Raised faecal calprotectin is associated with subsequent symptomatic relapse, in children and adolescents with inflammatory bowel disease in clinical remission

K. Diederen, D. R. Hoekman, A. Leek, V. M. Wolters, T. Z. Hummel, T. G. de Meij, B. G.P. Koot, M. M. Tabbers, M. A. Benninga, A. Kindermann

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Reliable data on inflammatory biomarkers for predicting relapse of paediatric inflammatory bowel disease (IBD) are lacking. Aim: To investigate the predictive value of faecal calprotectin (FC) and CRP for symptomatic relapse in pediatric IBD in clinical remission. Methods: In this cross-sectional cohort study, patients <18 years with Crohn’s disease or ulcerative colitis in clinical remission ≥3 months were included. At baseline, clinical and biochemical disease activity were assessed using the abbreviated-Pediatric Crohn’s Disease Activity Index or Pediatric Ulcerative Colitis Activity Index, and FC and CRP respectively. Disease course over the subsequent 12 months was retrospectively assessed. Results: In total, 114 patients (56% males; median age 14.9 years) were included. Baseline FC was higher in patients that developed symptomatic relapse [median (IQR), relapse 370 μg/g (86–1100) vs. remission 122 μg/g (40–344), P = 0.003]. Baseline FC was predictive of symptomatic relapse within 6 months [HR per 250 μg/g (95% CI): 1.46 (1.21–1.77), P < 0.001], with good predictive accuracy (AUC: 0.82). Optimal FC cut-off was 350 μg/g, with positive and negative predictive value of 41% and 96%. Baseline CRP was higher in patients that developed symptomatic relapse [median (IQR), relapse 1.0 μg/g (0.6–5.0) vs. remission 1.0 μg/g (0.4–2.0), P = 0.033]. Baseline CRP was predictive of symptomatic relapse within 6 months from baseline [HR per 1 mg/L (95% CI): 1.10 (1.02–1.19), P = 0.011], with fair predictive accuracy (AUC: 0.72). Optimal CRP cut-off was 1.0 mg/L, with positive and negative predictive value of 21% and 94%. Conclusions: Faecal calprotectin and CRP are predictive of symptomatic relapse and may be valuable in management of paediatric IBD in clinical remission.

Original languageEnglish
Pages (from-to)951-960
Number of pages10
JournalAlimentary Pharmacology and Therapeutics
Volume45
Issue number7
DOIs
Publication statusPublished - 1 Apr 2017

Cite this

@article{fac412f002f44f9fa778a1689867aa0d,
title = "Raised faecal calprotectin is associated with subsequent symptomatic relapse, in children and adolescents with inflammatory bowel disease in clinical remission",
abstract = "Background: Reliable data on inflammatory biomarkers for predicting relapse of paediatric inflammatory bowel disease (IBD) are lacking. Aim: To investigate the predictive value of faecal calprotectin (FC) and CRP for symptomatic relapse in pediatric IBD in clinical remission. Methods: In this cross-sectional cohort study, patients <18 years with Crohn’s disease or ulcerative colitis in clinical remission ≥3 months were included. At baseline, clinical and biochemical disease activity were assessed using the abbreviated-Pediatric Crohn’s Disease Activity Index or Pediatric Ulcerative Colitis Activity Index, and FC and CRP respectively. Disease course over the subsequent 12 months was retrospectively assessed. Results: In total, 114 patients (56{\%} males; median age 14.9 years) were included. Baseline FC was higher in patients that developed symptomatic relapse [median (IQR), relapse 370 μg/g (86–1100) vs. remission 122 μg/g (40–344), P = 0.003]. Baseline FC was predictive of symptomatic relapse within 6 months [HR per 250 μg/g (95{\%} CI): 1.46 (1.21–1.77), P < 0.001], with good predictive accuracy (AUC: 0.82). Optimal FC cut-off was 350 μg/g, with positive and negative predictive value of 41{\%} and 96{\%}. Baseline CRP was higher in patients that developed symptomatic relapse [median (IQR), relapse 1.0 μg/g (0.6–5.0) vs. remission 1.0 μg/g (0.4–2.0), P = 0.033]. Baseline CRP was predictive of symptomatic relapse within 6 months from baseline [HR per 1 mg/L (95{\%} CI): 1.10 (1.02–1.19), P = 0.011], with fair predictive accuracy (AUC: 0.72). Optimal CRP cut-off was 1.0 mg/L, with positive and negative predictive value of 21{\%} and 94{\%}. Conclusions: Faecal calprotectin and CRP are predictive of symptomatic relapse and may be valuable in management of paediatric IBD in clinical remission.",
author = "K. Diederen and Hoekman, {D. R.} and A. Leek and Wolters, {V. M.} and Hummel, {T. Z.} and {de Meij}, {T. G.} and Koot, {B. G.P.} and Tabbers, {M. M.} and Benninga, {M. A.} and A. Kindermann",
year = "2017",
month = "4",
day = "1",
doi = "10.1111/apt.13950",
language = "English",
volume = "45",
pages = "951--960",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
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Raised faecal calprotectin is associated with subsequent symptomatic relapse, in children and adolescents with inflammatory bowel disease in clinical remission. / Diederen, K.; Hoekman, D. R.; Leek, A.; Wolters, V. M.; Hummel, T. Z.; de Meij, T. G.; Koot, B. G.P.; Tabbers, M. M.; Benninga, M. A.; Kindermann, A.

