adverse events (p = 0.022).
Conclusions:
- Baseline serum HDL levels serve as an independent predictor of 52-week adverse events in Crohn's disease patients receiving infliximab.
- HDL may be a valuable predictive biomarker for optimizing infliximab therapy and patient outcomes in CD.
Background:
To assess whether baseline serum high density lipoprotein (HDL) levels predict the effectiveness of infliximab in patients with Crohn's disease (CD).
Methods:
This was a retrospective single-center study evaluating CD patients baseline data and effectiveness of infliximab at the Xiangya Hospital, Central South University, between January 2016 and September 2021. The primary endpoint was composite adverse outcome during 52 weeks, defined as clinical activity, changes in treatment, surgical treatment, or unexpected readmission.
Results:
Among the 166 enrolled patients, 37 (22.3%) experienced adverse events within the 52-week follow-up period. HDL was identified as a predictor of adverse outcomes at 52 weeks (AUC 0.661, p < 0.05), with an optimal cut-off value of 0.85. Patients with higher HDL levels not only exhibited elevated total cholesterol but were also associated with better nutritional status and lower inflammatory burden. HDL was negatively correlated with white blood cell count and C-reactive protein, and positively correlated with albumin level (p < 0.05). Baseline HDL level was an independent risk factor for adverse events within 52 weeks in CD patients treated with infliximab (p = 0.022). Moreover, the high-HDL group demonstrated a significantly lower risk of developing adverse events (p = 0.0017).
Conclusion:
The identification of HDL as an independent risk factor for 52-week adverse events in infliximab-treated CD patients suggests its potential utility as a predictive biomarker.
Trial Registration:
The study adhered to the Declaration of Helsinki. All participants provided written informed consent, and the study was approved by the Ethics Committee of Xiangya Hospital, Central South University with approval No. 202108158.
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