Infliximab response associates with radiologic findings in bio-naive Crohn's disease

ObjectivesSince a reliable model for predicting infliximab (IFX) benefits in bio-naive Crohn's disease (CD) is still lacking, we constructed a magnetic resonance enterography (MRE)-based model to predict the risk of loss of response to IFX in bio-naive patients with CD.MethodsThis retrospective multicenter study enrolled 188 bio-naive patients with CD who underwent MRE before IFX therapy. Therapeutic outcomes were determined based on clinical symptoms and endoscopic findings within 52 weeks. The areas of bowel wall segmentation were decided by two experienced radiologists in consensus. Texture features were extracted using the least absolute shrinkage and selection operator, and a radiomic model was built using multivariate logistic regression. The model performance was validated by receiver operating characteristic, calibration curve, and decision curve analysis.ResultsThe area under the curve of radiomic model was 0.88 (95% confidence interval: 0.82-0.95), and the model provided clinical net benefit in identifying the loss of response to IFX and exhibited remarkable robustness among centers, scanners, and disease characteristics. The high-risk patients defined by the radiomic model were more likely to develop IFX nonresponse than low-risk patients (all p < 0.05).ConclusionsThis novel pretreatment MRE-based model could act as an effective tool for the early estimation of loss of response to IFX in bio-naive patients with CD.