Crohn’s disease: elevated faecal calprotectin tied to disease progression

  • Kennedy NA & al.
  • Clin Gastroenterol Hepatol
  • 14 Feb 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Elevated faecal calprotectin (FC) is associated with an increased risk for disease progression over time in patients with Crohn’s disease (CD), independent of symptoms or disease location.

Why this matters

  • Measurements of faecal calprotectin during routine monitoring may identify patients at risk for disease progression. Therefore, screening of asymptomatic patients for mucosal inflammation and pursuing complete resolution of inflammation are important.

Study design

  • Retrospective study of 918 patients with CD (4218 patient-years of follow-up; median, 50.6 months) with 1 or more faecal calprotectin measurement made at ≥3 months following diagnosis.
  • Primary endpoint: composite of progression in Montreal behaviour, hospitalisation for flare, and resection.
  • Funding: Wellcome Trust.

Results

  • Elevated faecal calprotectin level at index visit was associated with increased risk for subsequent progression of CD, independent of symptoms or disease location (HR, 1.79; P= 1.9×10-10).
  • Median faecal calprotectin level at the index visit was high in patients who reached the composite endpoint vs those who did not (432 μg/g; interquartile range [IQR], 136-998 μg/g vs 180 μg/g; IQR, 50-665 μg/g; P=6.9×10-12).
  • After multivariable analysis, patients with a cutoff of 115 μg/g calprotectin were at increased risk for CD progression (HR, 2.4; P=7.2×10-10).

Limitations

  • Faecal calprotectin was not collected at fixed intervals.