A novel role of prognostic nutritional index in predicting the effectiveness of infliximab in Crohn's disease

OBJECTIVE: To investigate the predictive value of the prognostic nutritional index (PNI) for the effectiveness of infliximab (IFX) in patients with Crohn's disease (CD). METHODS: All data were retrospectively collected from Xiangya Hospital, Central South University between January 2016 and September 2021. Clinical remission at 52 weeks is the primary endpoint. RESULTS: Altogether, 193 CD patients were enrolled. PNI can identify clinical remission (p = 0.004), and the optimal cut-off value of the PNI was 39.2. 92/116 (79.3%) and 44/77 (57.1%) in the high- and low-PNI groups were in clinical remission at week 52 (p = 0.001). Patients with low PNI have poor general health at baseline. The body mass index, hemoglobin, platelet (PLT), serum creatinine, fibrinogen, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Crohn's disease activity index (CDAI), and location of disease significantly differed between the two groups (p < 0.05). PNI was negatively correlated with CRP, ESR, PLT and CDAI (p < 0.05). The lower PNI, smoking history, and higher CDAI at baseline were the independent risk factors of disease activity at 52 weeks (p < 0.05). The high-PNI group is less likely to develop poor outcomes (p = 0.033). CONCLUSION: The PNI may serve as a novel and promising biomarker in predicting the effectiveness of IFX and contribute to targeted management in CD.