title: Prediction of Crohn's disease relapse with faecal calprotectin in infliximab responders: a prospective study.
abstract: BACKGROUND
  Faecal calprotectin is a reliable tool for predicting Crohn's disease (CD) relapse in patients with sustained remission. Prediction of relapse with faecal calprotectin has been less studied in patients with severe CD treated with anti-TNF.
  
  
  OBJECTIVE
  To identify an association between faecal calprotectin concentration and CD clinical relapse in patients achieving remission with infliximab (IFX).
  
  
  METHODS
  From February 2007 to October 2008, consecutive patients with refractory luminal CD were prospectively included when they received three IFX infusions (5mg/kg at weeks 0, 2 and 6) followed by maintenance with an immunomodulator alone. Faecal calprotectin and C-reactive protein (CRP) were measured at entry and at week 14 (w14).
  
  
  RESULTS
  Sixty-five patients (43W; median age: 30.4years) were included, and 50 (77%) were in clinical remission off steroids at w14; twenty-three of fifty (46%) experienced CD clinical relapse during the first year of follow-up. Median faecal calprotectin level at w14 was similar in patients with and without CD clinical relapse (200 and 150μg/g respectively). When considering two suggested faecal calprotectin cut-offs to predict CD relapse, sensitivities and specificities were 61% and 48% for 130μg/g, respectively, and 43% and 57% for 250μg/g. Neither faecal calprotectin nor CRP at baseline and at w14 could predict relapse even when CD location subgroup analysis was considered.
  
  
  CONCLUSIONS
  In patients responding to an infliximab induction regimen, faecal calprotectin measurement at w14 cannot predict Crohn's disease clinical relapse at 1year.
authors.affiliation: CHU Bordeaux, Gastroenterology Department, Haut-Lévêque Hospital, Pessac, France. david.laharie@chu-bordeaux.fr
authors.forename: D
authors.initials: D
authors.lastname: Laharie
authors.forename: S
authors.initials: S
authors.lastname: Mesli
authors.forename: F
authors.initials: F
authors.lastname: El Hajbi
authors.forename: E
authors.initials: E
authors.lastname: Chabrun
authors.forename: E
authors.initials: E
authors.lastname: Chanteloup
authors.forename: M
authors.initials: M
authors.lastname: Capdepont
authors.forename: S
authors.initials: S
authors.lastname: Razaire
authors.forename: V
authors.initials: V
authors.lastname: de Lédinghen
authors.forename: F
authors.initials: F
authors.lastname: Zerbib
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D003424:Crohn Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D005243:Feces / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012044:Regression Analysis; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; D005765:Gastrointestinal Agents; D039841:Leukocyte L1 Antigen Complex; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab