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

Costa, F.; Mumolo, M. G.; Ceccarelli, L.; Bellini, M.; Romano, M. R.; Sterpi, C.; Ricchiuti, A.; Marchi, S.; Bottai, M.
March 2005
Gut;Mar2005, Vol. 54 Issue 3, p364
Academic Journal
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 μ/g (95% confidence interval (Cl) 21.7-418.5) in those patients who relapsed during follow up, and 220.5 μ/g (95% Cl 53-388) in non-relapsing patients (p=0.39,5). In UC, median calprotectin values were 220.6 μg/g (95% Cl 86-355.2) and 67 μ/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 μ/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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