Abstract: Objective Loss of response (LOR) has become an important clinical problem in patients with Crohn’s diseasereceiving infliximab (IFX) treatment. Neutrophil-lymphocyte ratio (NLR) has been shown to correlate with the activity ofinflammatory bowel disease (IBD), and NLR at the 14th week of IFX therapy potentially allows the prediction of sustainedresponse to IFX in Crohn’s patients. The aim of this study was to explore whether NLR at the 14th week of IFX therapy couldpredict the occurrence of LOR to IFX in Crohn’s patients. Methods Between January, 2012 and December, 2016, 54 patientswith Crohn’s disease underwent a 52-week treatment with IFX and successfully achieved response to the induction treatmentin Zhongnan Hospital. We retrospectively examined their medical records and assessed the association between NLR at 14weeks and LOR during IFX therapy. Results Of the 54 patients, 15 (27.8%) showed LOR to IFX during the follow-up. We noteda significant increase in NLR at 14 weeks in the patients with LOR as compared with the patients with sustained response toIFX [3.51 (2.9-6.25) vs 1.77 (1.23-2.56), P=0.00]. Receiver-operating characteristic analysis showed that at the cut-off value of 2.75,NLR at 14 weeks was predictive of LOR within 52 weeks of IFX therapy with a sensitivity of 93.33% and a specificity of 84.62%,and the area under curve (AUC) of NLR was 0.903 (0.731-0.959). Univariate analysis revealed a significant correlation betweenrelapse- free survival and the NLR at 14 weeks (P=0.00). Multivariate analysis identified NLR at 14 weeks as an independentprognostic factor for LOR with a hazard ratio of 1.851 (95% CI: 1.096-3.026, P=0.021). Conclusion NLR at the 14th week duringIFX therapy is a useful predictor for LOR in patients with Crohn’s disease.