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Comment
. 2023 Jul;55(7):865-871.
doi: 10.1016/j.dld.2023.02.017. Epub 2023 Mar 14.

Sarcopenia is a negative predictive factor for endoscopic remission in patients with Crohn's disease treated with biologics

Mauro Grova  1 , Federica Crispino  2 , Marcello Maida  3 , Alessandro Vitello  3 , Sara Renna  4 , Angelo Casà  4 , Lorenzo Tesè  5 , Fabio Salvatore Macaluso  4 , Ambrogio Orlando  4
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Comment

Sarcopenia is a negative predictive factor for endoscopic remission in patients with Crohn's disease treated with biologics

Mauro Grova et al. Dig Liver Dis. 2023 Jul.

Abstract

Background: Sarcopenia has been associated with poor prognosis in chronic diseases.

Aims: To investigate the role of sarcopenia in predicting clinical and endoscopic outcomes in patients with Crohn's disease (CD).

Methods: Consecutive CD patients who started biologics between 2014 and 2020 and underwent abdominal magnetic resonance or computed tomography within 6 months from the beginning of the biological therapy were enroled. Sarcopenia was defined as Psoas Muscle Index (PMI) lower than 5.4 cm²/m² (men) and 3.56 cm²/m² (women). Univariate and multivariate analyses were used to evaluate whether sarcopenia could predict steroid-free clinical remission (SFCR), endoscopic remission (ER), hospitalisation and surgery after 12 months of therapy.

Results: 358 patients were included. Sarcopenia was found in 18.2% of patients, and it was associated with a lower rate of ER (14.8% vs 47.7%; p = 0.002) after 12 months of therapy, while it was not associated with SFCR (65.1% vs 70.1%; p = 0.435), hospitalisation (9.2% vs 7.8%; p = 0.801) and surgery (3.1% vs 6.1%; p = 0.549). Sarcopenia was identified as a predictor of lack of ER (odds ratio [OR]=5.2; p = 0.006), as well as smoking (OR=2.5; p = 0.028) and perianal disease (OR=2.6; p = 0.020).

Conclusion: Sarcopenia is a negative prognostic factor for ER in CD patients treated with biologics.

Keywords: Crohn's disease; Endoscopic remission; Psoas; Sarcopenia.

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Conflict of interest statement

Conflict of interest S.R. served as an advisory board member for AbbVie and MSD Pharmaceuticals, and received lecture grants from AbbVie, Janssen, MSD, and Takeda Pharmaceuticals. F.S.M. served as an advisory board member and/or received lecture grants from AbbVie, Biogen, Galapagos, Janssen, MSD, Pfizer, Samsung Bioepis, and Takeda Pharmaceuticals. A.O served as an advisory board member for AbbVie, Galapagos, MSD, Janssen, Pfizer, Takeda Pharmaceuticals, and received lecture grants from AbbVie, MSD, Sofar, Chiesi, Janssen, Pfizer, and Takeda Pharmaceuticals. All other authors have no conflict of interest to declare.

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