Resolution of dominant patient‐reported outcome at end of induction predicts clinical and endoscopic remission in Crohn’s disease Journal Articles uri icon

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abstract

  • SummaryBackgroundIt is unclear whether improvement in patient‐reported outcomes (PROs) relative to baseline symptom burden in Crohn’s disease (CD) is associated with subsequent endoscopic remission.AimTo evaluate the relationship between dominant PRO resolution post‐induction and achievement of clinical and endoscopic remission.MethodsThis post‐hoc analysis of clinical trial data from 251 participants evaluated the relationship between the resolution of the dominant PRO (most severely elevated baseline PRO) or clinical response (CDAI ≥100 reduction) after induction therapy with biologics (post‐induction) and 1‐year clinical remission (CDAI <150) and/or endoscopic remission (SES‐CD <3). Multivariate logistic regression models evaluated the relationship between post‐induction‐dominant PRO resolution and 1‐year outcomes adjusted for confounders.ResultsParticipants with dominant PRO resolution post‐induction had higher odds of combined endoscopic and clinical remission compared to those without resolution (aOR: 1.94 [95% CI: 1.01–3.74], P = 0.047). Combining dominant PRO resolution with post‐induction endoscopic response (SES‐CD ≥50% reduction) was associated with higher odds of 1‐year endoscopic and clinical remission (aOR: 6.89 [95% CI: 1.65–28.72], P = 0.008). Clinical and PRO2 response (≥30% decrease in stool frequency and/or ≥30% decrease in abdominal pain score and both not worse than baseline) at post‐induction did not predict these outcomes. No significant differences were observed with 1‐year endoscopic remission for post‐induction‐dominant PRO resolution, clinical or PRO2 response.ConclusionsPost‐induction resolution of dominant PRO, but not clinical or PRO2 response, was strongly associated with 1‐year endoscopic and clinical remission. Resolution of dominant baseline PRO after induction therapy may be informative for 1‐year outcomes. Further validation is required.

publication date

  • May 2022