Can Calprotectin Predict Relapse Risk in Inflammatory Bowel Disease?

Abstract

Measuring calprotectin may help to identify UC and colonic CD patients at higher risk of clinical relapse.

Measurement of Fecal Calprotectin Improves Monitoring and Detection of Recurrence of Crohn's Disease After Surgery

“…8,15 Increased FC concentrations are associated with an increased risk of clinical relapse. [16][17][18][19][20][21] Its value in the post-operative setting, however, is uncertain.…”

How should we follow the Crohn’s disease patients in remission?

“…The 71 patients with Crohn's disease were checked for the erythrocyte sedimentation rate and CRP every 6 weeks, and the relapse risk in the short term has been found to be 8 times higher in those with a sedimentation rate >15 mm and CRP >20 mg/L. The sensitivity of the fecal calprotectin is 68% to 100% and the specificity is 30% to 67% in determining the relapse for patients with clinical and endoscopic remission (6,11,12). The colonoscopy should be performed every 1 -2 years for surveillance against tumor development in patients having Crohn's colitis in 8-10 years after the diagnosis of the disease for the patients with complete colonic (13).…”

A prospective single‐centre evaluation of the intra‐individual variability of faecal calprotectin in quiescent Crohn's disease

“…Data support its use in differentiating irritable bowel syndrome (IBS) from inflammatory bowel disease (IBD), 1,[22][23][24][25] evaluating abdominal discomfort, 26 reducing the need for endoscopy in suspected IBD, 27 assessing treatment response in IBD, 14,15,[28][29][30] predicting relapse in IBD 7,8,[10][11][12][13] and predicting mucosal healing in IBD. 3,6,30,31 Indeed at our own institution, the monthly FC workload has increased from 50 samples a month in January 2007 to over 1000 per month in August 2012.…”

“…Studies investigating CD relapse rates have reported that FC concentration may be a less reliable predictor of relapse in ileal CD. 11,12 We included 15 patients of this subtype in our analysis. When analysed separately we discovered that both consistency and case reliability were lower for these patients than for the whole study group.…”

“…FC has been shown to have a homogenous distribution in human faeces, 5 supporting the notion that accurate analyses can be undertaken on a spot stool sample. It has been proposed that it may even be useful to predict mucosal healing at levels below threshold (50 μg/ g), 6 to potentially predict the risk of clinical relapse [7][8][9][10][11][12][13] or to monitor response to biological therapies. 14 However, these possibilities rely on the premise that levels of FC do not vary significantly from day to day in individual patients with CD.…”