Objective: To investigate the predictive value of serum free triiodothyronine(FT3), free tetraiodothyronine(FT4), FT3/FT4 and thyroid stimulating hormone(TSH) on clinical response to Vedolizumab(VDZ) in patients with Crohn's disease(CD). Methods: From May 2020 to May 2022, 54 patients with CD who received VDZ treatment for more than 3 months in our hospital and 89 healthy control cases(the control group) were included. FT3, FT4, FT3/FT4, TSH and other data of the control group and CD patients were collected before and 3 months after VDZ treatment. CD activity index(CDAI) was used to evaluate CD disease activity. The difference of thyroid function between CD group and the control group was compared. According to whether the difference of CDAI(ΔCDAI) before and after VDZ was more than 100 points, CD patients were divided into response group and non-response group. The changes of thyroid function indexes before and after VDZ treatment and the correlation between the differences(ΔFT3, ΔFT4, ΔFT3/FT4, ΔTSH) and ΔCDAI were compared between the two groups. The predictive value of the above difference to VDZ clinical response was analyzed by using receiver operating characteristic(ROC) curve. Results: Before treatment, FT3 and FT3/FT4 in CD patients were lower than those in the control group(P<0.05). After 3 months of VDZ treatment, FT3 and FT3/FT4 were increased, while FT4 was decreased(P<0.05). FT3, FT4, FT3/FT4 and CDAI in the response group were compared before and after VDZ treatment, and the differences were statistically significant(P<0.05). Before and after VDZ treatment, ΔFT3, ΔFT3/FT4 were negatively correlated with ΔCDAI(P<0.05), while there was no linear correlation between ΔFT4, ΔTSH and ΔCDAI(P>0.05). The area under curve(AUC) of ΔFT3 and ΔFT3/FT4 to predict the clinical response potential of VDZ treatment were 0.837 and 0.827, respectively, with sensitivity of 82.9% and 80.5% and specificity of 81.8%. Conclusion: The changes of serum free thyroid function indexes, especially FT3 and FT3/FT4, are negatively correlated with the changes of clinical activity index in CD patients after VDZ treatment, and have certain predictive value for clinical response. |
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