Goals: This study aimed to investigate the correlation between sarcopenia and the efficacy of ustekinumab in patients with Crohn’s disease (CD) and to identify predictors of treatment efficacy. Background: Sarcopenia has been consistently associated with adverse CD-related prognoses in previous studies, and identifying predictors that impact biological efficacy remains crucial in the management of CD. Study: This retrospective study defined sarcopenia by the L3 skeletal muscle index (L3 SMI). Primary nonresponse (PNR) and secondary loss of response (SLOR), categorized as clinical and objective, were assessed at weeks 24 and 48, respectively. Associations were analyzed using multivariable regression, propensity score matching, and other analytical approaches. Results: Sarcopenia was significantly associated with higher rates of both clinical and objective PNR (both P <0.001) and served as an independent risk factor for clinical (OR=4.07, 95% CI: 1.51-10.98, P =0.006) and objective PNR (OR=4.42, 95% CI: 1.66-11.78, P =0.003). During maintenance therapy, sarcopenia was associated with objective SLOR ( P <0.001) and constituted an independent risk factor for it (OR=4.415, 95% CI: 1.655-11.781, P =0.003). In contrast, no significant association was observed between sarcopenia and clinical SLOR ( P =0.324). In addition, no significant improvement in L3 SMI was observed after ustekinumab treatment ( P =0.058), and trough concentrations did not differ significantly between patients with and without sarcopenia ( P =0.241). Conclusions: Sarcopenia is an independent predictor of both PNR and objective SLOR in patients with CD.
Sun et al. (Fri,) studied this question.