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Objectives <p>Altered body fat and muscle mass in Crohn’s disease (CD) have been linked to adverse disease course and outcomes. Prediction of treatment response or remission (RoR) of small bowel CD (SBCD) to biologic therapy remains challenging. We aimed to establish the prognostic value of body composition parameters measured using MR enterography (MRE) for RoR at 1 year in patients with SBCD commencing biologic therapy.</p> Methods <p>Participants were identified from those recruited to a prospective, multicentre study investigating the predictive ability of motility MRI for 1 year RoR in patients starting biologic therapy for active SBCD (MOTILITY trial). Myopenia, skeletal muscle:fat and visceral:subcutaneous fat were measured from baseline MRE. RoR at 1 year was judged using a composite of clinical and morphological MRE parameters. We compared the likelihood of RoR in patients with and without myopenia or low skeletal muscle:fat using logistic regression models.</p> Results <p>Ninety-six participants were included (mean age 38.2 years; 40 (42%) female). There were 34 (35%) responders. There was no significant difference in RoR at 1 year between those patients with and without skeletal muscle myopenia (OR: 0.85, 95% CI: 0.27, 2.66, <i>p</i>-value: 0.78), or those with or without low skeletal muscle:fat (OR: 0.71, 95% CI: 0.19, 2.71, <i>p</i>-value: 0.62).</p> Conclusions <p>Body composition parameters demonstrated no value for predicting therapeutic RoR in patients commencing biologic therapy for SBCD.</p> Critical relevance statement <p>Prediction of response to biologic therapy in small bowel Crohn’s disease (SBCD) remains challenging. Body composition parameters cannot predict biologic therapeutic response or remission for SBCD reliably.</p> Key Points <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Altered body fat and muscle mass in Crohn’s disease have been linked to adverse outcomes.</p> </ItemContent> <ItemContent> <p>Prediction of response to biologic therapy in small bowel CD (SBCD) would be useful for treatment optimisation.</p> </ItemContent> <ItemContent> <p>Body composition parameters measured using MRI cannot reliably predict biological therapeutic response or remission for SBCD.</p> </ItemContent> </UnorderedList></p> Graphical Abstract <p></p>

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MRI assessment of body composition for prediction of therapeutic response to biologic agents in patients with Crohn’s disease

  • 期刊论文

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  • 发表日期：

    2025年3月19日

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  • Naomi S. Sakai,
  • Andrew A. Plumb,
  • Norin Ahmed,
  • Kashfia Chowdhury,
  • Yakup Kilic,
  • Maira Hameed,
  • Anisha Patel,
  • Anisha Bhagwanani,
  • Emma Helbren,
  • Rachel Hyland,
  • Gauraang Bhatnagar,
  • Harbir Sidhu,
  • Hannah Lambie,
  • James M. Franklin,
  • Maryam Mohsin,
  • Elen Thomson,
  • Darren Boone,
  • Damian Tolan,
  • Safi Rahman,
  • Nik Ding,
  • Gordon W. Moran,
  • Stuart Bloom,
  • Ailsa Hart,
  • Alex Menys,
  • Simon Travis,
  • Steve Halligan,
  • Stuart A. Taylor,
  • Tariq Ahmad,
  • Saiam Ahmed,
  • Fardowsa Ahmed-Timms,
  • Rachel Baldwin-Cleland,
  • Uday Bannur Chikkeragowda,
  • Nina Barratt,
  • Teresita Beeston,
  • Biljana Brezina,
  • Amanda Cetroni,
  • Junaid Choudhury,
  • Bessie Cipriano,
  • Maria Dilawershah,
  • Heather Fitzke,
  • Tracy Foster,
  • James Franklin,
  • Anmol Gangi-Burton,
  • Nicola Gibbons,
  • Edmund Godfrey,
  • Arun Gupta,
  • Anthony Higginson,
  • Judith Holmes,
  • Elizabeth Isaac,
  • Ilan Jacobs,
  • Roman Jastrub,
  • Mayamol Joseph,
  • Jaspreet Kaur,
  • Klaartje Bel Kok,
  • Felix Kpodo,
  • Shankar Kumar,
  • Sarah Langlands,
  • Eric Loveday,
  • Sara McCartney,
  • Peter Mooney,
  • Gordon Moran,
  • Felicia Onoviran,
  • Miles Parkes,
  • Jaymin Patel,
  • Kamal Patel,
  • Kamini Patel,
  • Nishant Patodi,
  • Sue Philpott,
  • Andrew Plumb,
  • Richard Pollok,
  • Robert Przemiosolo,
  • Helen Rafferty,
  • Javen Ramsami,
  • Charlotte Robinson,
  • Suzanne Roffe,
  • Lindsay Rogers,
  • Konstantina Rosiou,
  • Naomi Sakai,
  • Abi Seward,
  • Stuart Taylor,
  • Belinda Theis,
  • Nora Thoua,
  • Anvi Wadke,
  • Lana Ward,
  • Annamaria Wilce,
  • Steven Williams

摘要

Objectives

Altered body fat and muscle mass in Crohn’s disease (CD) have been linked to adverse disease course and outcomes. Prediction of treatment response or remission (RoR) of small bowel CD (SBCD) to biologic therapy remains challenging. We aimed to establish the prognostic value of body composition parameters measured using MR enterography (MRE) for RoR at 1 year in patients with SBCD commencing biologic therapy.

Methods

Participants were identified from those recruited to a prospective, multicentre study investigating the predictive ability of motility MRI for 1 year RoR in patients starting biologic therapy for active SBCD (MOTILITY trial). Myopenia, skeletal muscle:fat and visceral:subcutaneous fat were measured from baseline MRE. RoR at 1 year was judged using a composite of clinical and morphological MRE parameters. We compared the likelihood of RoR in patients with and without myopenia or low skeletal muscle:fat using logistic regression models.

Results

Ninety-six participants were included (mean age 38.2 years; 40 (42%) female). There were 34 (35%) responders. There was no significant difference in RoR at 1 year between those patients with and without skeletal muscle myopenia (OR: 0.85, 95% CI: 0.27, 2.66, p-value: 0.78), or those with or without low skeletal muscle:fat (OR: 0.71, 95% CI: 0.19, 2.71, p-value: 0.62).

Conclusions

Body composition parameters demonstrated no value for predicting therapeutic RoR in patients commencing biologic therapy for SBCD.

Critical relevance statement

Prediction of response to biologic therapy in small bowel Crohn’s disease (SBCD) remains challenging. Body composition parameters cannot predict biologic therapeutic response or remission for SBCD reliably.

Key Points

Altered body fat and muscle mass in Crohn’s disease have been linked to adverse outcomes.

Prediction of response to biologic therapy in small bowel CD (SBCD) would be useful for treatment optimisation.

Body composition parameters measured using MRI cannot reliably predict biological therapeutic response or remission for SBCD.

Graphical Abstract