Fecal calprotectin as a biomarker of microscopic bowel inflammation in patients with spondyloarthritis

Fecal calprotectin as a biomarker of microscopic bowel inflammation in patients with spondyloarthritis

Aim Microscopic bowel inflammation is present in up to 60% of all patients with spondyloarthritis (SpA) and appears to be associated with more severe joint disease and a higher risk of developing inflammatory bowel disease (IBD). This study aimed to determine the utility of fecal calprotectin (fCAL)...

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Published in:International journal of rheumatic diseases Vol. 25; no. 9; pp. 1078 - 1086
Main Authors: Campos, Júlia Faria, Resende, Gustavo Gomes, Barbosa, Alfredo José Afonso, Carvalho, Silas Castro, Lage, Junia Aguiar, Cunha, Pedro Ferrari Sales, Souza, Stela Cristina Silva, Ferrari, Maria de Lourdes Abreu
Format: Journal Article
Language:English
Published: Richmond Wiley Subscription Services, Inc 01-09-2022
Subjects:
ankylosing spondylitis
Arthritis
biomarker
Biopsy
Endoscopy
fecal calprotectin
Inflammation
inflammatory bowel disease
Inflammatory bowel diseases
Inflammatory diseases
Intestine
Joint diseases
Nonsteroidal anti-inflammatory drugs
Rheumatic diseases
spondyloarthritis
Statistical analysis
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Summary:Aim Microscopic bowel inflammation is present in up to 60% of all patients with spondyloarthritis (SpA) and appears to be associated with more severe joint disease and a higher risk of developing inflammatory bowel disease (IBD). This study aimed to determine the utility of fecal calprotectin (fCAL) in evaluating endoscopic and histological bowel inflammation in SpA patients. Methods Ileocolonoscopies with biopsies and fCAL measurements were performed in 65 patients with SpA. Results In 47 (72.3%) patients, the fCAL levels were higher than 50 μg/g, whereas in 20 (30.7%), these levels were greater than 250 μg/g. A total of 38 (58.5%) patients presented with microscopic bowel inflammation, and 13 (20%) presented with signs of endoscopic inflammation. fCAL levels were significantly higher in patients with microscopic bowel inflammation than in those without inflammatory findings (P < .001); additionally, these levels were slightly higher in patients with endoscopic signs of bowel inflammation (P = .053). A fCAL cutoff value of 96 μg/g predicted histological bowel inflammation with 73% sensitivity and 67% specificity. No statistically significant difference was observed in the fCAL levels between patients who had been treated or not treated with nonsteroidal anti‐inflammatory drugs (NSAIDs). Conclusion Our findings confirm a high prevalence of microscopic bowel inflammation in SpA patients, regardless of the use of NSAIDs. The evaluation of fCAL levels proved to be useful in the identification of microscopic inflammation and could help in the more judicious indication of ileocolonoscopy. These results support the use of fCAL for the evaluation of microscopic bowel inflammation in SpA patients.
Bibliography:UFMG Research Ethics Committee (Ethical approval number 2.510.480).
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ISSN:1756-1841
1756-185X
DOI:10.1111/1756-185X.14388