Accuracy of Consecutive Fecal Calprotectin Measurements to Predict Relapse in Inflammatory Bowel Disease Patients Under Maintenance With Anti-TNF Therapy: A Prospective Longitudinal Cohort Study
Predicting relapse in inflammatory bowel disease (IBD) patients could allow early changes in therapy. We aimed at evaluating the accuracy of consecutive fecal calprotectin (FC) measurements to predict flares in IBD patients under maintenance treatment with anti-tumor necrosis factor (TNF) drugs. A p...
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| Veröffentlicht in: | Journal of clinical gastroenterology 2018-03, Vol.52 (3), p.229-234 |
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| container_title | Journal of clinical gastroenterology |
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| creator | Ferreiro-Iglesias, Rocio Barreiro-de Acosta, Manuel Lorenzo-Gonzalez, Aurelio Dominguez-Muñoz, Juan E |
| description | Predicting relapse in inflammatory bowel disease (IBD) patients could allow early changes in therapy. We aimed at evaluating the accuracy of consecutive fecal calprotectin (FC) measurements to predict flares in IBD patients under maintenance treatment with anti-tumor necrosis factor (TNF) drugs.
A prospective longitudinal cohort study with 16-month follow-up period was designed. IBD patients in clinical remission for at least 6 months under anti-TNF therapy were included. FC was quantified at 4-month intervals for 1 year, and patients were clinically evaluated for relapse at 2-month intervals. Diagnostic accuracy of FC for predicting relapse was evaluated by receiver-operating characteristic curve analysis.
In total, 95 of 106 included patients finalized the study and were analyzed (median age 44 y, 50.5% female, 75% with Crohn's disease). A total of 30 patients (31.6%) had a relapse over follow-up. FC concentration was significantly higher in patients who relapsed (477 μg/g) than in patients who maintained in remission (65 μg/g) (P |
| doi_str_mv | 10.1097/MCG.0000000000000774 |
| format | Article |
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A prospective longitudinal cohort study with 16-month follow-up period was designed. IBD patients in clinical remission for at least 6 months under anti-TNF therapy were included. FC was quantified at 4-month intervals for 1 year, and patients were clinically evaluated for relapse at 2-month intervals. Diagnostic accuracy of FC for predicting relapse was evaluated by receiver-operating characteristic curve analysis.
In total, 95 of 106 included patients finalized the study and were analyzed (median age 44 y, 50.5% female, 75% with Crohn's disease). A total of 30 patients (31.6%) had a relapse over follow-up. FC concentration was significantly higher in patients who relapsed (477 μg/g) than in patients who maintained in remission (65 μg/g) (P<0.005). The optimal cutoff to predict remission was 130 μg/g (negative predictive value of 100%), and 300 μg/g to predict relapse (positive predictive value of 78.3%).
FC is a good predictor of clinical relapse and a particularly good predictor of remission over the following 4 months in patients with IBD on maintenance therapy with anti-TNF drugs. FC levels <130 μg/g is consistently associated with maintained disease remission, whereas concentrations >300 μg/g allow predicting relapse with a high probability at any time over the following 4 months.</description><identifier>ISSN: 0192-0790</identifier><identifier>EISSN: 1539-2031</identifier><identifier>DOI: 10.1097/MCG.0000000000000774</identifier><identifier>PMID: 27984399</identifier><language>eng</language><publisher>United States</publisher><subject>Adolescent ; Adult ; Aged ; Cohort Studies ; Colitis, Ulcerative - diagnosis ; Colitis, Ulcerative - drug therapy ; Crohn Disease - diagnosis ; Crohn Disease - drug therapy ; Feces - chemistry ; Female ; Follow-Up Studies ; Humans ; Leukocyte L1 Antigen Complex - analysis ; Longitudinal Studies ; Male ; Middle Aged ; Prospective Studies ; Recurrence ; Tumor Necrosis Factor-alpha - antagonists & inhibitors ; Young Adult</subject><ispartof>Journal of clinical gastroenterology, 2018-03, Vol.52 (3), p.229-234</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c153t-3227d8a5a61a6b009d50221f876a4ae718f1868ab266eec5864879b550bf3ff13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27984399$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ferreiro-Iglesias, Rocio</creatorcontrib><creatorcontrib>Barreiro-de Acosta, Manuel</creatorcontrib><creatorcontrib>Lorenzo-Gonzalez, Aurelio</creatorcontrib><creatorcontrib>Dominguez-Muñoz, Juan E</creatorcontrib><title>Accuracy of Consecutive Fecal Calprotectin Measurements to Predict Relapse in Inflammatory Bowel Disease Patients Under Maintenance With Anti-TNF Therapy: A Prospective Longitudinal Cohort Study</title><title>Journal of clinical gastroenterology</title><addtitle>J Clin Gastroenterol</addtitle><description>Predicting relapse in inflammatory bowel disease (IBD) patients could allow early changes in therapy. We aimed at evaluating the accuracy of consecutive fecal calprotectin (FC) measurements to predict flares in IBD patients under maintenance treatment with anti-tumor necrosis factor (TNF) drugs.
