Abstract
OBJECTIVE: The objective of this study was to identify prognostic clinicopathological factors in patients with Crohn's disease (CD) receiving infliximab (IFX) treatment and to develop a new nomogram for predicting outcomes in this population. METHODS: The primary outcome was endoscopic healing (EH) in CD patients receiving IFX at week 30. Logistic regression models were employed to identify predictors of EH. Receiver operating characteristic analysis and calibration plots were used to assess the accuracy and clinical relevance of the developed nomogram. RESULTS: This retrospective study included 179 CD patients treated with IFX. Both univariate and multivariate logistic regression identified age (P =.059), platelet-lymphocyte ratio (PLR) (P =.001), anti-drug antibody concentration at 14 weeks (P =.005), IFX concentration at 14 weeks (P =.017) and C-reactive protein level at 14 weeks (P =.001) as independent predictors of EH. A nomogram was constructed based on these factors, its discrimination ability was assessed using area under the curve (AUC) in both the training cohort (N = 126) and validation cohort (N = 53), yielding an AUC of 0.828 (95% CI 0.757-0.899) and 0.731 (95% CI 0.593-0.869), respectively. Decision curve analysis demonstrated the nomogram's clinical utility at risk thresholds above 0.13, with optimal utility between probabilities of 0.13 and 0.94. CONCLUSION: This TDM- and PLR-based nomogram enables early identification of IFX responders, potentially reducing unnecessary endoscopic evaluations and guiding personalized therapy in CD management.