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
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Article info
Publication history
Published online: March 14, 2023
Accepted:
February 22,
2023
Received:
August 12,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
