Association of Faecal Calprotectin Level and Combined Endoscopic and Radiological Healing in Patients With Crohn's Disease Receiving Anti-tumour Necrosis Factor Therapy.
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.
['Noh|Soo Min|SM|', 'Oh|Eun Hye|EH|', 'Park|Seong Ho|SH|', 'Lee|Jung Bok|JB|', 'Kim|Jin Yong|JY|', 'Park|Jae Cheol|JC|', 'Kim|Jeongseok|J|', 'Ham|Nam Seok|NS|', 'Hwang|Sung Wook|SW|', 'Park|Sang Hyoung|SH|', 'Yang|Dong-Hoon|DH|', 'Byeon|Jeong-Sik|JS|', 'Myung|Seung-Jae|SJ|', 'Yang|Suk-Kyun|SK|', 'Ye|Beyong Duk|BD|']
D000068879:Adalimumab D000328:Adult D015415:Biomarkers D002097:C-Reactive Protein D003424:Crohn Disease D016145:Endoscopy, Digestive System D005243:Feces D005260:Female D006801:Humans D000069285:Infliximab D039841:Leukocyte L1 Antigen Complex D008297:Male D017063:Outcome Assessment, Health Care D011237:Predictive Value of Tests D012372:ROC Curve D011859:Radiography D012008:Recurrence D056910:Republic of Korea D012709:Serum Albumin D000079424:Tumor Necrosis Factor Inhibitors
faecal calprotectin Crohn’s disease disease monitoring