Meta-analysis

Abstract

The FC test is a reliable marker for assessing IBD disease activity and may have greater ability to evaluate disease activity in UC than CD.

Fecal Calprotectin Measured By Patients at Home Using Smartphones—A New Clinical Tool in Monitoring Patients with Inflammatory Bowel Disease

“…A meta-analysis of FC measurements as assessment of IBD activity pooled 13 studies (1471 patients) and found that 66% of the patients had disease activity when FC was measured. 8 This difference in prevalence could explain the lower PPV and higher NPV found in our study. A more generalizable measure is the LR+ or LR2, which can be used to determine whether a test result (i.e., a given FC concentration) usefully changes the probability of a specific condition, for example, a relapse in patients with IBD.…”

“…The cutoff of 200 mg/g was per protocol and based on studies showing high-positive predictive values (PPV) for relapse around 150 to 300 mg/g while ruling out symptoms arising from irritable bowel syndrome. 5,8,21,22 Statistics Chi square tests or Mann-Whitney Wilcoxon tests were used for comparison of patients' characteristics. To assess sample-to-sample reproducibility of the CalproSmart test, 42 different fecal samples (21 from patients with CD and 21 from patients with UC) were tested 3 times on 3 different LFDs using the same extraction, and the interassay coefficient of variation (CV) was calculated.…”

“…With respect to the aforementioned meta-analysis and with FC cutoff values ranging from 200 to 274 mg/g, the sensitivity, specificity, LR+, and LR-were 0.80, 0.82, 4.17, and 0.22, respectively, for 7 pooled studies. 8 As such, the CalproSmart test is in our opinion suitable for screening patients with IBD in clinical remission for possible subclinical/ mucosal disease activity with the possibility of predicting future relapse. Furthermore, we believe that giving the patient the opportunity to monitor their disease objectively and the responsibility to react promptly to, e.g., a suspicion of a relapse will empower patients and hereby increase their compliance.…”

“…[4][5][6] Most tests for FC are performed by enzyme-linked immunosorbent assays (ELISA) with accurate results that correlate well with endoscopic findings but less with clinical symptom indices. 4,5,[7][8][9] However, this method is time consuming and performed in a batch-like procedure only once every 1 or 2 weeks in most clinics limiting its use in clinical decision making. During the delay period from sampling to analysis, patients may have deteriorated or undergone (unnecessary) endoscopy.…”

The role of inflammation in temporal shifts in the inflammatory bowel disease mucosal microbiome

“…Faecal specimens do not necessarily reflect the nature of the mucosa-adherent bacteria, 18 nor the degree of inflammation. 19 While the use of faecal calprotectin measurements is useful in the setting of screening for gastrointestinal inflammation, 20 it is not as accurate as endoscopic or histological assessment in patients with IBD, especially those with small bowel inflammation. 21 , 22 …”