• Citer

Consecutive fecal calprotectin measurements to predict relapse in patients with ulcerative colitis receiving infliximab maintenance therapy

par De Vos, Martine;Louis, Edouard;Jahnsen, Jørgen;Vandervoort, Jo G P;Noman, Maja;Dewit, Olivier;D'Haens, Geert;Franchimont, Denis ;Baert, Filip;Torp, Roald R.A.;Henriksen, Magne;Potvin, Philippe;Van Hootegem, Ph;Hindryckx, Pieter P.M.;Moreels, Tom;Collard, Arnaud;Karlsen, Lars Normann;Kittang, Eirik;Lambrecht, Guy;Grimstad, Tore;Koch, Jonas;Lygren, Idar;Coche, Jean Claude R J J.C.;Mana, Fazia;Van Gossum, André ;Belaiche, Jacques;Cool, Mike M.R.;Fontaine, Fernand;Maisin, Jean Marc G;Muls, Vinciane ;Neuville, Bart;Staessen, Dirk A J D.;Van Assche, Gert Van;De Lange, Thomas;Solberg, Inger Camilla;Cruyssen, Bert-Vander;Vermeire, Séverine
Référence Inflammatory bowel diseases, 19, 10, page (2111-2117)
Publication Publié, 2013-09

Article révisé par les pairs

• Détails
• Contenu

Résumé :

Background: This study examined whether fecal calprotectin can be used in daily practice as a marker to monitor patients with ulcerative colitis (UC) receiving infliximab maintenance therapy. Methods: This prospective multicenter study enrolled adult patients with UC in clinical remission under infliximab maintenance therapy. Fecal calprotectin levels were measured every 4 weeks. Sigmoidoscopies were performed at inclusion and at study end. Relapse was defined as a clinical need for change in treatment or an endoscopic Mayo subscore of ≥2 at week 52. Sustained deep remission was defined as a partial Mayo score <3 at all points and an endoscopic Mayo score 0 at week 52. Results: Full analysis was possible for 87 of 113 included patients with UC (77%). Of these patients, 30 (34.4%) were considered to be in sustained deep remission and 13 (14.9%) to have relapsed. Calprotectin levels in patients with sustained deep remission remained very low (median < 40 mg/kg at all time points). Patients who flared had significantly higher calprotectin levels (median > 300 mg/kg) already 3 months before the flare. Further receiver operator curve analysis suggested that a calprotectin level >300 mg/kg had a reasonable sensitivity (58.3%) and specificity (93.3%) to model flare. Two consecutive calprotectin measurements of >300 mg/kg with 1-month interval were identified as the best predictor of flare (61.5% sensitivity and 100% specificity). Conclusions: Fecal calprotectin can be used in daily practice to monitor patients with UC receiving infliximab maintenance therapy. Two consecutive measurements >300 mg/kg is more specific than a single measurement for predicting relapse. Copyright © 2013 Crohn's & Colitis Foundation of America, Inc.