ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Prognostic Nutritional Index and Pan-Immune-Inflammation Value as Predictors of One-Year Clinical Recurrence in Crohn's Disease Following Infliximab Therapy: A Retrospective Cohort Study
Provisionally accepted
- The First Affiliated Hospital of Bengbu Medical College, Handan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Identifying Crohn’s disease (CD) patients at high risk of recurrence after infliximab (IFX) treatment is essential for personalized medicine. The Prognostic Nutritional Index (PNI) and Pan-Immune-Inflammation Value (PIV) are composite biomarkers reflecting nutritional status and systemic inflammation. While PNI and PIV have shown prognostic utility in other conditions, their combined role in predicting recurrence in CD following biologic therapy remains underexplored. This study evaluated their predictive potential for 1-year clinical recurrence post-IFX induction. Materials and Methods: In this retrospective cohort study, CD patients who completed IFX induction at The First Affiliated Hospital of Bengbu Medical University were enrolled. The primary endpoint was clinical recurrence within one year. PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per μL). PIV was calculated as (neutrophil count × platelet count × monocyte count) / lymphocyte count. Univariate/multivariate logistic regression identified independent risk factors, and ROC analysis assessed biomarker discrimination. Results: Among 158 eligible patients, 46 (29.1%) experienced clinical recurrence. Patients with recurrence exhibited significantly lower baseline PNI (42.5 ± 5.9 vs. 48.3 ± 4.9, P < 0.001) and higher PIV (389.2 ± 168.4 vs. 235.7 ± 108.9, P < 0.001). Multivariate analysis confirmed both PNI (Odds Ratio (OR) = 0.87, 95% Confidence Interval (CI): 0.82-0.93, P < 0.001) and PIV (OR = 1.008, 95% CI: 1.004-1.012, P < 0.001) as independent predictors. The area under the curve (AUC) was 0.81 for PNI and 0.78 for PIV. A model combining PNI, PIV, and stricturing/penetrating disease behavior achieved superior predictive accuracy (AUC = 0.87, 95% CI: 0.81-0.92). Conclusions: Pre-treatment PNI and PIV are robust, independent biomarkers for predicting 1-year clinical recurrence in CD patients treated with IFX. A lower PNI and higher PIV signify substantially increased recurrence risk. Integration of these readily available biomarkers into clinical practice could enhance risk stratification and guide personalized treatment strategies, potentially improving long-term outcomes.
Keywords: Crohn's disease, Disease recurrence, infliximab, Pan-Immune-Inflammation Value, Prognostic nutritional index
Received: 17 Nov 2025; Accepted: 02 Jan 2026.
Copyright: © 2026 Cui, Liu, Huang and Ke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiquan Ke
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.