Fecal Calprotectin as Predictor of Relapse in Patients With Inflammatory Bowel Disease Under Maintenance Infliximab Therapy

• Published in: Journal of clinical gastroenterology Vol. 50; no. 2; p. 147
• Main Authors: Ferreiro-Iglesias, Rocio, Barreiro-de Acosta, Manuel, Otero Santiago, Manuel, Lorenzo Gonzalez, Aurelio, Alonso de la Peña, Carmen, Benitez Estevez, Alfonso J, Dominguez-Muñoz, Juan Enrique
• Format: Journal Article
• Language: English
• Published: United States 01.02.2016
• Subjects: Adolescent; Adult; Aged; Anti-Inflammatory Agents - therapeutic use; Area Under Curve; Biomarkers - metabolism; Colitis, Ulcerative - diagnosis; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - metabolism; Crohn Disease - diagnosis; Crohn Disease - drug therapy; Crohn Disease - metabolism; Cross-Sectional Studies; Feces - chemistry; Female; Gastrointestinal Agents - therapeutic use; Humans; Infliximab - therapeutic use; Leukocyte L1 Antigen Complex - metabolism; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Recurrence; Remission Induction; Risk Factors; ROC Curve; Time Factors; Treatment Outcome; Up-Regulation; Young Adult
• ISSN: 1539-2031
• DOI: 10.1097/MCG.0000000000000312

Predicting relapse in Inflammatory Bowel Disease (IBD) could allow for early changes of treatment. Close monitoring of fecal calprotectin (FC) could be useful to predict relapse in IBD. Aim of the study was to evaluate the predictive value of a rapid FC test to predict flares in patients with IBD under maintenance therapy with Infliximab. A prospective observational cohort study was designed. IBD patients in clinical remission under maintenance Infliximab therapy were included. FC was measured using a rapid test on a stool sample obtained within 24 hours before Infliximab infusion. Clinical examination was performed 2 months after that infusion. Fifty-three patients were included (52.8% female). Thirty-three patients (62.3%) had Crohn's disease and 20 (37.7%) had ulcerative colitis. All patients were in remission at inclusion. After 2 months, 41 patients (77.4%) remained in clinical remission and 12 (22.6%) presented a relapse. FC (mean±SD) in relapsing and not-relapsing disease was 332±168 and 110±163 µg/g, respectively (P<0.005). A FC concentration>160 µg/g had a sensitivity of 91.7%, and specificity of 82.9% to predict relapse. In IBD patients under Infliximab maintenance therapy, high FC levels allow predicting relapse within the following 2 months. Long-term remission is associated with low calprotectin levels. Further studies are required to confirm these results.