Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease.
OBJECTIVE
The clinical course of inflammatory bowel disease is characterised by a succession of relapses and remissions. The aim of our study was to assess whether the predictive value of faecal calprotectin-a non-invasive marker of intestinal inflammation-for clinical relapse is different in ulcerative colitis (UC) and Crohn's disease (CD).


METHODS
Seventy nine consecutive patients with a diagnosis of clinically quiescent inflammatory bowel disease (38 CD and 41 UC) were followed for 12 months, undergoing regular clinical evaluations and blood tests. A single stool sample was collected at the beginning of the study from each patient and the calprotectin concentration was assessed by a commercially available enzyme linked immunoassay.


RESULTS
In CD, median calprotectin values were 220.1 mug/g (95% confidence interval (CI) 21.7-418.5) in those patients who relapsed during follow up, and 220.5 mug/g (95% CI 53-388) in non-relapsing patients (p=0.395). In UC, median calprotectin values were 220.6 mug/g (95% CI 86-355.2) and 67 microg/g (95% CI 15-119) in relapsing and non-relapsing patients, respectively (p<0.0001). The multivariate Cox (proportional hazard) regression model, after adjustment for possible confounding variables, showed a twofold and 14-fold increase in the relapse risk, respectively, in those patients with CD and UC in clinical remission who had a faecal calprotectin concentration higher than 150 microg/g.


CONCLUSIONS
Faecal calprotectin proved to be an even stronger predictor of clinical relapse in UC than in CD, which makes the test a promising non-invasive tool for monitoring and optimising therapy.
Costa
F
F
Department of Internal Medicine, Section of Gastroenterology, University of Pisa, Pisa, Italy. fcosta@int.med.unipi.it
Mumolo
M G
MG
Ceccarelli
L
L
Bellini
M
M
Romano
M R
MR
Sterpi
C
C
Ricchiuti
A
A
Marchi
S
S
Bottai
M
M
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000378:metabolism; D003424:Crohn Disease / Q000175:diagnosis* / Q000378:metabolism; D004812:Epidemiologic Methods; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex