Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease

D’Haens, Geert R.; Ferrante, Marc; Vermeire, Séverine; Baert, Filip; Noman, Maja; Moortgat, Liesbeth; Geens, Patricia; Iwens, Doreen; Aerden, Isolde; Assche, Gert Van; Olmen, Gust Van; Rutgeerts, Paul

doi:10.1002/ibd.22917

Cited by 705 publications

(589 citation statements)

References 31 publications

Supporting

Mentioning

548

Contrasting

Unclassified

Order By: Relevance

“…As endoscopies are also invasive, expensive, and time-consuming with a risk of complications, there is a need for noninvasive screening methods for detecting relapse and postoperative recurrence of CD. Clinical activity indices and serum inflammatory markers correlate poorly with endoscopic disease activity [9,17,18,21]. Fecal calprotectin, which is excreted by migrating neutrophils to the lumen of the inflamed bowel, has been demonstrated a useful surrogate marker for disease activity in both children and adults [18,21,22,31,32].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical activity indices and serum inflammatory markers correlate poorly with endoscopic disease activity [9,17,18,21]. Fecal calprotectin, which is excreted by migrating neutrophils to the lumen of the inflamed bowel, has been demonstrated a useful surrogate marker for disease activity in both children and adults [18,21,22,31,32]. However, FC is not specific to inflammatory bowel disease and may increase in the presence of other gastrointestinal disorders, such as infectious colitis and polyposis [33,34].…”

Section: Discussionmentioning

confidence: 99%

“…Despite resolution of active mucosal inflammation during medical therapy for CD, FC levels may remain elevated reflecting persistent microscopic inflammation of the bowel wall [17,18,21,22,31,32]. Suggested cutoff values for detection of relapse vary between 150 and 275 μg/g, usually with moderate sensitivity but good specificity [17,18,21,32].…”

Section: Discussionmentioning

confidence: 99%

“…Calprotectin is a neutrophil-derived protein excreted in stool in abundance in the presence of mucosal inflammation [17][18][19][20]. Fecal calprotectin (FC) outperforms serum markers in the detection of bowel wall inflammation and reflects the endoscopic activity of CD reliably in both children and adults [17,18,[20][21][22][23].…”

mentioning

confidence: 99%

“…Fecal calprotectin (FC) outperforms serum markers in the detection of bowel wall inflammation and reflects the endoscopic activity of CD reliably in both children and adults [17,18,[20][21][22][23]. Its concentration has been shown to increase in the presence of histological pouch inflammation following proctocolectomy for ulcerative colitis [24].…”

mentioning

confidence: 99%

See 4 more Smart Citations

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Hukkinen

Pakarinen

Merras‐Salmio

et al. 2016

Journal of Pediatric Surgery

View full text Add to dashboard Cite

a b s t r a c t a r t i c l e i n f oBackground: Fecal calprotectin (FC) correlates with endoscopic recurrence of Crohn's disease (CD) in adults but has not been studied among children postoperatively. We aimed to analyze whether FC relates with postoperative CD recurrence in children. Methods: Altogether 51 postoperative endoscopies and FC measurements from 22 patients having undergone surgery for CD at age ≤18 years were included. Results: Ileocecal resection (n = 15), small bowel resection (n = 6), or left hemicolectomy (n = 1) was performed at median age of 15.1 (interquartile range 14.4-17.6) years. Following surgery, FC decreased significantly (659 vs. 103 μg/g, p = 0.001). During median follow-up of 5.7 (4.2-7.7) years, either endoscopic or histological recurrence occurred in 17 patients (77%). FC N139 μg/g at time of endoscopy or FC increase of 79 μg/g compared to first postoperative value was suggestive of endoscopic recurrence (Rutgeerts score i2-i4), while FC N101 μg/g or increase of 21 μg/g indicated histological recurrence. Best accuracy for prediction of recurrence was obtained by combining FC at endoscopy and the postoperative increase of FC. The corresponding AUROC values were 0.74 (95% 0.58-0.89) for endoscopic recurrence whereas 0.81 (95% CI 0.67-0.95) for histological recurrence. Conclusion: FC is a useful surrogate marker of postoperative recurrence also in pediatric CD patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Hukkinen

