Background/Aims : The recent update on Selecting Therapeutic Targets in Inflammatory Bowel Disease initiative has added a decrease in fecal calprotectin (FC) to an acceptable range as an intermediate target for Crohn's disease (CD). We aimed to investigate whether postinduction FC could predict future persistent remission (PR) and endoscopic healing (EH) after 1 year of treatment with infliximab (IFX) in pediatric patients with CD. Methods : This multicenter retrospective observational study included pediatric patients with CD who were followed up for at least 1 year after starting IFX. The association of postinduction FC with PR and EH was investigated. Results : A total of 132 patients were included in this study. PR and EH were observed in 71.2% (94/132) and 73.9% (82/111) of the patients, respectively. In multivariate logistic regression analysis, only the postinduction FC level was associated with PR (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.08 to 0.66; p=0.009). The FC levels at initiation of IFX and postinduction were significantly associated with EH (OR, 0.73; 95% CI, 0.53 to 0.99; p=0.044 and OR, 0.20; 95% CI, 0.06 to 0.49; p=0.002, respectively). According to the receiver operating characteristic curve analysis, the optimal cutoff level for postinduction FC associated with PR was 122 mg/kg, and that associated with EH was 377 mg/kg. Conclusions : Postinduction FC was associated with PR and EH after 1 year of treatment with IFX in pediatric patients with CD. Our findings emphasize the importance of FC as an intermediate target in the treat-to-target era.

中文翻译：

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诱导后的粪便钙卫蛋白能够预测克罗恩病儿科患者接受英夫利昔单抗治疗 1 年后的持续缓解和内镜愈合。

背景/目标：最近关于选择炎症性肠病治疗靶点计划的更新已将粪便钙卫蛋白 (FC) 降低至可接受的范围，作为克罗恩病 (CD) 的中间靶点。我们的目的是研究诱导后 FC 是否可以预测 CD 儿科患者接受英夫利昔单抗 (IFX) 治疗 1 年后未来的持续缓解 (PR) 和内镜下愈合 (EH)。方法：这项多中心回顾性观察研究纳入了 CD 儿科患者，他们在开始 IFX 后随访至少 1 年。研究了诱导后 FC 与 PR 和 EH 的关联。结果：本研究共纳入 132 名患者。分别有 71.2% (94/132) 和 73.9% (82/111) 的患者出现 PR 和 EH。在多变量逻辑回归分析中，只有诱导后 FC 水平与 PR 相关（比值比 [OR]，0.26；95% 置信区间 [CI]，0.08 至 0.66；p=0.009）。IFX 开始时和诱导后的 FC 水平与 EH 显着相关（OR，0.73；95% CI，0.53 至 0.99；p=0.044；OR，0.20；95% CI，0.06 至 0.49；p=0.002）。根据受试者工作特征曲线分析，与 PR 相关的诱导后 FC 的最佳截止水平为 122 mg/kg，与 EH 相关的最佳截止水平为 377 mg/kg。结论：CD 儿科患者接受 IFX 治疗 1 年后，诱导后 FC 与 PR 和 EH 相关。我们的研究结果强调了 FC 作为目标治疗时代中间目标的重要性。