Comparative Evaluation of Fecal Calprotectin and S100A12 as Non-Invasive Markers for Disease Activity in Inflammatory Bowel Disease

Abstract Background This multicenter prospective study (UMIN000019958) aimed to evaluate the usefulness of serum leucin-rich alpha-2 glycoprotein (LRG) levels in monitoring disease activity in inflammatory bowel disease (IBD). Methods Patients with moderate-to-severe IBD initiated on adalimumab therapy were enrolled herein. Serum LRG, C-reactive protein (CRP), and fecal calprotectin (fCal) levels were measured at week 0, 12, 24, and 52. Colonoscopy was performed at week 0, 12, and 52 for ulcerative colitis (UC), and at week 0, 24, and 52 for Crohn’s disease (CD). Endoscopic activity was assessed using the Simple Endoscopic Score for Crohn’s Disease (SES-CD) for CD and the Mayo endoscopic subscore (MES) for UC. Results A total of 81 patients was enrolled. Serum LRG levels decreased along with improvements in clinical and endoscopic outcomes upon adalimumab treatment (27.4 ± 12.6 μg/ml at week 0, 15.5 ± 7.7 μg/ml at week 12, 15.7 ± 9.6 μg/ml at week 24, and 14.5 ± 6.8 μg/ml at week 52), being correlated with endoscopic activity at each time point (SES-CD: r = 0.391 at week 0, r = 0.563 at week 24, r = 0.697 at week 52; MES: r = 0.534 at week 0, r = 0.429 at week 12, r = 0.335 at week 52). Endoscopic activity better correlated with LRG compared to CRP and fCal on pooled analysis at all time points (SES-CD: LRG: r = 0.636, CRP: r = 0.402, fCal: r = 0.435; MES: LRG: r = 0.568, CRP: 0.389, fCal: r = 0.426). Conclusions Serum LRG is a useful biomarker of endoscopic activity both in CD and UC during the adalimumab treatment.

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AB0702 THE FREQUENCY OF INFLAMMATORY BOWEL DISEASES IN PATIENTS WITH ANKYLOSING SPONDYLITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3798 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1647.2-1647

Author(s):

G. Lukina ◽

P. Kulakova ◽

N. Savenkova ◽

E. Volnukhin ◽

A. Kovshik ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Longitudinal Study ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Bowel Disease ◽

Rapid Test ◽

Neutrophil Infiltration ◽

Fecal Calprotectin ◽

High Disease Activity ◽

Inflammatory Bowel

Background:Аnkylosing Spondylitis (AS) is closely associated with inflammatory bowel disease (IBD). About 6-46% of patients with IBD have various lesions of the musculoskeletal system [1]. 5-10% of patients with spondylarthritis (SpA) eventually develop IBD, with Crohn’s disease (CD) being more common than Ulcerative colitis (UC) [2]. Determining the level of fecal calprotectin (FC) is a study that allows to diagnose IBD. The concentration of FC directly depends on the neutrophil infiltration of the intestinal mucosa and has a direct connection with the activity of the inflammatory process [3]. It is known that level of FC increases in 2/3 of patients with AS and is closely related to parameters reflecting higher disease activity [4].Objectives:The aim of this study was to evaluate the frequency of IBD in patients with AS using an assessment of FC level.Methods:In the analysis were included 40 patients with AS, fulfilling the modified New York criteria, among them man -26 (65%), woman -14 (35%), mean age of patients was 41.2 ±10.5, mean disease duration - 13±8.8 years. All patients were examined with ESR, CRP, esophagogastroduodenoscopy, colonoscopy and quantitative analysis of the fecal calprotectin levels using the method of lateral immunochromatography with the BUHLMANN Quantum Blue rapid test. Standart range: 100-1800 µg /g.Results:All patients had a high disease activity, mean BASDAI was 5.2 ± 1.7, mean ASDAS CRP 3.8 ± 1.1. 35 patients (87.5 %) had FC level more than 100 µg / g, the remaining 5 patients (12.5%) less than 100 µg /g. 12 patients (30 %) had FC level more than 1,800 µg / g, 23 (57.5 %) from 101 µg / g to 1800 µg / g. All patients with FC levels more than 100 µg / g showed an increase CRP (mean 28.4 mg / l) and ESR (mean 36.3 mm\h) levels. IBD were diagnosed in 9 cases (22.5%): 5 patients (12.5 %) with CD and 4 patients (10 %) - UC, in the remaining cases (77.5%) was no intestinal pathology.Conclusion:The results showed high frequency of IBD in patients with AS. Patients with high FC levels (more than 100 μg/g) had high disease activity (AS). In most cases, inflammatory bowel disease were diagnosed in patients with FC levels more than 100 µg/g.References:[1] Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. 2001 Apr;96(4):1116-22.[2] Klingberg, E., Strid, H., Stahl, A.et al. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. Arthritis Res Ther 2017. 19(1):21[3] Cypers H, Varkas G, Beeckman S, et al. Elevated calprotectin levels reveal bowel inflammation in spondyloarthritis. Annals of the Rheumatic Diseases. 2016. 75:1357-1362[4] Arzu Duran, Senol Kobak, Nazime Sen, et al. Fecal calprotectin is associated with disease activity in patients with ankylosing spondylitis. Bosnian Journal of Basic Medical Sciences. 2016. 16 (1):71-4Disclosure of Interests:Galina Lukina Speakers bureau: Novartis, Pfizer, UCB, Abbvie, Biocad, MSD, Roche, Polina Kulakova: None declared, Nadezhda Savenkova: None declared, Evgeniy Volnukhin: None declared, Anton Kovshik: None declared, Elena Alexandrova: None declared, Alexandr Novikov: None declared

