. 2025 Mar 19;16(1):61.

doi: 10.1186/s13244-025-01930-w.

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

Naomi S Sakai^{1

2}, Andrew A Plumb^{1

2}, Norin Ahmed³, Kashfia Chowdhury³, Yakup Kilic², Maira Hameed^{1

2}, Anisha Patel⁴, Anisha Bhagwanani⁵, Emma Helbren⁶, Rachel Hyland⁷, Gauraang Bhatnagar^{1

8}, Harbir Sidhu^{1

2}, Hannah Lambie⁷, James M Franklin⁹, Maryam Mohsin⁷, Elen Thomson⁷, Darren Boone², Damian Tolan⁷, Safi Rahman¹⁰, Nik Ding¹¹, Gordon W Moran^{12

13}, Stuart Bloom¹⁴, Ailsa Hart¹⁵, Alex Menys¹⁶, Simon Travis¹⁷, Steve Halligan^{1

2}, Stuart A Taylor^{18

19}; Motility trial investigators

Collaborators, Affiliations

Collaborators

Motility trial investigators:
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

Affiliations

¹ Centre for Medical Imaging, University College London, Division of Medicine London, London, UK.
² Department of Radiology, University College London Hospitals, London, UK.
³ Comprehensive Clinical Trials Unit, University College London, London, UK.
⁴ Radiology Department, Western General Hospital, Edinburgh, UK.
⁵ Radiology Department, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.
⁶ Radiology Department, Hull University Teaching Hospital NHS Foundation Trust, Hull, UK.
⁷ St James's University Hospital, Leeds, UK.
⁸ Frimley Park Hospital, Surrey, UK.
⁹ Institute of Medical Imaging and Visualisation, Bournemouth University, Bournemouth, UK.
¹⁰ Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.
¹¹ Gastroenterology Department, St Vincent's Hospital, Melbourne, VIC, Australia.
¹² Translational Medical Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
¹³ NIHR Nottingham BRC, University of Nottingham and Nottingham University Hospitals, Nottingham, UK.
¹⁴ Department of Gastroenterology, University College London Hospitals NHS Foundation Trust, London, UK.
¹⁵ St Mark's the National Bowel Hospital, London, UK.
¹⁶ Motilent, London, UK.
¹⁷ Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK.
¹⁸ Centre for Medical Imaging, University College London, Division of Medicine London, London, UK. Stuart.taylor1@nhs.net.
¹⁹ Department of Radiology, University College London Hospitals, London, UK. Stuart.taylor1@nhs.net.

PMID: 40106118
PMCID: PMC11923306
DOI: 10.1186/s13244-025-01930-w

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

Naomi S Sakai et al. Insights Imaging. 2025.

. 2025 Mar 19;16(1):61.

doi: 10.1186/s13244-025-01930-w.

Authors

Collaborators

Motility trial investigators:
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

Affiliations

¹ Centre for Medical Imaging, University College London, Division of Medicine London, London, UK.
² Department of Radiology, University College London Hospitals, London, UK.
³ Comprehensive Clinical Trials Unit, University College London, London, UK.
⁴ Radiology Department, Western General Hospital, Edinburgh, UK.
⁵ Radiology Department, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.
⁶ Radiology Department, Hull University Teaching Hospital NHS Foundation Trust, Hull, UK.
⁷ St James's University Hospital, Leeds, UK.
⁸ Frimley Park Hospital, Surrey, UK.
⁹ Institute of Medical Imaging and Visualisation, Bournemouth University, Bournemouth, UK.
¹⁰ Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.
¹¹ Gastroenterology Department, St Vincent's Hospital, Melbourne, VIC, Australia.
¹² Translational Medical Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
¹³ NIHR Nottingham BRC, University of Nottingham and Nottingham University Hospitals, Nottingham, UK.
¹⁴ Department of Gastroenterology, University College London Hospitals NHS Foundation Trust, London, UK.
¹⁵ St Mark's the National Bowel Hospital, London, UK.
¹⁶ Motilent, London, UK.
¹⁷ Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK.
¹⁸ Centre for Medical Imaging, University College London, Division of Medicine London, London, UK. Stuart.taylor1@nhs.net.
¹⁹ Department of Radiology, University College London Hospitals, London, UK. Stuart.taylor1@nhs.net.

PMID: 40106118
PMCID: PMC11923306
DOI: 10.1186/s13244-025-01930-w

Abstract

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.

Keywords: Biological therapy; Body composition; Crohn’s disease; Magnetic resonance imaging.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This was a prespecified substudy of the MOTILITY trial (ISRCTN14481560). The study was ethically approved by the NHS West Midlands Research Ethics Committee: 17/WM/0106. All participants gave written informed consent. Consent for publication: Not applicable. Competing interests: G.W.M. is in receipt of research funding from AstraZeneca, Bristol Myers Squibb, Jansen, Alimentiv and Pfizer; provided consultancy services on advisory boards for Jansen, Pfizer, Abbvie; is a consultant for Alimetiv Inc. and Satisfai health. S.T. has received grants/research support from AbbVie, Celgene, Celsius, ECCO, Galapagos, Helmsley Trust, IOIBD, Janssen, Lilly, Pfizer, Takeda, UKIERI, Vifor, and Norman Collisson Foundation; consulting Fees from Alimentiv, Apexian, Apollo, Arcturis, Arena, AstraZeneca, BMS, Buhlmann, Celgene, ChemoCentryx, Clario, Cosmo, Dynavax, Endpoint Health, EQrX, Equillium, Ferring, Galapagos, Genentech/Roche, Gilead, GSK, Janssen, Lilly, Mestag, Microbiotica, ONO, Pfizer, Protagonist, Sanofi, Satisfai, Sensyne Health, Sorriso, Syndermix, Takeda, Theravance, Topivert, Tr1X Bio, UCB Pharma, Vifor; speaker fees from BMS, Ferring, Janssen, Lilly, Pfizer, Sun Pharma, Takeda and has share options in Satisfai Health Inc. H.L. has received speaking honoraria from Takeda Pharmaceuticals. G.B. is a consultant for Alimentiv, is an employee of Motilent, has share options in Motilent and owns patent P295276.US.02, system to characterise topology and morphology of fistulae from medical imaging data. A.M. is CEO of Motilent. S.A.T. receives research support from Takeda, is a consultant to AstraZeneca and shareholder in Motilent. The remaining authors declare that they have no competing interests.

Figures

**Fig. 1**
Example of segmentation using a T2 axial image with regions of interest drawn at the L3 vertebral body level, on subcutaneous fat (green), visceral fat (pink), and skeletal muscle (blue)

**Fig. 2**
Flow of study participants. * Baseline eligible: includes baseline SES-CD score or baseline MRE score, height, baseline skeletal muscle area, baseline visceral and subcutaneous fat. ** 12-month eligible: includes 12-month SES-CD or MRE score. SES-CD, simple endoscopic score for Crohn’s disease; MRE, magnetic resonance enterography

See this image and copyright information in PMC

References

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1. Bryant RV, Schultz CG, Ooi S et al (2018) Obesity in inflammatory bowel disease: gains in adiposity despite high prevalence of myopenia and osteopenia. Nutrients 10:1192 - PMC - PubMed
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MRI assessment of body composition for prediction of therapeutic response to biologic agents in patients with Crohn's disease

Collaborators

Affiliations

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

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources