Background Secondary loss of response to biological therapy is a challenge when treating Crohn’s disease (CD) and ulcerative colitis (UC). Currently, no single marker has been found to be valid as a prognostic indicator of response to biologic therapy in patients with CD and UC. In this study, we aimed to assess whether disease activity after 14 weeks of biologic therapy has a prognostic impact on surgery and steroid-free remission during 6 months following completion of induction therapy. Methods In an unselected cohort study based on data from 4 national Danish health registries, we identified 493 patients with UC and 620 patients with CD who completed induction therapy with biologics from 2016 to 2019. Following induction therapy with biologics, we defined disease activity based on C-reactive protein and clinical scores of disease activity. The composite endpoint, “not being well treated,” included surgery or use of corticosteroid within 6 months following induction therapy. Results In patients with UC with disease activity following induction therapy, the adjusted odds ratio for surgery or steroid treatment during 6 months of follow-up was 3.9 (95% CI, 1.6-9.3) compared with patients without disease activity, and in patients with CD, the adjusted odds ratio was 3.6 (95% CI, 1.7-7.6). Conclusions A positive treatment response to biologic treatment after induction therapy (measured by C-reactive protein and clinical scores) predicts a better short-term outcome in patients with CD and UC.

中文翻译：

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生物制剂诱导治疗后的疾病活动能否预测克罗恩病和溃疡性结肠炎的短期结果？

背景 在治疗克罗恩病 (CD) 和溃疡性结肠炎 (UC) 时，继发性生物治疗反应丧失是一个挑战。目前，尚未发现任何单一标志物可有效作为 CD 和 UC 患者对生物治疗反应的预后指标。在这项研究中，我们旨在评估 14 周生物治疗后的疾病活动是否对诱导治疗完成后 6 个月内手术和无类固醇缓解的预后影响。方法 在一项基于丹麦 4 个国家卫生登记处数据的非选择性队列研究中，我们确定了 493 名 UC 患者和 620 名 CD 患者，他们在 2016 年至 2019 年间完成了生物制剂诱导治疗。在生物制剂诱导治疗后，我们根据以下指标定义了疾病活动度： C反应蛋白和疾病活动的临床评分。复合终点“未得到很好的治疗”包括诱导治疗后 6 个月内进行手术或使用皮质类固醇。结果 在诱导治疗后有疾病活动的 UC 患者中，与无疾病活动的患者和有CD，调整后的比值比为 3.6（95% CI，1.7-7.6）。结论 诱导治疗后对生物治疗的积极治疗反应（通过 C 反应蛋白和临床评分衡量）预示着 CD 和 UC 患者的短期结果更好。结果 在诱导治疗后有疾病活动的 UC 患者中，与无疾病活动的患者和有CD，调整后的比值比为 3.6（95% CI，1.7-7.6）。结论 诱导治疗后对生物治疗的积极治疗反应（通过 C 反应蛋白和临床评分衡量）预示着 CD 和 UC 患者的短期结果更好。结果 在诱导治疗后有疾病活动的 UC 患者中，与无疾病活动的患者和有CD，调整后的比值比为 3.6（95% CI，1.7-7.6）。结论 诱导治疗后对生物治疗的积极治疗反应（通过 C 反应蛋白和临床评分衡量）预示着 CD 和 UC 患者的短期结果更好。