Serum REG3α was evaluated as a prognostic biomarker for complicated Crohn's disease (CD) across two cross-sectional cohorts (Mount Sinai, Leuven; n=394 patients) and one pre-diagnostic cohort (PREDICTS) with serial samples up to 10 years before CD diagnosis.
High serum REG3α independently predicted CD progression (hospitalization, surgery, steroid use, or new advanced therapy) in both cross-sectional cohorts (HR 1.9, 95% CI 1.3–2.8; HR 2.9, 95% CI 1.9–4.6; both p<0.001), including patients with mild or inactive disease, and predicted complicated (B2/B3) or surgical CD presentations up to 10 years before diagnosis.
Cross-sectional design in two of three cohorts limits causal inference; sample size (n=394) is modest; REG3α cutoff thresholds and assay standardization for clinical use are not yet defined.
Consider serum REG3α as an adjunct prognostic tool in CD — even in patients with mild or inactive disease — as elevated levels may flag those at risk for complicated disease course independent of CRP and endoscopic activity. This biomarker may also have future utility in pre-diagnostic risk stratification.
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