Related Experiment Video
Updated: Apr 15, 2026
Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
Can peripheral blood eosinophils predict primary non-response to Infliximab therapy in pediatric Crohn's disease?
Quanhua Wei1, Dexiu Guan2, Yongli Fang2
1Beijing Tsinghua Changgung Hospital, Beijing, China.
Insights
Peripheral blood eosinophils can predict primary non-response to infliximab in pediatric Crohn's disease. This finding may help guide treatment decisions for physicians, improving patient outcomes.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Inflammatory Bowel Disease Research
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease affecting children.
- Infliximab is a biologic therapy used for moderate to severe CD.
- Predicting primary non-response to infliximab is crucial for optimizing treatment strategies.
Purpose of the Study:
- To evaluate peripheral blood eosinophils as a predictive biomarker for primary non-response to infliximab in pediatric CD patients.
- To identify baseline factors associated with infliximab non-response in pediatric Crohn's disease.
Main Methods:
- Retrospective analysis of 37 pediatric CD patients receiving infliximab induction (2018-2022).
- Collection of baseline clinical and laboratory data, including peripheral blood eosinophil counts.
- Statistical analysis using Mann-Whitney U, t-test, multivariable logistic regression, and ROC curve analysis to assess predictors of primary non-response at week 14.
Main Results:
- Primary non-response to infliximab was observed in 27% of assessable pediatric CD patients.
- Baseline disease duration, neutrophils, lymphocytes, eosinophils, albumin, and total bilirubin correlated with primary non-response.
- Multivariable analysis identified disease duration, neutrophils, and peripheral blood eosinophils as independent predictors. The model including eosinophils demonstrated excellent predictive discrimination (AUC=0.974).
Conclusions:
- Peripheral blood eosinophil counts at baseline show significant promise as biomarkers for predicting primary non-response to infliximab in pediatric Crohn's disease.
- These findings suggest that eosinophil levels could aid clinicians in making timely therapeutic decisions for infliximab treatment in pediatric CD.
Purpose:
The aim of this study was to assess whether peripheral blood eosinophils can predict primary non-response in pediatric Crohn's disease on infliximab therapy.
Methods:
A total of 37 patients diagnosed with Crohn's disease who had received infliximab induction between 2018 and 2022 were enrolled in this study. Clinical and other laboratory data were collected at baseline of infliximab therapy. Primary non-response was determined at week 14. The Mann-Whitney U test and t-test were used to evaluate correlation of variables at baseline with primary non-response at week 14. Multivariable logistic regression was used to construct prediction models. The Area Under Curve of the receiver operating characteristic curve was calculated.
Results:
Primary non-response occurred in 27% patients who were assessable at week 14. Analysis of baseline clinical data and laboratory data showed that disease duration (P = 0.003), neutrophils (P = 0.013), lymphocyte (P = 0.003), eosinophils (P = 0.013), albumin (P = 0.001) and total bilirubin (P = 0.028) correlated with primary non-response at week 14. Multiple logistic regression withheld three final independent predictors for primary non-response: disease duration (1.49, 95%CI [1.01-2.21], P = 0.046), neutrophils (2.30, 95%CI [1.02-5.19], P = 0.044), and eosinophils at first infliximab (0.97, 95%CI [0.93-1.02], P = 0.019). The validated model containing peripheral blood eosinophils showed excellent discrimination to primary non-response with an Area Under Curve of 0.974.
Conclusions:
Peripheral blood eosinophils are promising biomarkers in prediction of primary non-response to infliximab and may be useful for guiding physicians in therapeutic decision-making.
