title: Fast and sharp decrease in calprotectin predicts remission by infliximab in anti-TNF naïve patients with ulcerative colitis.
abstract: OBJECTIVE
  To evaluate the effect of infliximab induction therapy on calprotectin levels in patients with ulcerative colitis (UC).
  
  
  METHODS
  In this prospective study 53 patients with active UC from 17 centers were treated with infliximab therapy (5 mg/kg) at baseline, week 2, and week 6. Faecal calprotectin was measured every week. Sigmoidoscopies were performed at baseline, week 6 and week 10.
  
  
  RESULTS
  Median calprotectin levels decreased from 1260 (IQR 278.5- 3418) at baseline to 72.5 (IQR 18.5 - 463) at week 10 (p<0.001). After 10 weeks, infliximab therapy induced endoscopic remission and a decrease in calprotectin to<50 mg/kg or at least a 80% decrease from baseline level in 58% of patients. A significant and steep decrease of calprotectin levels was seen at week 2 for patients with an endoscopic remission at week 10 as compared to patients who did not show a remission. (p<0.001). At week 10 an excellent correlation was found between endoscopic remission and clinical Mayo score reflected by an AUC of ROC analyses of 0.94 (0.87-1) and with calprotectin measurements (AUC 0.91 (0.81-1)) : all patients with calprotectin levels <50 mg/kg, and a normal clinical Mayo score (=0) were in endoscopic remission.
  
  
  CONCLUSIONS
  Infliximab induces a fast and significant decrease of faecal calprotectin levels in anti-TNF naïve patients with ulcerative colitis predictive for remission of disease.
authors.affiliation: Ghent University Hospital, Gent, Belgium. martine.devos@ugent.be
authors.forename: M
authors.initials: M
authors.lastname: De Vos
authors.forename: O
authors.initials: O
authors.lastname: Dewit
authors.forename: G
authors.initials: G
authors.lastname: D'Haens
authors.forename: F
authors.initials: F
authors.lastname: Baert
authors.forename: F
authors.initials: F
authors.lastname: Fontaine
authors.forename: S
authors.initials: S
authors.lastname: Vermeire
authors.forename: D
authors.initials: D
authors.lastname: Franchimont
authors.forename: T
authors.initials: T
authors.lastname: Moreels
authors.forename: D
authors.initials: D
authors.lastname: Staessen
authors.forename: L
authors.initials: L
authors.lastname: Terriere
authors.forename: B
authors.initials: B
authors.lastname: Vander Cruyssen
authors.forename: E
authors.initials: E
authors.lastname: Louis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005243:Feces / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D000069285:Infliximab; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D012812:Sigmoidoscopy; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab