Validation of a care pathway for the use of faecal calprotectin in monitoring patients with Crohn's disease

Turvill, James; Rook, Lisa; Rawle, Maxine; Robins, Gerry; Smale, Simon; Kant, Prashant; Phillips, Anne

doi:10.1136/flgastro-2016-100780

Cited by 7 publications

(5 citation statements)

References 33 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, 69% of the patients with an FC > 250 μg/g were in clinical but not endoscopic remission. This result suggests that monitoring patients with FC could be relevant for pre‐symptomatic disease therapeutic modifications …”

Section: Resultsmentioning

confidence: 92%

“…This result suggests that monitoring patients with FC could be relevant for presymptomatic disease therapeutic modifications. 21 Fecal calprotectin concentrations show variations in respect to different disease localizations, but available information in this respect is still controversial or conflicting. Thus, at present, FC cannot be used as a marker of localization of disease.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Is fecal calprotectin an accurate marker in the management of Crohn's disease?

Vernia

Ruscio

Stefanelli

et al. 2019

J of Gastro and Hepatol

View full text Add to dashboard Cite

Although lacking validated cutoff values, fecal calprotectin (FC), besides C‐reactive protein, is considered the standard test for assessing disease activity in Crohn's disease (CD). The aim of the present review is to provide a general overview of the literature addressing the role of FC in the clinical and endoscopic assessment of disease activity in CD, seeking correlations with capsule endoscopy, response to therapy, prediction of relapse, and postoperative recurrence. A systematic search of the literature up to September 2019 was performed using Medline, Embase, and the Cochrane Library. Only papers written in English concerning FC in adult patients affected by CD were included. Pediatric studies, in vitro studies, animal studies, studies on blood/serum samples, and studies analyzing FC in ulcerative colitis or in both CD and ulcerative colitis were excluded. Out of 713 citations, 65 eligible studies were identified. FC showed high accuracy in the assessment of intestinal inflammation and response to therapy, in particular in colonic disease, thus proving a good surrogate marker for these aims. FC is useful in identifying patients at high risk for endoscopic relapse or postoperative recurrence, for optimizing or downstage therapy. Unfortunately, FC performs less well in small bowel CD. FC is an effective fecal marker in the management of CD patients, optimizing the use of endoscopic procedures. Owing to its diagnostic accuracy, FC may represent a cornerstone of the “treat‐to‐target” management strategy of CD patients.

show abstract

Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Is fecal calprotectin an accurate marker in the management of Crohn's disease?

Vernia

Ruscio

Stefanelli

et al. 2019

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…As a non-invasive tool to aid in the detection of intestinal inflammation, faecal calprotectin (FC) levels can be measured using enzyme-linked immunosorbent assays (ELISAs) or, more recently, a home-use kit associated with a smartphone application[ 37 ]. Such measurement has a relatively good correlation with clinical and endoscopic results in patients with UC[ 38 ] and in those with CD, for which FC has also been used to monitor the risk of disease relapse[ 39 ].…”

Section: Damps Implicated In Intestinal Inflammationmentioning

confidence: 99%

Damage-associated molecular patterns in inflammatory bowel disease: From biomarkers to therapeutic targets

Nanini

Bernardazzi

Castro

et al. 2018

WJG

View full text Add to dashboard Cite

The chronic inflammatory process underlying inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, derives from the interplay of several components in a genetically susceptible host. These components include environmental elements and gut microbiota a dysbiosis. For decades, immune abnormalities have been investigated as critically important in IBD pathogenesis, and attempts to develop effective therapies have predominantly targeted the immune system. Nevertheless, immune events represent only one of the constituents contributing to IBD pathogenesis within the context of the complex cellular and molecular network underlying chronic intestinal inflammation. These factors need to be appreciated within the milieu of non-immune components. Damage-associated molecular patterns (DAMPs), which are essentially endogenous stress proteins expressed or released as a result of cell or tissue damage, have been shown to act as direct pro-inflammatory mediators. Excessive or persistent signalling mediated by such molecules can underlie several chronic inflammatory disorders, including IBD. The release of endogenous DAMPs amplifies the inflammatory response driven by immune and non-immune cells and promotes epigenetic reprogramming in IBD. The effects determine pathologic changes, which may sustain chronic intestinal inflammation and also underlie specific disease phenotypes. In addition to highlighting the potential use of DAMPs such as calprotectin as biomarkers, research on DAMPs may reveal novel mechanistic associations in IBD pathogenesis and is expected to uncover putative therapeutic targets.

