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The prognostic significance of faecal calprotectin in patients with inactive inflammatory bowel disease
Univ Orebro, Dept Gastroenterol, Fac Med & Hlth, SE-70182 Orebro, Sweden..
Univ Orebro, Clin Epidemiol & Biostat, Sch Med Sci, Orebro, Sweden.;Karolinska Inst, Unit Biostat, Inst Environm Med, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Gastroenterology/Hepatology. Univ Orebro, Dept Gastroenterol, Fac Med & Hlth, SE-70182 Orebro, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Gastroenterology/Hepatology.
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2016 (English)In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 44, no 5, 495-504 p.Article in journal (Refereed) Published
Abstract [en]

BackgroundFaecal calprotectin, an established biomarker used to assess mucosal inflammation, has been shown to correlate with endoscopic activity in inflammatory bowel disease (IBD). Longitudinal monitoring of faecal calprotectin, however, has rarely been employed beyond assessment of therapy response and post hoc analyses of clinical trials. AimTo study whether consecutive measurements of faecal calprotectin every third month are useful for monitoring patients with IBD in clinical remission. MethodsPatients aged 18 years or older, with a known diagnosis of IBD in clinical remission, were prospectively studied. Patients provided faecal samples every third month and were prospectively followed until the first clinical relapse or the end of the 2-year follow-up period. Measurements (EK-CAL, Buhlmann Lab. AG, Switzerland) were done at the end of the study. A Cox model with time-dependent covariates was used for analysis. ResultsAmong 104 patients, Crohn's disease (n = 49) and ulcerative colitis (n = 55), 37 had a relapse. A doubling of faecal calprotectin level between two consecutively collected samples was associated with a 101% increased risk of relapse (HR: 2.01; 95% CI: 1.53-2.65; P < 0.001). The relative risk of relapse attenuated with time (HR: 0.80; 95% CI: 0.75-0.86; P < 0.001), by a 20% decrease in risk of relapse per 3-month period since the sample was obtained. ConclusionsBy consecutively measuring faecal calprotectin every third month, we quantified the risk of relapse related to faecal calprotectin change and observed attenuation of the risk across time. Our data suggest that longitudinal monitoring of faecal calprotectin is informative in predicting relapse in IBD.

Place, publisher, year, edition, pages
2016. Vol. 44, no 5, 495-504 p.
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Gastroenterology and Hepatology
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URN: urn:nbn:se:uu:diva-303016DOI: 10.1111/apt.13731ISI: 000380921300007PubMedID: 27402063OAI: oai:DiVA.org:uu-303016DiVA: diva2:970794
Funder
Swedish Foundation for Strategic Research , RB13-0160Swedish Research Council, 521-2011-2764
Available from: 2016-09-14 Created: 2016-09-14 Last updated: 2016-09-14Bibliographically approved

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Amcoff, KarinCarlson, Marie
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