Xu et al reported a model for predicting secondary non-response of a patient with Crohn's disease to Infliximab. This can help to identify a patient who should be evaluated for an alternative therapy. The authors are from the Shanghai Institute of Digestive Disease and Shanghai Jiao Tong University in China.
Patient selection: Crohn's disease treated with infliximab
Secondary non-response: initial improvement at 14 weeks of infliximab therapy but relapse/recurrence by 54 weeks
Parameters:
(1) previous surgery
(2) TNFRSF1B (676 T>G)
(3) serum CRP in mg/L
(4) erythrocyte sedimentation rate in mm in first hours
Parameter
Finding
Points
previous surgery
no
0
yes
21.2
TNFRSF1B at 676
TT
0
TG
50
GG
100
serum CRP
<= 5 mg/L
0
> 5 mg/L
57
ESR
<= 20 mm in first hour
0
> 20 mm in first hour
30
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 208.2
• The higher the score the greater the likelihood of secondary non-response.
value of X =
= (0.06509 * (score)) - 9.369
probability of secondary non-response to infliximab =
= 1 / (1 + EXP((-1) * X))
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