Association of Fecal Calprotectin Level and Combined Endoscopic and Radiologic Healing in Patients with Crohn’s Disease Receiving Anti-tumor Necrosis Factor Therapy
- Authors
- Noh, Soo Min; Oh, Eun Hye; Park, Seong Ho; Lee, Jung Bok; Kim, Jin Yong; Park, Jae Cheol; Kim, Jeongseok; Ham, Nam Seok; Hwang, Sung Wook; Park, Sang Hyoung; Yang, Dong-Hoon; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun; Ye, Beyong Duk
- Issue Date
- Sep-2020
- Publisher
- OXFORD UNIV PRESS
- Keywords
- Crohn' s disease; faecal calprotectin; disease monitoring
- Citation
- JOURNAL OF CROHNS & COLITIS, v.14, no.9, pp.1231 - 1240
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CROHNS & COLITIS
- Volume
- 14
- Number
- 9
- Start Page
- 1231
- End Page
- 1240
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/191880
- DOI
- 10.1093/ecco-jcc/jjaa042
- ISSN
- 1873-9946
- Abstract
- Background and Aims: Combined endoscopic and radiological healing, or deep healing, is associated with favourable outcomes in patients with Crohn's disease; thus, a non-invasive biomarker for predicting deep healing would be invaluable. We evaluated the usefulness of faecal calprotectin for predicting deep healing in patients with Crohn's disease receiving anti-tumour necrosis factor [TNF] therapy.
Methods: We analysed the records of patients with Crohn's disease who received anti-tumour necrosis factor therapy and underwent endoscopic evaluation, radiological evaluation, and faecal calprotectin measurement within a period of 3 months between August 2017 and November 2018. Results of endoscopic and radiological studies were independently reviewed by two gastrointestinal endoscopists and a gastrointestinal radiologist, respectively. Serum C-reactive protein and albumin were also measured.
Results: Out of 268 patients analysed, 77 [28.7%] had deep healing, 36 [13.4%] had endoscopic healing only, 36 [13.4%] had radiological healing only, and 119 [44.4%] had neither. The median duration of anti-TNF treatment was 40.0 months. The deep healing group had the lowest median faecal calprotectin level [56.5 mg/kg] among the four groups [p < 0.001]. The faecal calprotectin cutoff level of 81.1 mg/kg showed a sensitivity of 0.623 and a specificity of 0.817 in predicting deep healing (area under the receiver operating characteristic curve [AUROC], 0.767; 95% confidence interval, 0.702-0.832). Adding serum C-reactive protein and serum albumin to faecal calprotectin further increased the AUROC to 0.805 [95% confidence interval, 0.752-0.858].
Conclusions: Faecal calprotectin, when combined with serum C-reactive protein and albumin, showed acceptable performance in predicting deep healing in patients with Crohn's disease.
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