Consecutive fecal calprotectin measurements to predict relapse in patients with ulcerative colitis receiving infliximab maintenance therapy

This study examined whether fecal calprotectin can be used in daily practice as a marker to monitor patients with ulcerative colitis (UC) receiving infliximab maintenance therapy. This prospective multicenter study enrolled adult patients with UC in clinical remission under infliximab maintenance th...

Full description

Saved in:

Bibliographic Details
Published in:	Inflammatory bowel diseases Vol. 19; no. 10; pp. 2111 - 2117
Main Authors:	De Vos, Martine, Louis, Edouard J, Jahnsen, Jørgen, Vandervoort, Jo G P, Noman, Maja, Dewit, Olivier, Dʼhaens, Geert R, Franchimont, Denis, Baert, Filip J, Torp, Roald A, Henriksen, Magne, Potvin, Philippe M R, Van Hootegem, Philippe P, Hindryckx, Pieter M, Moreels, Tom G, Collard, Arnaud, Karlsen, Lars Normann, Kittang, Eirik, Lambrecht, Guy, Grimstad, Tore, Koch, Jonas, Lygren, Idar, Coche, Jean-Claude R J, Mana, Fazia, Van Gossum, André, Belaiche, Jacques, Cool, Mike R, Fontaine, Fernand, Maisin, Jean-Marc G, Muls, Vinciane, Neuville, Bart, Staessen, Dirk A J, Van Assche, Gert A, de Lange, Thomas, Solberg, Inger Camilla, Vander Cruyssen, Bert J K, Vermeire, Severine A R A
Format:	Journal Article Web Resource
Language:	English
Published:	England Lippincott Williams & Wilkins 01-09-2013
Subjects:	Adult Aged Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Antibodies, Monoclonal - therapeutic use Area Under Curve Biomarkers - metabolism Colitis, Ulcerative - complications Colitis, Ulcerative - drug therapy Colitis, Ulcerative - metabolism Enzyme-Linked Immunosorbent Assay Feces - chemistry Female Follow-Up Studies Gastroenterology & hepatology Gastroentérologie & hépatologie Human health sciences Humans Infliximab Leukocyte L1 Antigen Complex - metabolism Longitudinal Studies Male Middle Aged Prognosis Prospective Studies Recurrence Remission Induction Sciences de la santé humaine Sigmoidoscopy Young Adult
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	This study examined whether fecal calprotectin can be used in daily practice as a marker to monitor patients with ulcerative colitis (UC) receiving infliximab maintenance therapy. This prospective multicenter study enrolled adult patients with UC in clinical remission under infliximab maintenance therapy. Fecal calprotectin levels were measured every 4 weeks. Sigmoidoscopies were performed at inclusion and at study end. Relapse was defined as a clinical need for change in treatment or an endoscopic Mayo subscore of ≥2 at week 52. Sustained deep remission was defined as a partial Mayo score <3 at all points and an endoscopic Mayo score 0 at week 52. Full analysis was possible for 87 of 113 included patients with UC (77%). Of these patients, 30 (34.4%) were considered to be in sustained deep remission and 13 (14.9%) to have relapsed. Calprotectin levels in patients with sustained deep remission remained very low (median < 40 mg/kg at all time points). Patients who flared had significantly higher calprotectin levels (median > 300 mg/kg) already 3 months before the flare. Further receiver operator curve analysis suggested that a calprotectin level >300 mg/kg had a reasonable sensitivity (58.3%) and specificity (93.3%) to model flare. Two consecutive calprotectin measurements of >300 mg/kg with 1-month interval were identified as the best predictor of flare (61.5% sensitivity and 100% specificity). Fecal calprotectin can be used in daily practice to monitor patients with UC receiving infliximab maintenance therapy. Two consecutive measurements >300 mg/kg is more specific than a single measurement for predicting relapse.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 scopus-id:2-s2.0-84884550176
ISSN:	1078-0998 1536-4844 1536-4844
DOI:	10.1097/MIB.0b013e31829b2a37