scholarly journals Fecal Calprotectin Use in Inflammatory Bowel Disease and Beyond: A Mini-Review

2015 ◽  
Vol 29 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Bashaar Alibrahim ◽  
Mohammed I Aljasser ◽  
Baljinder Salh
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Intestinal Tract ◽  
Fecal Calprotectin ◽  
Response To Treatment ◽  
Gastrointestinal Disorders ◽  
Disease Relapse ◽  
Inflammatory Bowel ◽  
Irritable Bowel

Given the number of inflammatory disorders affecting the gastrointestinal tract directly and indirectly, coupled with the considerable overlap with functional disorders, it is evident that more useful noninvasive diagnostic tests are required to aid with diagnosis. If these tests can also have some utility for individual patient follow-up in terms of disease activity and response to treatment, as well as providing forewarning of disease relapse, it would be extremely useful information for the clinician. One recently described test that may fulfill several of these attributes is based on leakage of a mononuclear cell cytoplasmic protein, calprotectin, along the intestinal tract, which can then be quantified in feces. This has been used to distinguish patients exhibiting symptoms of irritable bowel syndrome from patients with inflammatory bowel disease, with a measure of success greater than with currently used techniques. The present article summarizes the experience with this test used in inflammatory bowel disease, as well as a variety of gastrointestinal disorders.

scholarly journals Rational Use of Fecal Calprotectin in Irritable Bowel Syndrome and Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Roberto Catanzaro ◽  
Alfio Maugeri ◽  
Morena Sciuto ◽  
Fang He ◽  
Baskar Balakrishnan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Irritable Bowel Syndrome ◽  
Differential Diagnosis ◽  
Bowel Disease ◽  
Intestinal Inflammation ◽  
Gastrointestinal Disorder ◽  
Fecal Calprotectin ◽  
Mean Values ◽  
Inflammatory Bowel ◽  
Irritable Bowel

The gastrointestinal pathologies have increased over the last years. The clinical pictures of inflammatory and irritable bowel disease might overlap, leading to expensive and invasive tests. Our study aims to investigate fecal calprotectin as an effective tool for differential diagnosis of gastrointestinal disorders. Two hundred fifty-six patients with the diagnosis of the gastrointestinal disorder and subjected to colonoscopy were collected for the statistical analysis of fecal calprotectin. The differential diagnosis of intestinal inflammation or non-inflammation was performed according to the Receiver Operating Characteristic (ROC) curve that outlines the Area Under Curve (AUC), Sensitivity (Se), Specificity (Sp). Fecal calprotectin was significantly elevated in patients with inflammatory bowel disease compared with patients with irritable bowel syndrome. Especially, the mean values of fecal calprotectin were 522 g/g (IQR=215-975) and 21 g/g (IQR=14-34.5) in patients with and without inflammation, respectively (P<0.0001). AUC value of fecal calprotectin was 0.958 (Se=88.9%, Sp=91.1%, with a cut-off value of 50 g/g) for differentiating between inflammatory bowel disease and irritable bowel syndrome. Fecal calprotectin seems to be a non-invasive and inexpensive biomarker useful for the purpose of a differential diagnosis between inflammatory bowel disease and irritable bowel syndrome.

scholarly journals P533 Adalimumab 80mg every other week in inflammatory bowel disease: Treatment intensification outcomes in real life clinical practice

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S507-S509
Author(s):  
M I Calvo Moya ◽  
I Omella Usieto ◽  
I El Hajra Martinez ◽  
E Santos Perez ◽  
Y Gonzalez Lama ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Practice ◽  
Bowel Disease ◽  
Smoking Habit ◽  
Real Life ◽  
Fecal Calprotectin ◽  
Treatment Intensification ◽  
Loss Of Response ◽  
Inflammatory Bowel

