BACKGROUND: Non-invasive monitoring of inflammatory bowel disease is an unmet clinical need as patients in clinical remission may have residual mucosal inflammation preceding clinical relapse. AIMS: We aimed to assess the value of fecal calprotectin and standardized clinical activity scoring to monitor disease activity in ulcerative colitis under medical treatment. METHODS: Forty-one patients with ulcerative colitis were included in a prospective observational study. Medical treatment was guided by clinical judgement of treating physicians. Fecal calprotectin and the clinical activity index (CAI) were measured blinded to treating physicians every 2 months until the end of follow-up. Twenty-six patients received colonoscopy for clinical reason. RESULTS: As defined by the CAI, patients were in clinical remission (63.4 %), having mild (26.8 %) or moderate (11.2 %) disease activity. Of those in clinical remission (CAI ≤ 4), 86.4 % showed residual endoscopic activity (Mayo Score ≥1). Calprotectin levels were higher in endoscopically active disease (779.0 vs 331.5 μg/g, P = 0.034) and calprotectin testing identified more patients with endoscopic disease activity (86.4 %) than the CAI (45.5 %, P = 0.034). Medical treatment was escalated in 90.2 % during the study. Values of the CAI and calprotectin correlated with therapy escalation (OR 3.94 and 3.22, respectively). Only for calprotectin, changes between two measurements were related to intensified medical treatment (OR 1.39). CONCLUSION: Fecal calprotectin was similarly useful to the CAI to monitor disease activity of ulcerative colitis during medical treatment but identified endoscopic disease activity far more reliably. Changes of calprotectin values between measurements might indicate clinical relapse earlier than the CAI.
BACKGROUND: Non-invasive monitoring of inflammatory bowel disease is an unmet clinical need as patients in clinical remission may have residual mucosal inflammation preceding clinical relapse. AIMS: We aimed to assess the value of fecal calprotectin and standardized clinical activity scoring to monitor disease activity in ulcerative colitis under medical treatment. METHODS: Forty-one patients with ulcerative colitis were included in a prospective observational study. Medical treatment was guided by clinical judgement of treating physicians. Fecal calprotectin and the clinical activity index (CAI) were measured blinded to treating physicians every 2 months until the end of follow-up. Twenty-six patients received colonoscopy for clinical reason. RESULTS: As defined by the CAI, patients were in clinical remission (63.4 %), having mild (26.8 %) or moderate (11.2 %) disease activity. Of those in clinical remission (CAI ≤ 4), 86.4 % showed residual endoscopic activity (Mayo Score ≥1). Calprotectin levels were higher in endoscopically active disease (779.0 vs 331.5 μg/g, P = 0.034) and calprotectin testing identified more patients with endoscopic disease activity (86.4 %) than the CAI (45.5 %, P = 0.034). Medical treatment was escalated in 90.2 % during the study. Values of the CAI and calprotectin correlated with therapy escalation (OR 3.94 and 3.22, respectively). Only for calprotectin, changes between two measurements were related to intensified medical treatment (OR 1.39). CONCLUSION: Fecal calprotectin was similarly useful to the CAI to monitor disease activity of ulcerative colitis during medical treatment but identified endoscopic disease activity far more reliably. Changes of calprotectin values between measurements might indicate clinical relapse earlier than the CAI.
Authors: A Dignass; G Van Assche; J O Lindsay; M Lémann; J Söderholm; J F Colombel; S Danese; A D'Hoore; M Gassull; F Gomollón; D W Hommes; P Michetti; C O'Morain; T Oresland; A Windsor; E F Stange; S P L Travis Journal: J Crohns Colitis Date: 2010-01-15 Impact factor: 9.071
Authors: Mark S Silverberg; Jack Satsangi; Tariq Ahmad; Ian D R Arnott; Charles N Bernstein; Steven R Brant; Renzo Caprilli; Jean-Frédéric Colombel; Christoph Gasche; Karel Geboes; Derek P Jewell; Amir Karban; Edward V Loftus; A Salvador Peña; Robert H Riddell; David B Sachar; Stefan Schreiber; A Hillary Steinhart; Stephan R Targan; Severine Vermeire; B F Warren Journal: Can J Gastroenterol Date: 2005-09 Impact factor: 3.522
Authors: Petr Ricanek; Stephan Brackmann; Gøri Perminow; Lars G Lyckander; Jon Sponheim; Oyvind Holme; Ole Høie; Andreas Rydning; Morten H Vatn Journal: Scand J Gastroenterol Date: 2011-05-30 Impact factor: 2.423
Authors: Alain M Schoepfer; Christoph Beglinger; Alex Straumann; Ekaterina Safroneeva; Yvonne Romero; David Armstrong; Carsten Schmidt; Michael Trummler; Valérie Pittet; Stephan R Vavricka Journal: Inflamm Bowel Dis Date: 2013-02 Impact factor: 5.325
Authors: Romy M Heilmann; Nora Berghoff; Joanne Mansell; Niels Grützner; Nolie K Parnell; Corinne Gurtner; Jan S Suchodolski; Jörg M Steiner Journal: J Vet Intern Med Date: 2018-02-20 Impact factor: 3.333
Authors: Ludimilla Dos Reis Malvão; Kalil Madi; Barbara Cathalá Esberard; Renata Fernandes de Amorim; Kelly Dos Santos Silva; Katia Farias E Silva; Heitor Siffert Pereira de Souza; Ana Teresa Pugas Carvalho Journal: Medicine (Baltimore) Date: 2021-01-22 Impact factor: 1.889