Clinical and Proteomic Predictors of Primary Response to Infliximab in Crohn’s Disease with Small Bowel Involvement: A Pilot Study in China

ABSTRACT: Background and Aim: Crohn’s disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract. Although various biomarkers have been used to predict infliximab (IFX) response in CD, its efficacy in patients with small bowel involvement remains underexplored. This study combined clinical data with serum proteomics to develop prediction models for IFX efficacy at week 14 in small bowel-involved CD. Methods: In this pilot study, 41 patients with small bowel-involved CD treated with IFX between January 2020 and December 2023 at two Chinese hospitals were included. Clinical response and remission at week 14 were assessed using the Crohn’s Disease Activity Index (CDAI). Pre-treatment serum proteomics identified differentially expressed proteins (fold change >1.2, p < 0.05). Predictive models were developed via logistic regression and validated with ROC curve analysis using SPSS 24.0 and R 4.4.0 (p < 0.05). Results: Clinical analysis identified extraintestinal manifestations (EIM), hemoglobin <87.5 g/L, and a history of CD-related surgery as key predictors of primary non-response (AUC = 0.846, 95% CI: 0.715–0.978). Proteomic analysis revealed 13 differentially expressed proteins (individual AUCs: 0.588-0.868). A serum model combining MSN, SAA4, VNN1, and IGFBP5 achieved an AUC of 0.931 (95% CI: 0.845-1.000). Integrating MSN with clinical predictors yielded combined models with AUCs between 0.882 and 0.914; notably, the MSN + CD-related surgery model performed best (AUC = 0.914, 95% CI: 0.829–0.998). Conclusions: The developed clinical, serum, and combined prediction models effectively forecast IFX efficacy in small bowel-involved CD, providing valuable tools for personalized treatment strategies.

INSTRUMENT(S):

ORGANISM(S): Homo Sapiens (human)

TISSUE(S): Blood Serum

SUBMITTER: Yaqing Bai  

LAB HEAD: Xiaoyin Bai

PROVIDER: PXD076080 | Pride | 2026-03-26

REPOSITORIES: Pride