Faecal calprotectin predicts endoscopic and histological activity in clinically quiescent ulcerative colitis

Lara Hart, Mallory Chavannes, Omar Kherad, Chelsea Maedler, Nathalie Mourad, Victoria Marcus, Waqqas Afif, Alain Bitton, Peter L. Lakatos, Paul Brassard, Talat Bessissow

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Abstract

Introduction: Faecal calprotectin [FC] is a reliable surrogate marker for disease activity in ulcerative colitis [UC]; however, there are no consensus cut-off values for remission. The study aim was to correlate FC with Mayo Endoscopic Score [MES] and histological disease activity of UC patients in clinical remission. Methods: Our study recruited adult UC patients at the McGill IBD Center between 2013 and 2017. Patients in clinical remission [partial Mayo score ≤2], undergoing endoscopy for disease activity or dysplasia surveillance, were enrolled. Before bowel preparation, FC was collected. MES was documented during colonoscopy. Biopsies were taken; histological activity was assessed using Geboes score and the presence of basal plasmacytosis. Results: A total of 185 patients were recruited. The area under the curve [AUC] in receiver operating characteristic [ROC] analysis to predict MES 1-3 [from 0] was 0.743 [95% CI 0.67-0.82; p <0.001] with an FC cut-off value 170 μg/g [64% sensitivity, 74% specificity], and to predict MES 2-3 [from 0-1] was 0.722 [95% CI 0.61-0.83; p <0.001] with an FC cut-off value 170 μg/g [69% sensitivity, 65% specificity]. To differentiate MES 0 from MES 1, an FC value 130 μg/g yields a 70% sensitivity and 68% specificity. The AUC in ROC analysis to predict Geboes <3.1 was 0.627 [95% CI 0.55-0.71; p = 0.003], with an FC value 135 μg/g [54% sensitivity, 69% specificity]. Conclusions: In this large study, FC ≥170 μg/g predicts endoscopic activity and FC ≥135 μg/g predicts histological activity. Therefore in clinical practice, lower faecal calprotectin thresholds can be chosen to optimise identification of patients with ongoing endoscopic and histological disease activity.

Original languageEnglish
Pages (from-to)46-52
Number of pages7
JournalJournal of Crohn's and Colitis
Volume14
Issue number1
DOIs
Publication statusPublished - Jan 1 2020

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Keywords

  • Faecal calprotectin
  • endoscopic healing
  • histological remission
  • ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Hart, L., Chavannes, M., Kherad, O., Maedler, C., Mourad, N., Marcus, V., Afif, W., Bitton, A., Lakatos, P. L., Brassard, P., & Bessissow, T. (2020). Faecal calprotectin predicts endoscopic and histological activity in clinically quiescent ulcerative colitis. Journal of Crohn's and Colitis, 14(1), 46-52. https://doi.org/10.1093/ecco-jcc/jjz107