P200 Faecal calprotectin in assessing endoscopic and histologic remission in patients with ulcerative colitis. (16th January 2018)

• Record Type: Journal Article
• Authors: Mak, W Y; Buisson, A; Andersen Jr, M J; Lei, D; Pekow, J; Cohen, R D; Kahn, S A; Pereira, B; Rubin, D T
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S199
• Page End: S200
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.327
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Persistent active endoscopic and histological inflammation are associated with poorer outcomes in ulcerative colitis (UC). Faecal calprotectin is a surrogate marker of endoscopic and histological remission. We studied the correlation between faecal calprotectin and endoscopic or histological disease activity and in order to define the optimal cut-off value to detect endoscopic and histological remission. Methods: From a prospectively maintained database, we analysed 61 UC patients who had faecal calprotectin measurements and endoscopy performed within one month. Endoscopic activity was graded using the Mayo endoscopic subscore (MES). Histological remission was defined as normal histology or quiescent histological activity. Results: Eighteen patients (29.5%) and 5 patients (8.1%) had endoscopic remission defined as MES ≤ 1 or MES = 0, respectively. We observed a significantly lower median level of faecal calprotectin in patients with endoscopic remission than those with endoscopic activity for both definition of endoscopic remission i.e. MES ≤ 1 (158 vs. 490 µg/g, p = 0.0005) or MES = 0 (94 µg/g vs. 414 µg/g, p = 0.013). The median level of faecal calprotectin was 94 µg/g for MES 0, 167.9 µg/g for MES 1, 428 µg/g for MES 2 and 780 µg/g for MES 3. (Figure 1) Biopsies were taken during endoscopy from 57 UC patients. Seven patients (11.5%) were in histological remission, whereas 5 patients (8.8%) presented with mild histologic activity, 26 patients (45.6%) with moderate histologic activity and 19 patients (33.3%) with severe histologic activity. Those in remission had a lower median level of feacal calprotectin than those with active histological inflammation (107 µg/g vs. 416 µg/g, p = 0.016) (Figure 2). Using ROC curve, faecal calprotectin <250 µg/g predicted endoscopic remission (MES ≤ 1) with a sensitivity of 67% and specificity of 77% while faecal calprotectin <200 µg/g predicted histological remission with a sensitivity of 71% and specificity of 76%. Conclusions: Faecal calprotectin levels correlate with both endoscopic and histological activity and are reliable biomarkers in assessing mucosal healing in UC.