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Fecal Calprotectin in Combination With Standard Blood Tests in the Diagnosis of Inflammatory Bowel Disease in Children

Frontiers in Pediatrics ◽

10.3389/fped.2020.609279 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shaun S. C. Ho ◽

Michael Ross ◽

Jacqueline I. Keenan ◽

Andrew S. Day

Keyword(s):

Inflammatory Bowel Disease ◽

Platelet Count ◽

Bowel Disease ◽

Predictive Value ◽

Screening Test ◽

Fecal Calprotectin ◽

Non Invasive ◽

Blood Tests ◽

Inflammatory Bowel ◽

Sensitivity Specificity

Introduction: Fecal calprotectin (FC) is a useful non-invasive screening test but elevated levels are not specific to inflammatory bowel disease (IBD). The study aimed to evaluate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FC alone or FC in combination with other standard blood tests in the diagnosis of IBD.Methods: Children aged <17 years who had FC (normal range <50 μg/g) measured and underwent endoscopy over 33 months in Christchurch, New Zealand were identified retrospectively (consecutive sampling). Medical records were reviewed for patient final diagnoses.Results: One hundred and two children were included; mean age was 12.3 years and 53 were male. Fifty-eight (57%) of the 102 children were diagnosed with IBD: 49 with Crohn's disease, eight with ulcerative colitis and one with IBD-unclassified. FC of 50 μg/g threshold provided a sensitivity of 96.6% [95% confident interval (CI) 88.3–99.4%] and PPV of 72.7% (95% CI 61.9–81.4%) in diagnosing IBD. Two children with IBD however were found to have FC <50 μg/g. Sensitivity in diagnosing IBD was further improved to 98.3% (95% CI 90.7–99.1%) when including FC >50 μg/g or elevated platelet count. Furthermore, PPVs in diagnosing IBD improved when FC at various thresholds was combined with either low albumin or high platelet count.Conclusion: Although FC alone is a useful screening test for IBD, a normal FC alone does not exclude IBD. Extending FC to include albumin or platelet count may improve sensitivity, specificity, PPV and NPV in diagnosing IBD. However, prospective studies are required to validate this conclusion.

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Effect of Cognitive Behavioral Therapy on Clinical Disease Course in Adolescents and Young Adults With Inflammatory Bowel Disease and Subclinical Anxiety and/or Depression: Results of a Randomized Trial

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz073 ◽

2019 ◽

Vol 25 (12) ◽

pp. 1945-1956 ◽

Cited By ~ 3

Author(s):

Gertrude van den Brink ◽

Luuk Stapersma ◽

Anna Sophia Bom ◽

Dimitris Rizopolous ◽

C Janneke van der Woude ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Cognitive Behavioral Therapy ◽

Disease Activity ◽

Bowel Disease ◽

Behavioral Therapy ◽

Fecal Calprotectin ◽

Clinical Disease ◽

Disease Course ◽

First Relapse ◽

Inflammatory Bowel

Abstract Background Anxiety and depressive symptoms are prevalent in patients with inflammatory bowel disease (IBD) and may negatively influence disease course. Disease activity could be affected positively by treatment of psychological symptoms. We investigated the effect of cognitive behavioral therapy (CBT) on clinical disease course in 10–25-year-old IBD patients experiencing subclinical anxiety and/or depression. Methods In this multicenter parallel group randomized controlled trial, IBD patients were randomized to disease-specific CBT in addition to standard medical care (CBT + care us usual [CAU]) or CAU only. The primary outcome was time to first relapse in the first 12 months. Secondary outcomes were clinical disease activity, fecal calprotectin, and C-reactive protein (CRP). Survival analyses and linear mixed models were performed to compare groups. Results Seventy patients were randomized (CBT+CAU = 37, CAU = 33), with a mean age of 18.3 years (±50% < 18 y, 31.4% male, 51.4% Crohn’s disease, 93% in remission). Time to first relapse did not differ between patients in the CBT+CAU group vs the CAU group (n = 65, P = 0.915). Furthermore, clinical disease activity, fecal calprotectin, and CRP did not significantly change over time between/within both groups. Exploratory analyses in 10–18-year-old patients showed a 9% increase per month of fecal calprotectin and a 7% increase per month of serum CRP in the CAU group, which was not seen in the CAU+CBT group. Conclusions CBT did not influence time to relapse in young IBD patients with subclinical anxiety and/or depression. However, exploratory analyses may suggest a beneficial effect of CBT on inflammatory markers in children.

