P658 Faecal calprotectin is capable of predicting mucosal healing in paediatric-onset Crohn's disease patients under sustained clinical remission with biologics. (16th January 2018)

• Record Type: Journal Article
• Authors: Kang, B; Kim, J Y; Lee, K; Choe, B H; Choe, Y H
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S443
• Page End: S443
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.785
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Despite the emergence of mucosal healing (MH) as a major therapeutic goal in Crohn's disease (CD), its feasibility into real-life practice is limited, especially in the paediatric population. We aimed to investigate whether faecal calprotectin (FC) may serve as a surrogate marker of predicting MH in paediatric-onset CD patients under sustained clinical remission with biologics. Methods: This study was a cross-sectional study conducted at the Department of Paediatrics of two tertiary hospitals in Korea. Patients included in the study were (1) paediatric-onset CD patients diagnosed before the age of 19, (2) were under sustained clinical remission for at least 6 months with biologics, and (3) had simultaneously performed ileocolonoscopies and FC as well as other laboratory tests. The correlation between Simple endoscopic score for Crohn's disease (SES-CD) and FC levels, as well as the association between MH and FC were investigated. Furthermore, the cut-off level of FC in predicting MH was derived. Complete MH was defined as SES = 0, and partial MH was defined as SES-CD < 3. Results: A total 99 patients (65 males, and 34 females) were included in this study. FC levels were significantly higher in patients who had achieved complete MH (median 34.1 vs. 514.3 μg/g, p < 0.001), and also who had achieved partial MH (median 38.5 vs. 710.5 μg/g, p < 0.001), respectively. SES-CD scores and FC levels showed a significant correlation ( ρ = 0.71, p < 0.001). According to logistic regression analysis, FC × 10 −2 was the only factor associated with both complete MH (OR = 0.47, 95% CI 0.31–0.63, p < 0.001), and partial MH (OR = 0.62, 95% CI 0.5–0.73, p < 0.001), respectively. According to receiver operating curve analysis, cut-off levels of FC in predicting complete MH and partial MH were 97.9 (AUC = 0.907, 95% CI 0.844–0.969, sensitivity 88.2%, specificity 87.5%, PPV 87.5%, NPV 88.2%, p < 0.001) and 122.4 (AUC = 0.904, 95% CI 0.842–0.967, sensitivity 79.7%, specificity 94.3%, PPV 71.7%, NPV 96.2%, p < 0.001), respectively. Conclusions: FC is capable of predicting mucosal healing in paediatric-onset CD patients under sustained clinical remission with biologics.