Evaluation of the Role of Faecal Calprotectin in the Management of Psoriatic Patients under Treatment with Biologic Drugs

Abstract

Background: Fecal calprotectin has emerged as a significant, validated, and non-invasive biomarker allowing for the evaluation of inflammatory bowel disease. Our study assessed the reliability of the use of faecal calprotectin as a valuable tool in the management of psoriatic patients on biological therapy. Methods: This was a single-centre prospective study including adult patients affected by moderate-to-severe psoriasis starting biological therapy. Faecal calprotectin levels were evaluated at baseline and at week 24 (W24) of treatment in all enrolled patients. Results: Overall, 129 patients were enrolled. The mean baseline faecal calprotectin levels were 74.7 μg/g and a significant reduction was detected at W24 of biological therapy (57.5 μg/g). An analysis of faecal CP values stratified by therapy type was performed. No significant reduction was assessed at W24 for any of the anti-IL17 drugs, whereas a significant reduction was detected for all IL23 inhibitors. Conclusions: Our study showed the potential use of faecal CP levels as a valuable tool for exploring intestinal inflammation in the management of psoriatic patients undergoing treatment with biologic drugs.

Keywords: biological therapy; calprotectin; faecal calprotectin; inflammatory bowel disease; psoriasis.

Figure 1

(a) Mean baseline and W24 faecal CP levels. (b) Mean baseline and W24 faecal CP levels stratified by anti-IL17 and anti-IL23 treatments. (a,b) Data are displayed as mean ± SD. Statistical analysis was performed with Wilcoxon matched pairs test: * p < 0.05 with respect to baseline; Mann–Whitney test: # p < 0.05 with respect to subjects on anti-IL17 drugs.

Figure 2

Mean baseline and W24 faecal CP levels stratified by co-morbidities. Data are displayed as mean. Statistical analysis was performed with Wilcoxon matched pairs test: * p < 0.05 with respect to baseline; Mann–Whitney test: ## p < 0.01 with respect to subjects with PsA.

Figure 3

Mean baseline and W24 faecal CP levels stratified by single biological drug. Data are displayed as mean. Statistical analysis was performed with Wilcoxon matched pairs test, * p < 0.05.