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Levels of C-reactive protein are associated with response to infliximab therapy in patients with Crohn's disease

Author
Organization
Abstract
BACKGROUND & AIMS: Infliximab is an antibody against tumor necrosis factor-alpha that is used to treat patients with moderate to severe Crohn's disease (CD). C-reactive protein (CRP) is a marker used to identify and follow individuals with CD. We analyzed changes in levels of CRP in a large cohort of patients with CD undergoing treatment with infliximab. METHODS: Serial levels of CRP were analyzed in 718 CD patients. Blood was collected before each infusion; a total of 8845 CRP levels were available for analysis. The correlations between CRP levels and need for dose adjustment, outcomes, and mucosal healing (based on endoscopic analysis of 253 patients) were evaluated. Therapy adjustment was considered successful if therapy continued without need for change. Subgroup analysis was performed by using data from 268 patients who received 8 weeks of maintenance therapy. RESULTS: More patients with high baseline levels of CRP responded to infliximab than patients with normal levels (90.8% vs 82.6%; P = .014). Early normalization of CRP levels correlated with sustained long-term response (P < .001). CRP levels remained significantly higher among patients who lost their response to infliximab, compared with those with a sustained response (P = .001). At time of loss of response, CRP levels were significantly increased (median, 11.2 mg/L) and did not return to baseline levels (median, 18.2 mg/L; P = .039). CRP correlated with mucosal healing (P = .033). CONCLUSIONS: CRP is a good marker of disease activity in patients treated with infliximab. Increased levels of CRP indicate mucosal inflammation and a likelihood of clinical relapse.
Keywords
EFFICACY, INFLAMMATORY-BOWEL-DISEASE, SAFETY, IBD, FISTULAS, Inflammatory Bowel Disease, Anti-TNF Therapy, Biomarkers, Diagnostics

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MLA
Jurgens, M., et al. “Levels of C-Reactive Protein Are Associated with Response to Infliximab Therapy in Patients with Crohn’s Disease.” CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, vol. 9, no. 5, ELSEVIER SCIENCE INC, 2011, pp. 421-U1420, doi:10.1016/j.cgh.2011.02.008.
APA
Jurgens, M., John, J., Cleynen, I., Schnitzler, F., Fidder, H., Van Moerkercke, W., … Vermeire, S. (2011). Levels of C-reactive protein are associated with response to infliximab therapy in patients with Crohn’s disease. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 9(5), 421-U1420. https://doi.org/10.1016/j.cgh.2011.02.008
Chicago author-date
Jurgens, M, JMM John, I Cleynen, F Schnitzler, H Fidder, W Van Moerkercke, V Ballet, et al. 2011. “Levels of C-Reactive Protein Are Associated with Response to Infliximab Therapy in Patients with Crohn’s Disease.” CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 9 (5): 421-U1420. https://doi.org/10.1016/j.cgh.2011.02.008.
Chicago author-date (all authors)
Jurgens, M, JMM John, I Cleynen, F Schnitzler, H Fidder, W Van Moerkercke, V Ballet, M Noman, I Hoffman, G Van Assche, PJ Rutgeerts, Kristel Van Steen, and S Vermeire. 2011. “Levels of C-Reactive Protein Are Associated with Response to Infliximab Therapy in Patients with Crohn’s Disease.” CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 9 (5): 421-U1420. doi:10.1016/j.cgh.2011.02.008.
Vancouver
1.
Jurgens M, John J, Cleynen I, Schnitzler F, Fidder H, Van Moerkercke W, et al. Levels of C-reactive protein are associated with response to infliximab therapy in patients with Crohn’s disease. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY. 2011;9(5):421-U1420.
IEEE
[1]
M. Jurgens et al., “Levels of C-reactive protein are associated with response to infliximab therapy in patients with Crohn’s disease,” CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, vol. 9, no. 5, pp. 421-U1420, 2011.
@article{5906818,
  abstract     = {BACKGROUND & AIMS: Infliximab is an antibody against tumor necrosis factor-alpha that is used to treat patients with moderate to severe Crohn's disease (CD). C-reactive protein (CRP) is a marker used to identify and follow individuals with CD. We analyzed changes in levels of CRP in a large cohort of patients with CD undergoing treatment with infliximab. METHODS: Serial levels of CRP were analyzed in 718 CD patients. Blood was collected before each infusion; a total of 8845 CRP levels were available for analysis. The correlations between CRP levels and need for dose adjustment, outcomes, and mucosal healing (based on endoscopic analysis of 253 patients) were evaluated. Therapy adjustment was considered successful if therapy continued without need for change. Subgroup analysis was performed by using data from 268 patients who received 8 weeks of maintenance therapy. RESULTS: More patients with high baseline levels of CRP responded to infliximab than patients with normal levels (90.8% vs 82.6%; P = .014). Early normalization of CRP levels correlated with sustained long-term response (P < .001). CRP levels remained significantly higher among patients who lost their response to infliximab, compared with those with a sustained response (P = .001). At time of loss of response, CRP levels were significantly increased (median, 11.2 mg/L) and did not return to baseline levels (median, 18.2 mg/L; P = .039). CRP correlated with mucosal healing (P = .033). CONCLUSIONS: CRP is a good marker of disease activity in patients treated with infliximab. Increased levels of CRP indicate mucosal inflammation and a likelihood of clinical relapse.},
  author       = {Jurgens, M and John, JMM and Cleynen, I and Schnitzler, F and Fidder, H and Van Moerkercke, W and Ballet, V and Noman, M and Hoffman, I and Van Assche, G and Rutgeerts, PJ and Van Steen, Kristel and Vermeire, S},
  issn         = {1542-3565},
  journal      = {CLINICAL GASTROENTEROLOGY AND HEPATOLOGY},
  keywords     = {EFFICACY,INFLAMMATORY-BOWEL-DISEASE,SAFETY,IBD,FISTULAS,Inflammatory Bowel Disease,Anti-TNF Therapy,Biomarkers,Diagnostics},
  language     = {eng},
  number       = {5},
  pages        = {421--U1420},
  publisher    = {ELSEVIER SCIENCE INC},
  title        = {Levels of C-reactive protein are associated with response to infliximab therapy in patients with Crohn's disease},
  url          = {http://dx.doi.org/10.1016/j.cgh.2011.02.008},
  volume       = {9},
  year         = {2011},
}

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