Abstract Background Adalimumab (ADA) intensification is recommended for inadequate or loss of response in inflammatory bowel disease (IBD) patients. A new presentation of ADA 80mg administered every other week (eow) has been approved as an alternative to ADA 40mg every week (ew). Data regarding impact of ADA 80mg eow in clinical practice is still scarce. The aim of this study was to assess long-term durability, safety and cost-effectiveness of treatment with ADA 80mg eow in patients with IBD. Methods A retrospective cohort study in a tertiary hospital that included all IBD patients under intensified maintenance therapy with ADA 80mg eow was performed. Durability was calculated considering the time from the first dose to treatment withdrawn or to the end of follow-up. Biological remission (BR) was defined as CR together with fecal calprotectin (FC) &lt;250µg/g and C-reactive protein (CRP) &lt;5mg/dl. Economic impact of ADA 80mg eow was estimated considering current price of both ADA 40mg and ADA 80mg pens at our centre. Results Sixty-three patients (52 CD and 11 CU) were included; median age 47 (IQR 39–59), 54% male; median duration of the disease before ADA of 11 years (IQR 6–20); 30% were active smokers. Among CD patients, 56% had ileal disease, 17% colonic and 27% ileocolonic. The inflammatory behavior was the most frequent (52%) and 31% had perianal disease. In UC, 55% had extensive colitis. 44 patients (70%) were bio-naïve and 36 (57%) received immunosuppressants at baseline. At the time of escalation, 48 patients (76%) were symptomatic. After intensification, 52 (83%) patients (CD 42 and UC 10) achieved CR and 46 (73%) BR. The changes in the levels of FC, CRP and ADA were significant (p &lt;0.001) (Graphs 1–3). 22 patients (35%) discontinued treatment after a median of 6.5 (IQR 5–10) months due to: 11 no clinical response (50%), 4 loss of response (18%), 3 adverse events (14%) (psoriasis) and 4 endoscopic progression (18%). 44 patients (70%) remained under treatment and in CR (median follow-up 17 months, IQR 13–24) (Graph 4) and with a median ADA levels of 10.46 mg/l (IQR 7.34–15.25). Use of ADA 80 eow regimen saved 223500€ in patients who maintained treatment. In the multivariate analysis, being in CR when intensifying reduced the risk of treatment discontinuation by 87% (HR 0.13, 95%CI 0.02–0.99; p&lt;0.001), having reached BR by 99.5% (HR 0.05, 95%CI 0.02–0.14; p &lt;0.001) and having ADA levels ≥5 mg/l after intensification by 68% (HR 0.32, 95%CI 0.13–0.75; p = 0.02). Smoking habit was associated with treatment withdrawn (HR 1.74, 95%CI 1.02–2.96; p=0.04). Conclusion ADA intensification to 80mg eow in IBD patients is safe, effective and may reduce costs in real life clinical practice. Early intensification, even in CR, may enhance ADA treatment durability.

Analytical Performance and Clinicopathologic Correlation of Four Fecal Calprotectin Methods

2019 ◽  
Vol 152 (3) ◽  
pp. 392-398
Author(s):  
Leonie P J Pelkmans ◽  
Monique J M de Groot ◽  
Joyce Curvers
Keyword(s):  
Inflammatory Bowel Disease ◽  
Irritable Bowel Syndrome ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Analytical Performance ◽  
Clinicopathologic Correlation ◽  
Patient Category ◽  
Noninvasive Biomarker ◽  
Inflammatory Bowel ◽  
Irritable Bowel

Abstract Objectives Calprotectin is a noninvasive biomarker that can distinguish inflammatory bowel disease from irritable bowel syndrome. We investigated four automated fecal calprotectin methods on five different platforms for their preanalytical process, analytical performance, and clinicopathologic correlation. Methods Four calprotectin methods (Bühlmann, EliA CN, EliA CN2, and DiaSorin) were performed on five platforms (Cobas 8000 E502, Phadia Immunocap 100 and 250, and Liaison and Liaison XL) in two hospital laboratories. Results Overall variation for the different extraction devices was less than 19% when feces were of normal consistency. Freeze-thawing of samples resulted in comparable results compared with fresh samples. The different methods had a good analytic correlation (R = 0.83-0.95). Their clinicopathologic correlation was comparable, but the Bühlmann method showed significantly higher calprotectin values in every patient category. Conclusions The automated calprotectin methods showed a good performance and comparable clinicopathologic correlation. Due to lack of standardization, the numerical values differ for the various methods.

