title: How to predict clinical relapse in inflammatory bowel disease patients.
abstract: Inflammatory bowel diseases have a natural course characterized by alternating periods of remission and relapse. Disease flares occur in a random way and are currently unpredictable for the most part. Predictors of benign or unfavourable clinical course are required to facilitate treatment decisions and to avoid overtreatment. The present article provides a literature review of the current evidence on the main clinical, genetic, endoscopic, histologic, serologic and fecal markers to predict aggressiveness of inflammatory bowel disease and discuss their prognostic role, both in Crohn's disease and ulcerative colitis. No single marker seems to be reliable alone as a flare predictor, even in light of promising evidence regarding the role of fecal markers, in particular fecal calprotectin, which has reported good results recently. In order to improve our daily clinical practice, validated prognostic scores should be elaborated, integrating clinical and biological markers of prognosis. Finally, we propose an algorithm considering clinical history and biological markers to intercept patients with high risk of clinical relapse.
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Matteo Bellanova, Andrea Belluzzi, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Liverani
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Matteo Bellanova, Andrea Belluzzi, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Scaioli
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Matteo Bellanova, Andrea Belluzzi, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
authors.forename: Richard John
authors.initials: RJ
authors.lastname: Digby
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Matteo Bellanova, Andrea Belluzzi, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bellanova
authors.affiliation: Elisa Liverani, Eleonora Scaioli, Matteo Bellanova, Andrea Belluzzi, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Belluzzi
mesh_terms: D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003424:Crohn Disease / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003661:Decision Support Techniques; D016099:Endoscopy, Gastrointestinal; D005820:Genetic Testing; D006801:Humans; D011237:Predictive Value of Tests; D012008:Recurrence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: Clinical predictors; Clinical relapse; Crohn’s disease; Fecal calprotectin; Ulcerative colitis
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