Faecal calprotectin measurement predicts relapse in IBD patients under anti-TNF therapy
In patients with inflammatory bowel disease (IBD) on maintenance therapy with antitumour necrosis factor (anti-TNF) drugs, faecal calprotectin (FC) appears to be a good predictor of clinical relapse as well as remission over the following 4 months, reports a recent study.
“FC levels <130 μg/g are consistently associated with maintained disease remission, whereas concentrations >300 μg/g allow predicting relapse with a high probability at any time over the following 4 months,” the authors said.
Of the 106 included patients, 95 completed the study and were thus analysed (median age 44 years; 50.5 percent female; 75 percent with Crohn’s disease).
There were 30 patients (31.6 percent) who had a relapse over follow-up. FC concentration was significantly greater in patients who relapsed (477 μg/g) as compared with those who maintained in remission (65 μg/g; p<0.005). The optimal cutoff was 130 μg/g for predicting remission (negative predictive value, 100 percent) and 300 μg/g for predicting relapse (positive predictive value, 78.3 percent).
To assess the accuracy of consecutive FC measurements in predicting flares, the authors designed a prospective longitudinal cohort study with 16-month follow-up period, which included IBD patients in clinical remission for at least 6 months under anti-TNF therapy.
Measurement of FC levels was conducted at 4-month intervals for 1 year, and patients were clinically examined for relapse at 2-month intervals. Receiver-operating characteristic curve analysis was used to assess the diagnostic accuracy of FC for predicting relapse.
“Predicting relapse in IBD patients could allow early changes in therapy,” according to the authors.