scholarly journals A249 FREQUENCY AND CLINICAL SIGNIFICANCE OF INFLAMMATORY BOWEL DISEASE IN PATIENTS WITH AUTOIMMUNE HEPATITIS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 126-127
Author(s):  
E Lytvyak ◽  
L A Dieleman ◽  
A J Montano-Loza
Keyword(s):  
Inflammatory Bowel Disease ◽  
Autoimmune Hepatitis ◽  
Median Time ◽  
Bowel Disease ◽  
Cox Regression ◽  
Age At Diagnosis ◽  
Response To Treatment ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background Previous studies suggested that patients with autoimmune hepatitis (AIH) and inflammatory bowel disease (IBD) have poorer outcomes; however, the significance of this association is limited. Aims To describe the phenotype of AIH-associated IBD and assess the impact of IBD on the response to treatment and risk of adverse liver outcomes in patients with AIH. Methods In our retrospective cohorts, we identified patients with concomitant diagnoses of IBD and a definite AIH. The comparison cohort consisted of AIH patients matched by gender, age at diagnosis, ethnicity, and time to follow-up. Chi-square and Mann-Whitney tests were used to assess differences. Univariate analysis was performed using the Cox proportional hazards model. Results We identified a total of 16 patients (9 males, 56.3%) with AIH-associated IBD from a cohort of 6006 IBD patients (0.27%) and 357 AIH patients (4.5%). All patients were Caucasians. Twelve patients (75.0%) had ulcerative colitis with a pancolonic extent; 4 (25.0%) – Crohn’s disease: one patient had ileitis, three – ileocolitis with one having stricturing and fistulising gastroduodenal, ileocolonic and perianal disease. The median age at IBD diagnosis was 26.5 years old and varied from 2 to 53. The age at AIH diagnosis ranged from 7 to 59 years old (median 21.1) and median follow-up time was 11.1 years ranging from 11 days to 35.2 years. The matching cohort of 113 AIH-IBD- patients was comparable to the AIH-IBD+ cohort by gender (44 males, 38.9%; p=0.188), age at diagnosis (median 28.4, IQR 32; p=0.442), ethnicity, and the follow-up time (median 8.7 years, IQR 10.2; p=0.764). There was no difference in AST, ALT and ALP at diagnosis. Complete response rates were similar in AIH-IBD+ and AIH-IBD- groups (50.0% vs. 53.1%; p=0.816). The risk of developing cirrhosis and a median time to its onset did not differ significantly: 28.6% vs. 31.0% (p=0.853) and 11.8 vs. 8.2 years (p=0.359), respectively. In univariate Cox regression, IBD was not a predictor of progression to cirrhosis (HR 0.45; 95% CI 0.13–1.50; p=0.192). The risk of developing decompensation and a median time was also comparable between groups: 21.4% vs. 33.0% (p=0.384) and 18.4 vs. 9.8 years (p=0.053), supported by the Cox regression analysis (HR 0.44; 95% CI 0.13–1.48; p=0.187). The presence of IBD was not associated with higher need in liver transplant (18.8% vs. 30.1%; p=0.348), median time was slightly shorter (1.48 vs. 4.73 years; p=0.542), also evidenced by Cox regression (HR 1.40; 95% CI 0.42–4.65; p=0.578). The risk of liver-related death was also not different among the two groups (6.3% vs. 4.4%; p=0.746), and IBD was not a predictor of it (HR 1.94; 95% CI 0.17–21.69; p=0.589). Conclusions The presence of IBD in patients with AIH is rare and do not identify a subgroup of patients with worse response to treatment or poor clinical outcomes. Funding Agencies AbbVie

scholarly journals SAT0394 CAN FECAL CALPROTECTIN PREDICT FUTURE DEVELOPMENT OF INFLAMMATORY BOWEL DISEASE IN AXIAL SPONDYLOARTHRITIS PATIENTS? – TREASURE REAL-LIFE DATA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1146-1147
Author(s):  
G. K. Yardimci ◽  
O. C. İçaçan ◽  
G. Kabadayi ◽  
B. Farisoğullari ◽  
B. Armagan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Future Development ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Occurrence Rate ◽  
First Year ◽  
Calprotectin Level ◽  
Inflammatory Bowel