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Su1255 Fecal Calprotectin Is Elevated With Clinical Disease Activity During Pregnancy in Women With Inflammatory Bowel Disease

Gastroenterology ◽

10.1016/s0016-5085(15)31526-2 ◽

2015 ◽

Vol 148 (4) ◽

pp. S-452 ◽

Cited By ~ 3

Author(s):

Vivian Huang ◽

Jasmin Bal ◽

Rae R. Foshaug ◽

Lindsy Ambrosio ◽

Karen Kroeker ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Bowel Disease ◽

Fecal Calprotectin ◽

Clinical Disease ◽

Clinical Disease Activity ◽

Inflammatory Bowel

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Intestinal Ultrasound to Evaluate Treatment Response During Pregnancy in Patients With Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1093/ibd/izab216 ◽

2021 ◽

Author(s):

Floris De Voogd ◽

Harshad Joshi ◽

Elsa Van Wassenaer ◽

Steven Bots ◽

Geert D’Haens ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Disease Activity ◽

Treatment Response ◽

Bowel Disease ◽

Objective Evaluation ◽

Fecal Calprotectin ◽

Clinical Activity ◽

Third Trimester ◽

Inflammatory Bowel ◽

Active Disease

Abstract Introduction Active disease in inflammatory bowel disease patients during pregnancy is associated with poor maternal and fetal outcomes. Objective evaluation of disease activity is a core strategy in IBD, and during pregnancy noninvasive modalities are preferred. We aimed to evaluate feasibility and accuracy of intestinal ultrasound (IUS) to objectify disease activity throughout pregnancy. Methods Pregnant patients with known IBD were included and followed throughout pregnancy for clinical disease activity, with fecal calprotectin (FCP) and with IUS every trimester. Feasibility of IUS was assessed for all colonic segments and terminal ileum (TI). Intestinal ultrasound outcomes to detect active disease and treatment response were compared with clinical scores combined with FCP. Results In total, 38 patients (22 CD, 16 UC) were included, with 27 patients having serial IUS. Feasibility of IUS decreases significantly in third trimester for TI (first vs third trimester: 91.3% vs 21.7%, P < .0001) and sigmoid (first vs third trimester: 95.6% vs 69.5%, P = .023). Intestinal ultrasound activity showed moderate to strong correlation with clinical activity (r = 0.60, P < .0001) and FCP (r = 0.73, P < .0001). Throughout pregnancy, IUS distinguished active from quiescent disease with 84% sensitivity and 98% specificity according to FCP combined with clinical activity. IUS showed disease activity in >1 segment in 52% of patients and detected treatment response with 80% sensitivity and 92% specificity. Conclusions IUS is feasible and accurate throughout pregnancy, although visualization of the sigmoid and TI decreases in the third trimester. IUS provides objective information on disease activity, extent, and treatment response, even during second and third trimester, and offers a noninvasive strategy to closely monitor patients during pregnancy.

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Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11101926 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1926

Author(s):

Meshari T. Alshammari ◽

Rebecca Stevenson ◽

Buraq Abdul-Aema ◽

Guangyong Zou ◽

Vipul Jairath ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Diagnostic Accuracy ◽

Disease Activity ◽

Bowel Disease ◽

Meta Analysis ◽

Roc Curves ◽

Colonic Disease ◽

Non Invasive ◽

Us Studies ◽

Inflammatory Bowel

Endoscopy is the gold standard for objective assessment of colonic disease activity in inflammatory bowel disease (IBD). Non-invasive colonic imaging using bowel ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) may have a role in quantifying colonic disease activity. We reviewed the diagnostic accuracy of these modalities for assessment of endoscopically or histopathologically defined colonic disease activity in IBD. We searched Embase, MEDLINE, and the Web of Science from inception to 20 September 2021. QUADAS-2 was used to evaluate the studies’ quality. A meta-analysis was performed using a bivariate model approach separately for MRI and US studies only, and summary receiver operating characteristic (ROC) curves were obtained. CT studies were excluded due to the absence of diagnostic test data. Thirty-seven studies were included. The mean sensitivity and specificity for MRI studies was 0.75 and 0.91, respectively, while for US studies it was 0.82 and 0.90, respectively. The area under the ROC curves (AUC) was 0.88 (95% CI, 0.82 to 0.93) for MRI, and 0.90 (95% CI, 0.75 to 1.00) for US. Both MRI and US show high diagnostic accuracy in the assessment of colonic disease activity in IBD patients.

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