A prospective longitudinal cohort study with 16-month follow-up period was designed. IBD patients in clinical remission for at least 6 months under anti-TNF therapy were included. FC was quantified at 4-month intervals for 1 year, and patients were clinically evaluated for relapse at 2-month intervals. Diagnostic accuracy of FC for predicting relapse was evaluated by receiver-operating characteristic curve analysis.
In total, 95 of 106 included patients finalized the study and were analyzed (median age 44 y, 50.5% female, 75% with Crohn's disease). A total of 30 patients (31.6%) had a relapse over follow-up. FC concentration was significantly higher in patients who relapsed (477 μg/g) than in patients who maintained in remission (65 μg/g) (P<0.005). The optimal cutoff to predict remission was 130 μg/g (negative predictive value of 100%), and 300 μg/g to predict relapse (positive predictive value of 78.3%).
FC is a good predictor of clinical relapse and a particularly good predictor of remission over the following 4 months in patients with IBD on maintenance therapy with anti-TNF drugs. FC levels <130 μg/g is consistently associated with maintained disease remission, whereas concentrations >300 μg/g allow predicting relapse with a high probability at any time over the following 4 months.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Cohort Studies</subject><subject>Colitis, Ulcerative - diagnosis</subject><subject>Colitis, Ulcerative - drug therapy</subject><subject>Crohn Disease - diagnosis</subject><subject>Crohn Disease - drug therapy</subject><subject>Feces - chemistry</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Leukocyte L1 Antigen Complex - analysis</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Tumor Necrosis Factor-alpha - antagonists & inhibitors</subject><subject>Young Adult</subject><issn>0192-0790</issn><issn>1539-2031</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkdFu1DAQRS0EokvhDxDyD6TYcRInvC2BLZV2oYKteIwmzpg1SuzIdkD5Pb4MLwWEmJfRSHPmXs0l5DlnV5w18uWhvb5i_5aUxQOy4aVospwJ_pBsGG_yjMmGXZAnIXxljEsh-GNykcumLkTTbMiPrVKLB7VSp2nrbEC1RPMN6Q4VjLSFcfYuoorG0gNCWDxOaGOg0dFbj4NRkX7EEeaANK3cWD3CNEF0fqWv3Xcc6RsTEof0FqL5Rd7ZAT09gLERLViF9LOJJ7q10WTH9zt6PKGHeX1Ft0nBhfksngztnf1i4jIYe_blTs5H-inN61PySMMY8Nnvfknudm-P7bts_-H6pt3uM5V-EjOR53KooYSKQ9Uz1gwly3Oua1lBASh5rXld1dDnVYWoyroqatn0Zcl6LbTm4pIU93dVchU86m72ZgK_dpx150i6FEn3fyQJe3GPzUs_4fAX-pOB-AmPn4qN</recordid><startdate>201803</startdate><enddate>201803</enddate><creator>Ferreiro-Iglesias, Rocio</creator><creator>Barreiro-de Acosta, Manuel</creator><creator>Lorenzo-Gonzalez, Aurelio</creator><creator>Dominguez-Muñoz, Juan E</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201803</creationdate><title>Accuracy of Consecutive Fecal Calprotectin Measurements to Predict Relapse in Inflammatory Bowel Disease Patients Under Maintenance With Anti-TNF Therapy: A Prospective Longitudinal Cohort Study</title><author>Ferreiro-Iglesias, Rocio ; Barreiro-de Acosta, Manuel ; Lorenzo-Gonzalez, Aurelio ; Dominguez-Muñoz, Juan E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c153t-3227d8a5a61a6b009d50221f876a4ae718f1868ab266eec5864879b550bf3ff13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Cohort Studies</topic><topic>Colitis, Ulcerative - diagnosis</topic><topic>Colitis, Ulcerative - drug therapy</topic><topic>Crohn Disease - diagnosis</topic><topic>Crohn Disease - drug therapy</topic><topic>Feces - chemistry</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Leukocyte L1 Antigen Complex - analysis</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Tumor Necrosis Factor-alpha - antagonists & inhibitors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ferreiro-Iglesias, Rocio</creatorcontrib><creatorcontrib>Barreiro-de Acosta, Manuel</creatorcontrib><creatorcontrib>Lorenzo-Gonzalez, Aurelio</creatorcontrib><creatorcontrib>Dominguez-Muñoz, Juan E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Journal of clinical gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ferreiro-Iglesias, Rocio</au><au>Barreiro-de Acosta, Manuel</au><au>Lorenzo-Gonzalez, Aurelio</au><au>Dominguez-Muñoz, Juan E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of Consecutive Fecal Calprotectin Measurements to Predict Relapse in Inflammatory Bowel Disease Patients Under Maintenance With Anti-TNF Therapy: A Prospective Longitudinal Cohort Study</atitle><jtitle>Journal of clinical gastroenterology</jtitle><addtitle>J Clin Gastroenterol</addtitle><date>2018-03</date><risdate>2018</risdate><volume>52</volume><issue>3</issue><spage>229</spage><epage>234</epage><pages>229-234</pages><issn>0192-0790</issn><eissn>1539-2031</eissn><abstract>Predicting relapse in inflammatory bowel disease (IBD) patients could allow early changes in therapy. We aimed at evaluating the accuracy of consecutive fecal calprotectin (FC) measurements to predict flares in IBD patients under maintenance treatment with anti-tumor necrosis factor (TNF) drugs.
A prospective longitudinal cohort study with 16-month follow-up period was designed. IBD patients in clinical remission for at least 6 months under anti-TNF therapy were included. FC was quantified at 4-month intervals for 1 year, and patients were clinically evaluated for relapse at 2-month intervals. Diagnostic accuracy of FC for predicting relapse was evaluated by receiver-operating characteristic curve analysis.
In total, 95 of 106 included patients finalized the study and were analyzed (median age 44 y, 50.5% female, 75% with Crohn's disease). A total of 30 patients (31.6%) had a relapse over follow-up. FC concentration was significantly higher in patients who relapsed (477 μg/g) than in patients who maintained in remission (65 μg/g) (P<0.005). The optimal cutoff to predict remission was 130 μg/g (negative predictive value of 100%), and 300 μg/g to predict relapse (positive predictive value of 78.3%).
FC is a good predictor of clinical relapse and a particularly good predictor of remission over the following 4 months in patients with IBD on maintenance therapy with anti-TNF drugs. FC levels <130 μg/g is consistently associated with maintained disease remission, whereas concentrations >300 μg/g allow predicting relapse with a high probability at any time over the following 4 months.</abstract><cop>United States</cop><pmid>27984399</pmid><doi>10.1097/MCG.0000000000000774</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Cohort Studies Colitis, Ulcerative - diagnosis Colitis, Ulcerative - drug therapy Crohn Disease - diagnosis Crohn Disease - drug therapy Feces - chemistry Female Follow-Up Studies Humans Leukocyte L1 Antigen Complex - analysis Longitudinal Studies Male Middle Aged Prospective Studies Recurrence Tumor Necrosis Factor-alpha - antagonists & inhibitors Young Adult |
| title | Accuracy of Consecutive Fecal Calprotectin Measurements to Predict Relapse in Inflammatory Bowel Disease Patients Under Maintenance With Anti-TNF Therapy: A Prospective Longitudinal Cohort Study |
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