Prediction of Endoscopic Disease Activity in Ulcerative Colitis by Two Different Assays for Fecal Calprotectin

Kristensen, Vendel; Klepp, Pasquale; Cvancarova, Milada; Røseth, Arne; Skar, Viggo; Moum, Bjørn

doi:10.1093/ecco-jcc/jju015

Cited by 50 publications

(40 citation statements)

References 33 publications

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“…Variability in the cut‐off level is due to the use of different test kits and different study populations . FCP levels may also be elevated because of a few unspecific reasons.…”

Section: Discussionmentioning

confidence: 99%

Optimal cut‐off value of fecal calprotectin for the evaluation of ulcerative colitis: An unsolved issue?

et al. 2018

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IntroductionThere is variability in the fecal calprotectin (FCP) cut‐off level for the prediction of ulcerative colitis (UC) disease activity and differentiation from irritable bowel disease (IBS‐D). The FCP cut‐off levels vary from country to country.AimsWe aimed to assess FCP as a marker of disease activity in patients with UC. We determined the optimal FCP cut‐off value for differentiating UC and IBS‐D.MethodsIn a prospective study, we enrolled 76 UC and 30 IBS‐D patients. We studied the correlation of FCP with disease activity/extent as well as its role in differentiating UC from IBS‐D. We also reviewed literature regarding the optimal FCP cut‐off level for the prediction of disease activity and differentiation from IBS‐D patients.ResultsSensitivity, specificity, positive predictive value, and negative predictive value of FCP (cut‐off level, 158 μg/g) for the prediction of complete mucosal healing (using Mayo endoscopic subscore) were 90, 85, 94.7, and 73.3%, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value of FCP (cut‐off level, 425 μg/g) for the prediction of inactive disease (Mayo Score ≤ 2) were 94.3, 88.7, 86.2, and 95.4%, respectively. We also found a FCP cut‐off value of 188 μg/g for the differentiation of UC from IBS‐D.ConclusionsThe study reveals the large quantitative differences in FCP cut‐off levels in different study populations. This study demonstrates a wide variation in FCP cut‐off levels in the initial diagnosis of UC as well as in follow‐up post‐treatment. Therefore, this test requires validation of the available test kits and finding of appropriate cut‐off levels for different study populations.

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“…Variability in the cut‐off level is due to the use of different test kits and different study populations . FCP levels may also be elevated because of a few unspecific reasons.…”

Section: Discussionmentioning

confidence: 99%

Optimal cut‐off value of fecal calprotectin for the evaluation of ulcerative colitis: An unsolved issue?

et al. 2018

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“…Since then, many studies have confirmed this pivotal observation, but the proposed cut‐off for identifying patients who are at increased risk of relapse differs between the studies . One explanation for these cut‐off differences are the pronounced inter‐assay differences . Another explanation is that cut‐offs are disease and phenotype specific, since differences in the concentrations of FC have been reported between subgroups of patients with IBD, that is, patients with ileal and colonic Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

The prognostic significance of faecal calprotectin in patients with inactive inflammatory bowel disease

Zhulina

Cao

Amcoff

et al. 2016

Aliment Pharmacol Ther

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“…CRP levels > 5 mg/L were defined as active inflammation [21]. FC levels > 100 μg/g stool were considered a relevant elevation [24]. Vitamin D deficiency was considered with 25-OH-D3 values < 50 nmol/L [25,26].…”

Section: Assessmentsmentioning

confidence: 99%

High Prevalence of Vitamin D Deficiency among Patients with Inflammatory Bowel Disease

et al. 2017

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Background: Vitamin D is a hormone with immunomodulatory properties. Vitamin D deficiency has been reported for patients with inflammatory bowel disease (IBD). In this cross-sectional study, 25-hydroxyvitamin D3 (25-OH-D3) levels in patients with IBD were compared to those in patients with irritable bowel syndrome (IBS). Methods: A total of 181 patients, 156 with IBD and 25 with IBS, were included. The influence of disease activity, inflammatory markers, physical activity, and season were assessed. Results: A total of 58.6% (n = 58) of the patients with Crohn’s disease (CD) and 44.6% (n = 25) of the patients with ulcerative colitis (UC) had a 25-OH-D3 level < 50 nmol/L. CD patients showed significantly decreased 25-OH-D3 levels compared to the IBS patients (p = 0.018), but no significant difference was found for UC patients. In a linear regression model adjusted for age, gender, and BMI, a significant inverse association of C-reactive protein (CRP) (p = 0.031) and faecal calprotectin (FC) (p = 0.025) with 25-OH-D3 levels was observed for CD patients. Seasonal variation in 25-OH-D3 levels was found in CD patients, with significantly lower values in spring than in summer (p = 0.04). Conclusion: Vitamin D deficiency was common in all IBD patients, but more pronounced in CD patients, in whom it also showed a significant inverse association with inflammatory markers such as CRP and FC.

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Prediction of Endoscopic Disease Activity in Ulcerative Colitis by Two Different Assays for Fecal Calprotectin

Abstract: The study demonstrates the need for assay specific cut-off levels in clinical practice,as the f-calprotectin cut-off level for endoscopic disease activity differed in these two assays.

Cited by 50 publications

References 33 publications

Optimal cut‐off value of fecal calprotectin for the evaluation of ulcerative colitis: An unsolved issue?

Optimal cut‐off value of fecal calprotectin for the evaluation of ulcerative colitis: An unsolved issue?

The prognostic significance of faecal calprotectin in patients with inactive inflammatory bowel disease

High Prevalence of Vitamin D Deficiency among Patients with Inflammatory Bowel Disease

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