Background:Patients with active inflammatory bowel diseases (IBD) fecal calprotectin (FC) levels are high and FC can be used for diagnosis [1].Objectives:This study aimed to investigate whether fecal calprotectin levels could predict future development of IBD in axSpA patients.Methods:This study was practiced in three centers using TReasure database and that are able to measure FC. Fecal calprotectin levels were measured in 137 axSpA patients as of September 2018 and FC level ≥200 µg/g was considered significant. All study subjects were evaluated for IBD symptoms (loose defecation, mucous diarrhea, bloody defecation, bloody diarrhea, abdominal pain, obstruction, or pseudo-obstruction) at beginning of the study and every 3 months for the first year. 25 RA patients and 24 healthy volunteers were included as a control group. Disease activity was evaluated by the ASDAS CRP, BASDAI,BASFI, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analog scale (VAS)-pain, VAS-fatigue, and tender and swollen joint count for axSpA patients.Results:This study included 137 axSpA patients and all patients followed for 1 year. Of the 137 axSpA patients 33.6% were females and median (Q1-Q3) age was of 43 years (33-50 years), median (Q1-Q3) disease duration was 8.9 years (5.0-13.9 years). The median (Q1-Q3) fecal calprotectin level was 48 µg/g (30-122 µg/g) and FC level was ≥200 µg/g in 23/137 (16.8%) in axSpA patients. FC level was elevated in 15/24 (62.5%) RA patients and none of the healthy volunteers. Patients median (Q1-Q3) BASDAI was 2.2 (1.0-3.6) / 1.4 (0.4-2.2), median (Q1-Q3) BASFI 1.55 (0.4-3.4) / 1.5 (0.3-3.0) and median (Q1-Q3) ASDAS CRP 1.63 (1.3-2.2) / 1.5 (1.3-1.9) at baseline and first year respectively and there was no difference regarding fecal calprotectin level. In 1 year follow-up 9 (6.5%) patient had abdominal pain, 2 (1.4%) had bloody defecation, 1 (0.7%) had loose defecation and Crohn disease developed in an axSpA patient with high FC (266 µg/g) (Table 1). IBD occurrence rate was 0.73/100 patient-year for all SpA patients, and IBD occurrence rate was 4.34/100 patients year for SpA patients with ≥200 µg/g FC level.Table 1.IBD symptom inquiry and development of IBD in the first yearn (%)Loose defecation1 (0.73)Mucous diarrhea0Bloody defecation2 (1.45)Bloody diarrhea0Abdominal pain9 (6.56)Obstruction0Pseudo-obstruction0Inflammatory bowel disease1 (0.73)Conclusion:In one year follow-up, IBD occurrence rate was 0.73/100 patient-year, at a similar rate with DESIR cohort [2]. However, FC level may be a predictor for the development of IBD in SpA patients (occurrence rate 4.34/100 patients year). Further follow up duration and more patients may be needed to make conclusion in these field.References:[1]Simioni, J., et al.,Fecal Calprotectin, Gut Inflammation and Spondyloarthritis.Arch Med Res, 2019.50(1): p. 41-46.[2]Wendling, D., et al.,Effect of Gut Involvement in Patients with High Probability of Early Spondyloarthritis: Data from the DESIR Cohort.J Rheumatol, 2019.Disclosure of Interests:Gözde Kübra Yardimci: None declared, Ozan Cemal İçaçan: None declared, Gokhan Kabadayi: None declared, Bayram Farisoğullari: None declared, Berkan Armagan: None declared, Cemal Bes: None declared, Servet Akar: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB

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