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Review
. 2018 Oct;6(8):1117-1125.
doi: 10.1177/2050640618784046. Epub 2018 Jun 20.

Expert opinion for use of faecal calprotectin in diagnosis and monitoring of inflammatory bowel disease in daily clinical practice

Catherine Reenaers  1 , Peter Bossuyt  2 , Pieter Hindryckx  3 , Hilde Vanpoucke  4 , Anneline Cremer  5 , Filip Baert  6
Affiliations
Review

Expert opinion for use of faecal calprotectin in diagnosis and monitoring of inflammatory bowel disease in daily clinical practice

Catherine Reenaers et al. United European Gastroenterol J. 2018 Oct.

Abstract

Background: Despite many publications regarding the role of faecal calprotectin (FC) in inflammatory bowel disease (IBD), clear recommendations for its use in clinical practice are currently lacking in the literature.

Aim: The aim of this article is to provide practical guidance for clinicians for the use of FC in the detection and management of patients with IBD.

Methods: All relevant publications were analysed and practical statements were proposed based on a Delphi consensus approach.

Results: Different commercial assays have been developed but international standardisation is lacking. FC can help in the diagnosis process of IBD. In IBD, FC can predict response to therapy, detect subclinical inflammation and help to drive treatment decisions to achieve better endoscopic and clinical outcomes. After Crohn's surgery FC can identify patients with early endoscopic recurrence.

Conclusion: Although major therapeutic changes should not be based on FC alone, FC is a valuable tool to optimise the care for IBD patients.

Keywords: Crohn’s disease; Faecal calprotectin; mucosal healing; noninvasive biomarker; subclinical inflammation; tight monitoring; ulcerative colitis.

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Figures

Figure 1.
Figure 1.
Algorithm for the use of FC in the detection of IBD. aDifferent assay techniques are used without good international standardisation. bOptimal cut-offs may differ from assay to assay; consult your test’s manufacturer and literature. cIt is advised to use the same test in the follow-up of an individual patient to allow for optimal comparison. FC: faecal calprotectin; GI: gastrointestinal; IBD: inflammatory bowel disease; NSAIDs: nonsteroidal anti-inflammatory drugs.
Figure 2.
Figure 2.
Algorithm for the use of FC in symptomatic IBD patients. aUse prior FC value of a particular patient for comparison and for correlation if available with endoscopic disease activity. Using different tests from different manufacturers in one patient is not advisable because of the lack of international standardisation for FC measurement (Table 1). FC: faecal calprotectin; IBD: inflammatory bowel disease.
Figure 3.
Figure 3.
Interpretation of the different cut-off levels of FC in asymptomatic IBD patients. aRegular testing, e.g. at diagnosis, for monitoring, or at time of major therapeutic changes will allow for comparison within an individual patient. CD: Crohn’s disease; FC: faecal calprotectin; IBD: inflammatory bowel disease; MRI: magnetic resonance imaging; UC: ulcerative colitis.
See this image and copyright information in PMC

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