title: Rapid fecal calprotectin level assessment and the SIBDQ score can accurately detect active mucosal inflammation in IBD patients in clinical remission: a prospective study.
abstract: OBJECTIVE
  Mucosal healing is an important predictor of disease-related outcome in patients with inflammatory bowel disease (IBD) patients, including those in clinical remission. However, colonoscopy is an invasive procedure and many patients decline repeated endoscopic examinations. We aimed to assess whether noninvasive biomarkers could accurately detect endoscopic mucosal inflammatory activity in IBD patients in clinical remission.
  
  
  METHODS
  We conducted a prospective observational cohort study on IBD patients in clinical remission at Colentina Hospital, Bucharest. Clinical activity was assessed using the Mayo score and Crohn's Disease Activity Index (CDAI), quality of life was assessed using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Serum C-reactive protein (CRP) and fecal calprotectin (FC) levels were determined. All patients underwent ileo-colonoscopy to assess mucosal inflammatory activity.
  
  
  RESULTS
  48 patients were included in this study, with 67% showing endoscopic disease activity. SIBD questionnaire and FC performed well as noninvasive markers of intestinal inflammation (AUROC 0.78 and 0.77, respectively), while CRP could not accurately predict endoscopic disease activity. Fecal calprotectin levels > 30 µg/g showed a 93% sensitivity and a 50% specificity for detecting inflammatory changes of the mucosa while a combined test using FC > 30µg/g and a SIBDQ score < 6 achieved 81.2% sensitivity and 75% specificity, respectively, in detecting active endoscopic disease.
  
  
  CONCLUSIONS
  Fecal calprotectin and SIBDQ have good diagnostic accuracy in detecting mucosal inflammatory changes in IBD patients in clinical remission. Combining simple, noninvasive tests such as the SIBDQ and FC levels appears to be a practical method for monitoring disease activity in these patients, possibly reducing the need for repeat endoscopic examinations.
authors.affiliation: Colentina Clinical Hospital; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. theodor.voiosu@gmail.com.
authors.forename: Theodor
authors.initials: T
authors.lastname: Voiosu
authors.affiliation: Colentina Clinical Hospital,Bucharest, Romania.
authors.forename: Andreea
authors.initials: A
authors.lastname: Benguş
authors.affiliation: Colentina Clinical Hospital, Bucharest, Romania.
authors.forename: Roxana
authors.initials: R
authors.lastname: Dinu
authors.affiliation: Colentina Clinical Hospital; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Andrei M
authors.initials: AM
authors.lastname: Voiosu
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Paul
authors.initials: P
authors.lastname: Bălănescu
authors.affiliation: Colentina Clinical Hospital; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Cristian
authors.initials: C
authors.lastname: Băicuş
authors.affiliation: Carol Davila University of Medicine and Pharmacy; Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Mircea
authors.initials: M
authors.lastname: Diculescu
authors.affiliation: Carol Davila University of Medicine and Pharmacy,Bucharest, Romania.
authors.forename: Radu
authors.initials: R
authors.lastname: Voiosu
authors.affiliation: Colentina Clinical Hospital; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Mateescu
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019540:Area Under Curve; D015415:Biomarkers / Q000378:metabolism; D003106:Colon / Q000187:drug effects / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D003113:Colonoscopy; D005243:Feces / Q000737:chemistry*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007082:Ileum / Q000187:drug effects / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D018836:Inflammation Mediators / Q000378:metabolism*; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000523:psychology; D007413:Intestinal Mucosa / Q000187:drug effects / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012372:ROC Curve; D012074:Remission Induction; D012383:Romania; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D005765:Gastrointestinal Agents; D018836:Inflammation Mediators; D039841:Leukocyte L1 Antigen Complex