Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation

Waugh, Norman; Cummins, Eoin P.; Royle, Pamela; Kandala, Ngianga‐Bakwin; Shyangdan, D; Arasaradnam, Ramesh P.; Clar, Christine; Johnston, Rich D.

doi:10.3310/hta17550

Cited by 236 publications

(238 citation statements)

References 205 publications

(239 reference statements)

Supporting

Mentioning

209

Contrasting

Unclassified

Order By: Relevance

“…Calprotectin is the most used marker and has excellent diagnostic performance. In a meta-analysis the area under the receiver operating characteristic (ROC) curve was 0.97, with an optimal cut-off value of 50 mcg/g that yielded 93% sensitivity and 94% specificity in discriminating IBD from IBS [22] . Further on, calprotectin levels correlate very well with endoscopic activity [23][24][25][26][27] , predict occurrence of a flare [28] and are capable of predicting response to treatment [27,[29][30][31] .…”

Section: How Do I Know That Ibd Is In Remission?mentioning

confidence: 99%

“…It is therefore widely used in clinical practice. CRP is however an unspecific acute phase reactant, and up to 25% of patients with inflammatory activity will have normal levels [19,20] ; and (4) Determination of fecal markers of neutrophilic activity in intestinal mucosa is a simple tool that reliably predicts the presence of significant mucosal inflammation [21,22] . Calprotectin is the most used marker and has excellent diagnostic performance.…”

Section: How Do I Know That Ibd Is In Remission?mentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

Teruel

Garrido

Mesonero

2016

WJGPT

View full text Add to dashboard Cite

it in the present work. We describe a problematic that comprises physiopathological uncertainties, diagnostic difficulties, as IBS-like symptoms are very similar to those produced by an inflammatory flare, and the necessity of appropriate management of these patients, who, although in remission, have impaired quality of life. Ultimately, from almost a philosophical point of view, the presence of IBS-like symptoms in IBD patients in remission supposes a challenge to the traditional functional-organic dichotomy, suggesting the need for a change of paradigm. Core tip: Many inflammatory bowel disease patients in remission suffer from ongoing gastrointestinal symptoms that resemble those of irritable bowel syndrome and that hinder their quality of life. We review the pathogenesis of these symptoms, their prevalence and the best management strategies. Author contributions: All authors contributed equally to this work. Conflict-of-interest statement:The authors declare no conflicts of interest. AbstractInflammatory bowel disease (IBD) patients in remission may suffer from gastrointestinal symptoms that resemble irritable bowel syndrome (IBS). Knowledge on this issue has increased considerably in the last decade, and it is our intention to review and summarize REVIEWSubmit a

show abstract

Section: How Do I Know That Ibd Is In Remission?mentioning

confidence: 99%

Section: How Do I Know That Ibd Is In Remission?mentioning

confidence: 99%

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

Teruel

Garrido

Mesonero

2016

WJGPT

View full text Add to dashboard Cite

show abstract

“…It can be measured by laboratory tests, including the more recent point-of-care testing (POCT) [19]. This interesting characteristic of its stable distribution in feces reflects the need to examine only one sample of stool [20].…”

Section: Biomarkers Of Etiology/pathogenesismentioning

confidence: 99%

“…A systematic review by Waugh, et al concluded that FC can be used to differentiate between IBD and IBS at a cut-off level of 50 µg/g in both adults and children with sensitivities of 83-100% and specificities of 60-100% in adults and sensitivities of 95-100% and specificities of 44-93% in children [19].…”

Section: Biomarkers Of Etiology/pathogenesismentioning

confidence: 99%

Bio-Markers of Inflammatory Bowel Disease: Past, Present, and Future

Bahgat¹

2017

Austin J Gastroenterol

View full text Add to dashboard Cite

Ulcerative colitis (UC) and Crohn's disease (CD) exemplify the two main arms of the spectrum of an idiopathic chronic disease known as inflammatory bowel disease (IBD). To date, this disease remained a puzzling dilemma in many aspects; including difficulties in its etiology/pathogenesis, diagnosis, severity assessment, treatment and outcomes/complications. Physicians usually get the diagnosis of IBD through a combination of clinical features, laboratory tests, radiology, as well as the invasive technique of endoscopy/biopsy. In spite of these efforts, the definite diagnosis can't be established in a significant cohort of cases. This paved the way to searching for laboratory biomarkers that are noninvasive, reproducible, rapid and relatively cheap than other modalities. Unfortunately, we're still far from these ideal biomarkers. Some biomarkers are already being used in daily practice including C-reactive protein (CRP) and fecal calprotectin while others are still in need for confirmation before being applied in clinical practice. In this review article, the authors are going to discuss the past, present, and future utility of biomarkers in IBD. This article aims at highlighting the uses and limitations of all possible current and novel biomarkers in every aspect of the disease from predisposition to prognosis.

show abstract

“…The use of faecal calprotectin (FC) as a non-invasive biomarker in the initial screening, and monitoring of patients with suspected or known inflammatory bowel disease (IBD) has come to the fore in recent years [4] . It is of particular use in the distinction between inflammatory GI conditions such as IBD, from non-organic conditions such as irritable bowel syndrome (IBS) [5] .…”

Section: Introductionmentioning

confidence: 99%

Is NICE too Optimistic about Savings from Normal Faecal Calprotectin Results?

McFarlane

Chambers

Malik

et al. 2016

Journal of Gastroenterology and Hepatology Research

View full text Add to dashboard Cite

BACKGROUND:A recent systematic review confirmed the utility of faecal calprotectin (FC) in distinguishing organic (inflammatory bowel disease) from non-organic gastrointestinal disease (irritable bowel syndrome). FC levels <50 mcg/g have a negative predictive value >92% to exclude organic GI disease. Levels >250mcg/g correlate with endoscopic IBD disease activity; sensitivity 90%. This study aimed to determine clinical outcomes in those with a normal FC result. A retrospective study of FC testing in primary and secondary care. RESULTS:A new IBD diagnosis was made in only 1% of patients with a normal FC result. Conversely, a new IBS diagnosis was made in a further 40% of normal FC results referred to secondary care. Despite a normal FC and referral guidance, 40% of patients were still referred to secondary care. CONCLUSIONS: Normal FC testing remains a useful test in excluding organic GI conditions, although 40% were still referred to secondary care despite a normal FC.. Despite a normal FC, 6% still remained in secondary care at 12 monthswithout a new diagnosis.

show abstract

Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation

Cited by 236 publications

References 205 publications

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

Bio-Markers of Inflammatory Bowel Disease: Past, Present, and Future

Is NICE too Optimistic about Savings from Normal Faecal Calprotectin Results?

Contact Info

Product

Resources

About