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. 2005 Mar;54(3):364-8.
doi: 10.1136/gut.2004.043406.

Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease

F Costa  1 , M G Mumolo, L Ceccarelli, M Bellini, M R Romano, C Sterpi, A Ricchiuti, S Marchi, M Bottai
Affiliations

Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease

F Costa et al. Gut. 2005 Mar.

Abstract

Background and aims: The clinical course of inflammatory bowel disease is characterised by a succession of relapses and remissions. The aim of our study was to assess whether the predictive value of faecal calprotectin-a non-invasive marker of intestinal inflammation-for clinical relapse is different in ulcerative colitis (UC) and Crohn's disease (CD).

Methods: Seventy nine consecutive patients with a diagnosis of clinically quiescent inflammatory bowel disease (38 CD and 41 UC) were followed for 12 months, undergoing regular clinical evaluations and blood tests. A single stool sample was collected at the beginning of the study from each patient and the calprotectin concentration was assessed by a commercially available enzyme linked immunoassay.

Results: In CD, median calprotectin values were 220.1 mug/g (95% confidence interval (CI) 21.7-418.5) in those patients who relapsed during follow up, and 220.5 mug/g (95% CI 53-388) in non-relapsing patients (p=0.395). In UC, median calprotectin values were 220.6 mug/g (95% CI 86-355.2) and 67 microg/g (95% CI 15-119) in relapsing and non-relapsing patients, respectively (p<0.0001). The multivariate Cox (proportional hazard) regression model, after adjustment for possible confounding variables, showed a twofold and 14-fold increase in the relapse risk, respectively, in those patients with CD and UC in clinical remission who had a faecal calprotectin concentration higher than 150 microg/g.

Conclusions: Faecal calprotectin proved to be an even stronger predictor of clinical relapse in UC than in CD, which makes the test a promising non-invasive tool for monitoring and optimising therapy.

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Figures

Figure 1
Figure 1
(A). Receiver operating characteristic (ROC) curve for faecal calprotectin in predicting the relapse rate in Crohn’s disease. The area under the curve was 0.58 (95% confidence interval (CI) CI 0.40–0.77). (B). ROC curve for faecal calprotectin in predicting the relapse rate in ulcerative colitis. The area under the curve was 0.87 (95% CI 0.77–0.98).
Figure 2
Figure 2
(A) Kaplan-Meier survivor curves for Crohn’s disease patients, with values for calprotectin above and below 150 μg/g. Log rank test for equality of survivor functions, p value = 0.0432. (B) Kaplan-Meier survivor curves for ulcerative colitis patients with values of calprotectin above and below 150 μg/g. Log rank test for equality of survivor functions, p value = 0.0000.
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References

    1. Riley SA, Mani V, Goodman MJ, et al. Microscopic activity in ulcerative colitis: what does it mean? Gut 1991;32:174–8. - PMC - PubMed
    1. Crama-Bohbouth G, Pena AS, Biemond I, et al. Are activity indices helpful in assessing active intestinal inflammation in Crohn’s disease? Gut 1989;30:1236–40. - PMC - PubMed
    1. Modigliani R, Mary JY, Simon JF, et al. Clinical, biological, and endoscopic picture of attacks of Crohn’s disease. Gastroenterology 1990;98:811–18. - PubMed
    1. Cellier C, Sahmoud T, Froguel E, et al. Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn’s disease. A prospective multicentre study of 121 cases. Gut 1994;35:231–5. - PMC - PubMed
    1. Biancone L, De Nigris F, Del Vecchio Blanco G, et al. Review article: monitoring the activity of Crohn’s disease. Aliment Pharmacol Ther 2002;16 (suppl 4) :29–33. - PubMed