Pakarinen

Merras‐Salmio

et al. 2016

Journal of Pediatric Surgery

View full text Add to dashboard Cite

show abstract

SERENE ER Analysis Part 2 SERENE‐UC: Exposure‐response Analysis of Higher Versus Standard Adalimumab Dosing Regimens for Patients with Moderately to Severely Active Ulcerative Colitis

Stodtmann,

Chen,

Ponce‐Bobadilla

et al. 2024

Clinical Pharm in Drug Dev

View full text Add to dashboard Cite

SERENE UC (NCT02065622) evaluated whether a higher adalimumab induction regimen improved patients with ulcerative colitis (UC) response, but a flat dose‐response relationship was found in the induction study. We investigated exposure‐response (ER) relationships in induction and maintenance studies considering patients’ baseline characteristics. Adalimumab exposures were simulated using the established population pharmacokinetic model. Multivariable logistic regressions were used to assess the efficacy endpoints (clinical remission, endoscopic remission, endoscopic improvement) at weeks 8 and 52. In the induction study, an increasing ER trend with heterogeneity between induction regimens was shown, suggesting average concentration (Cavg) had a significant impact on primary efficacy endpoints within each group. However, data were not described by a single ER curve. Using inverse effective clearance as the exposure metric described trends across induction regimens with a single curve. Patients with inherently lower effective adalimumab clearance responded better. The patient response rates at week 52 showed no heterogeneity. A short‐term increase in adalimumab dose did not drive better responses for induction, and apparent ER relationships were better explained by patient‐inherent lower clearance. Conversely, during maintenance up to week 52, increasing the concentration via dose translated to better responses more robustly. The ER findings for SERENE UC were consistent with SERENE CD.

show abstract

SERENE ER Analysis Part 1‐SERENE CD: Exposure‐Response Analysis of Higher Versus Standard Adalimumab Dosing Regimens for Patients With Moderately to Severely Active Crohn Disease

Chen,

Ponce‐Bobadilla,

Stodtmann

et al. 2024

Clinical Pharm in Drug Dev

View full text Add to dashboard Cite

SERENE CD (NCT02065570) evaluated whether a higher adalimumab induction dose would improve patients with Crohn disease response and suggested a flat dose‐response relationship for efficacy in the induction study. We investigated exposure‐response relationships in induction and maintenance studies considering patients’ baseline characteristics. Adalimumab exposures were simulated using the established population pharmacokinetic model. Efficacy end points (clinical remission/endoscopic response) at Weeks 4, 12, and 56 were evaluated in exposure‐response analyses using multivariable logistic regression. Analyses showed an increasing trend with heterogeneity between induction regimens, which suggested that average concentration has an impact on coprimary efficacy end points within each group, but data did not fit a single‐response curve. Although higher concentrations within arms were associated with improved outcomes, increasing the concentration through a higher induction dose was not associated with increasing clinical remission/endoscopic response at Week 4/12. A model including inverse effective clearance eliminated heterogeneity and described trends across induction regimens with a single curve. In the maintenance study, the response rates at Week 56 showed no heterogeneity. In the induction study, patients with lower effective adalimumab clearance responded better, whereas in the maintenance study average concentration drove primary efficacy end points at Week 56. Research extending these findings to other indications is needed.

show abstract

Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease

Abstract: Fecal calprotectin levels correlate significantly with endoscopic disease activity in IBD. The test appears useful in clinical practice for assessment of endoscopic activity and remission.

Cited by 705 publications

References 31 publications

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

SERENE ER Analysis Part 2 SERENE‐UC: Exposure‐response Analysis of Higher Versus Standard Adalimumab Dosing Regimens for Patients with Moderately to Severely Active Ulcerative Colitis

SERENE ER Analysis Part 1‐SERENE CD: Exposure‐Response Analysis of Higher Versus Standard Adalimumab Dosing Regimens for Patients With Moderately to Severely Active Crohn Disease

Contact Info

Product

Resources

About