show abstract

“…In August 2017, a Consensus paper was published endorsing a nationally agreed algorithm for use in Primary Care, based upon initial work done in the Yorkshire and Humber region by Turvill et al 3 The algorithm recommends a very specific threshold of 100 μg calprotectin/g faeces (μg/g) to rule out organic bowel disease. Numerous studies have supported this algorithm and it has been widely adopted across the country, allowing colonoscopy resource to be targeted at those with persistent and elevated levels of faecal calprotectin.…”

Section: Introductionmentioning

confidence: 99%

“…1 In 2013, NICE published diagnostics guidance, DG11 which recommends that f-cal testing is used in adults with recent onset lower GI symptoms, without risk factors for colorectal cancer, to help to distinguish between IBS and IBD and prevent further unnecessary invasive investigation of IBS patients. 2 In August 2017, a Consensus paper was published endorsing a nationally agreed algorithm for use in Primary Care, based upon initial work done in the Yorkshire and Humber region by Turvill et al 3 The algorithm recommends a very specific threshold of 100 μg calprotectin/g faeces (μg/ g) to rule out organic bowel disease. Numerous studies have supported this algorithm and it has been widely adopted across the country, allowing colonoscopy resource to be targeted at those with persistent and elevated levels of faecal calprotectin.…”

Section: Introductionmentioning

confidence: 99%

Comparison of faecal calprotectin using two collection and extraction strategies for the BÜHLMANN CALEX® Cap – possible implications for clinical cut-offs?

et al. 2023

View full text Add to dashboard Cite

Background: Faecal calprotectin has been identified as a useful biochemical marker in the differentiation of inflammatory bowel disease and irritable bowel syndrome. Typically, patients send faecal specimens in a pot for manual extraction by the laboratory. During the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) pandemic, the routine laboratory service was temporarily suspended due to the potential increased risk to staff. In this study we investigated the possibility of patients collecting samples directly in to the faecal extraction tubes. Method: Patients submitted paired faecal samples for calprotectin analysis using a standard faecal container (current practice) and followed instructions for faecal collection using the BÜHLMANN CALEX® Cap device. Samples were returned to the laboratory immediately after collection. Laboratory staff manually extracted the calprotectin from the faecal samples using the CALEX® Cap prior to analysis of both extracts on the Cobas c702. Results: 91 paired faecal samples were included in the study. Clinical correlation was found to be 70% with numerical correlation showing a positive bias for the patient-collected CALEX® Cap sample when compared to the laboratory-extracted faecal sample around the clinical decision points 100-250 ug calprotectin/g faeces. Conclusion: The study shows that collection of a faecal sample using the CALEX® Cap works well and is a good alternative to using standard containers. The correlation gives rise to the possibility that faecal calprotectin is not stable when collected into standard collection containers. Prior to further roll-out of this process, questions surrounding the current cut-offs would need to be addressed.

show abstract

Validation of a care pathway for the use of faecal calprotectin in monitoring patients with Crohn's disease

Cited by 7 publications

References 33 publications

Is fecal calprotectin an accurate marker in the management of Crohn's disease?

Is fecal calprotectin an accurate marker in the management of Crohn's disease?

Damage-associated molecular patterns in inflammatory bowel disease: From biomarkers to therapeutic targets

Comparison of faecal calprotectin using two collection and extraction strategies for the BÜHLMANN CALEX® Cap – possible implications for clinical cut-offs?

Contact Info

Product

Resources

About