Anne-Claire Frin1, Jérôme Filippi1, Gilles Boschetti2, Bernard Flourie2, Jocelyne Drai3, Patricia Ferrari4, Xavier Hebuterne1, Stéphane Nancey5. 1. Department of Gastroenterology, Centre Hospitalier Universitaire L'Archet, Nice, France. 2. Department of Gastroenterology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre-Bénite, France & INSERM U1111, International Center for Research in Infectiology, Lyon, France. 3. Laboratory of Biochemistry, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre-Bénite, France. 4. Laboratory of Biochemistry, Centre Hospitalier Universitaire Pasteur, Nice, France. 5. Department of Gastroenterology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre-Bénite, France & INSERM U1111, International Center for Research in Infectiology, Lyon, France. Electronic address: stephane.nancey@chu-lyon.fr.
Abstract
BACKGROUND: Fecal markers might predict the response to anti-TNFα in ulcerative colitis (UC). AIMS: To compare the performance of fecal calprotectin (fCal), lactoferrin (fLact), M2-PK (fM2-PK), neopterin (fNeo), and zonulin (fZon) to predict the response to therapy in active UC patients. METHODS: Disease activity from 31 consecutive patients with an active UC, treated with infliximab (IFX) was assessed by the Mayo score at baseline and at week 14 and by the partial Mayo score at W52 and stool samples collected for fecal marker measurements at W0, W2, and W14. RESULTS: At W14, 19 patients (61%) were responders to IFX induction. The median levels of fCal, fLact and fM2-PK drop dramatically from baseline to W14 in clinical responders. At W2, fM2-PK, fLact and fCal levels predicted accurately the response to IFX induction. At W14, fLact, fCal, and fM2-PK were individually reliable markers to predict sustained response at W52. The performances of fNeo and fZon were weaker in this setting. CONCLUSIONS: The performance of fM2-PK at W2 to predict response to induction therapy with IFX was superior to that of fLact and fCal, whereas monitoring fLact was the best tool to predict adequately the course of the disease at one year under maintenance IFX in UC.
BACKGROUND: Fecal markers might predict the response to anti-TNFα in ulcerative colitis (UC). AIMS: To compare the performance of fecal calprotectin (fCal), lactoferrin (fLact), M2-PK (fM2-PK), neopterin (fNeo), and zonulin (fZon) to predict the response to therapy in active UC patients. METHODS: Disease activity from 31 consecutive patients with an active UC, treated with infliximab (IFX) was assessed by the Mayo score at baseline and at week 14 and by the partial Mayo score at W52 and stool samples collected for fecal marker measurements at W0, W2, and W14. RESULTS: At W14, 19 patients (61%) were responders to IFX induction. The median levels of fCal, fLact and fM2-PK drop dramatically from baseline to W14 in clinical responders. At W2, fM2-PK, fLact and fCal levels predicted accurately the response to IFX induction. At W14, fLact, fCal, and fM2-PK were individually reliable markers to predict sustained response at W52. The performances of fNeo and fZon were weaker in this setting. CONCLUSIONS: The performance of fM2-PK at W2 to predict response to induction therapy with IFX was superior to that of fLact and fCal, whereas monitoring fLact was the best tool to predict adequately the course of the disease at one year under maintenance IFX in UC.