Fast and sharp decrease in calprotectin predicts remission by infliximab in anti-TNF naïve patients with ulcerative colitis

Vos, Martine De; Dewit, Olivier; D’Haens, Geert R.; Baert, Filip; Fontaine, F; Vermeire, Séverine; Franchimont, Denis; Moreels, Tom G.; Staessen, Dirk; Terriere, L.; Cruyssen, Bert Vander; Louis, Édouard

doi:10.1016/j.crohns.2011.11.002

Cited by 129 publications

(79 citation statements)

References 15 publications

(13 reference statements)

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“…In adult CD patients, FC concentration decreased significantly during TNF-α induction from a median baseline concentration 1,173-130 μg/g and FC normalized in all patients who achieved endoscopic mucosal healing [59]. Similar results were later shown in UC, where infliximab induced a fast and significant decrease of FC concentrations in anti-TNF-naive patients, being predictive for remission of disease [60]. …”

Section: Calprotectinsupporting

confidence: 64%

Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin

Sipponen

2013

Dig Dis

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Crohn's disease (CD), ulcerative colitis (UC), and colitis unclassified, collectively defined as inflammatory bowel disease (IBD), are the consequence of chronic inflammatory reactions in the gastrointestinal tissue. Endoscopy with biopsies is the mainstay in the diagnosis of this inflammation and is also important in the assessment of disease activity and monitoring of treatment. Furthermore, mucosal healing is increasingly becoming a therapeutic target for treatment of IBD and the golden standard of assessing it is endoscopy. However, due to the costs, invasiveness, and to limited endoscopic capacity, the need is strong for reliable surrogate markers of intestinal inflammation. Bowel contents, being in close contact with intestinal mucosa, can take up molecules that are measurable from stool samples and thus can serve as markers of inflammation. The fecal neutrophil-derived biomarkers, especially calprotectin and lactoferrin, have several features of an ideal test for detecting intestinal inflammation: they are noninvasive, simple, and low in cost. The utility of these biomarkers in distinguishing IBD from noninflammatory conditions such as irritable bowel syndrome is well documented. They correlate closely with endoscopic activity both in CD and UC. They allow serial monitoring of disease activity and of treatment success, and can even serve in predicting clinical relapse in unsymptomatic patients or sustained remission after induction with TNF-α-blocking agents. In this review an overview will be given to the role of fecal neutrophil-derived biomarkers calprotectin and lactoferrin in diagnostics and prognostics of IBD.

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Section: Calprotectinsupporting

confidence: 64%

Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin

Sipponen

2013

Dig Dis

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“…In one study involving 53 consecutive IBD patients who were followed for 12 months (9), elevated FC levels (>340 µg/g) indicated an 18-fold higher risk for relapse (Figure 1). Conversely, reductions in FC levels have been associated with better response to treatment in IBD patients (24)(25)(26)(27).…”

Section: What Are the Potential Future Applications Of Fc In Ibd Care?mentioning

confidence: 99%

Clinicians’ Guide to the Use of Fecal Calprotectin to Identify and Monitor Disease Activity in Inflammatory Bowel Disease

Bressler

Panaccione

Fedorak

et al. 2015

Canadian Journal of Gastroenterology and Hepatology

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BACKGROUND: Objective monitoring of the severity of inflammation in patients with inflammatory bowel disease (IBD) is an essential part of disease management. However, repeat endoscopy to define extent and severity of inflammation is not practical. Fecal calprotectin (FC) is a biomarker that can be used as a surrogate test to distinguish inflammatory from noninflammatory gastrointestinal disease.METHODS: A targeted search of the literature regarding FC, focusing primarily on the past three years, was conducted to develop practical clinical guidance on the current utility of FC in the routine management of IBD patients.RESULTS: It is recommended that samples for FC testing be obtained from the first bowel excretion of the day. FC testing should be used as standard of care to accurately confirm inflammation and ‘real-time’ disease activity when a clinician suspects an IBD flare. Although FC is a reliable marker of inflammation, its role in routine monitoring in improving long-term outcomes has not yet been fully assessed. Based on available evidence, the authors suggest the following cut-off values and management strategies: when FC levels are <50 μg/g to 100 μg/g, quiescent disease is likely and therapy should be continued; when FC levels are >100 μg/g to 250 μg/g, inflammation is possible and further testing (eg, colonoscopy) is required to confirm inflammation; and when FC levels are >250 μg/g, active inflammation is likely and strategies to control inflammation should be initiated (eg, optimizing current therapies or switching to an alternative therapy).DISCUSSION: FC is a useful biomarker to accurately assess the degree of inflammation and should be incorporated into the management of patients with IBD.

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“…The rapid decrease in fecal calprotectin in patients receiving anti-TNF antibodies was significantly correlated with the intestinal endoscopic remission [64][65][66]. Few studies have evaluated the interest of determination of fecal calprotectin after bowel resection: Lamb et al published that the value of fecal calprotectin normalizes after 2 months of uncomplicated intestinal resection [16].…”

Section: Therapy Monitoringmentioning

confidence: 99%

Fecal calprotectin in inflammatory bowel diseases: update and perspectives

Manceau

Chicha-Cattoir²,

Puy

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Inflammatory bowel diseases (IBDs) are chronic diseases that result from the inflammation of the intestinal wall, suspected in any patient presenting with intestinal symptoms. Until recently, the diagnosis was mainly based on both clinical and endoscopic arguments. The use of an easy, fast, reliable, non-invasive, and inexpensive biological assay is mandatory not only in diagnosis but also in evolutionary and therapeutic monitoring. To date, the fecal calprotectin is the most documented in this perspective. This marker allows the discrimination between functional and organic bowel processes with good performance. The determination of the fecal calprotectin level contributes to the evaluation of the degree of disease activity and to monitoring of therapeutic response.

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Fast and sharp decrease in calprotectin predicts remission by infliximab in anti-TNF naïve patients with ulcerative colitis

Abstract: Infliximab induces a fast and significant decrease of faecal calprotectin levels in anti-TNF naïve patients with ulcerative colitis predictive for remission of disease.

Cited by 129 publications

References 15 publications

Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin

Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin

Clinicians’ Guide to the Use of Fecal Calprotectin to Identify and Monitor Disease Activity in Inflammatory Bowel Disease

Fecal calprotectin in inflammatory bowel diseases: update and perspectives

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