In: Alimentary Pharmacology and Therapeutics, Vol. 45, No. 7, 01.04.2017, p. 951-960.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Raised faecal calprotectin is associated with subsequent symptomatic relapse, in children and adolescents with inflammatory bowel disease in clinical remission

AU - Diederen, K.

AU - Hoekman, D. R.

AU - Leek, A.

AU - Wolters, V. M.

AU - Hummel, T. Z.

AU - de Meij, T. G.

AU - Koot, B. G.P.

AU - Tabbers, M. M.

AU - Benninga, M. A.

AU - Kindermann, A.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background: Reliable data on inflammatory biomarkers for predicting relapse of paediatric inflammatory bowel disease (IBD) are lacking. Aim: To investigate the predictive value of faecal calprotectin (FC) and CRP for symptomatic relapse in pediatric IBD in clinical remission. Methods: In this cross-sectional cohort study, patients <18 years with Crohn’s disease or ulcerative colitis in clinical remission ≥3 months were included. At baseline, clinical and biochemical disease activity were assessed using the abbreviated-Pediatric Crohn’s Disease Activity Index or Pediatric Ulcerative Colitis Activity Index, and FC and CRP respectively. Disease course over the subsequent 12 months was retrospectively assessed. Results: In total, 114 patients (56% males; median age 14.9 years) were included. Baseline FC was higher in patients that developed symptomatic relapse [median (IQR), relapse 370 μg/g (86–1100) vs. remission 122 μg/g (40–344), P = 0.003]. Baseline FC was predictive of symptomatic relapse within 6 months [HR per 250 μg/g (95% CI): 1.46 (1.21–1.77), P < 0.001], with good predictive accuracy (AUC: 0.82). Optimal FC cut-off was 350 μg/g, with positive and negative predictive value of 41% and 96%. Baseline CRP was higher in patients that developed symptomatic relapse [median (IQR), relapse 1.0 μg/g (0.6–5.0) vs. remission 1.0 μg/g (0.4–2.0), P = 0.033]. Baseline CRP was predictive of symptomatic relapse within 6 months from baseline [HR per 1 mg/L (95% CI): 1.10 (1.02–1.19), P = 0.011], with fair predictive accuracy (AUC: 0.72). Optimal CRP cut-off was 1.0 mg/L, with positive and negative predictive value of 21% and 94%. Conclusions: Faecal calprotectin and CRP are predictive of symptomatic relapse and may be valuable in management of paediatric IBD in clinical remission.

AB - Background: Reliable data on inflammatory biomarkers for predicting relapse of paediatric inflammatory bowel disease (IBD) are lacking. Aim: To investigate the predictive value of faecal calprotectin (FC) and CRP for symptomatic relapse in pediatric IBD in clinical remission. Methods: In this cross-sectional cohort study, patients <18 years with Crohn’s disease or ulcerative colitis in clinical remission ≥3 months were included. At baseline, clinical and biochemical disease activity were assessed using the abbreviated-Pediatric Crohn’s Disease Activity Index or Pediatric Ulcerative Colitis Activity Index, and FC and CRP respectively. Disease course over the subsequent 12 months was retrospectively assessed. Results: In total, 114 patients (56% males; median age 14.9 years) were included. Baseline FC was higher in patients that developed symptomatic relapse [median (IQR), relapse 370 μg/g (86–1100) vs. remission 122 μg/g (40–344), P = 0.003]. Baseline FC was predictive of symptomatic relapse within 6 months [HR per 250 μg/g (95% CI): 1.46 (1.21–1.77), P < 0.001], with good predictive accuracy (AUC: 0.82). Optimal FC cut-off was 350 μg/g, with positive and negative predictive value of 41% and 96%. Baseline CRP was higher in patients that developed symptomatic relapse [median (IQR), relapse 1.0 μg/g (0.6–5.0) vs. remission 1.0 μg/g (0.4–2.0), P = 0.033]. Baseline CRP was predictive of symptomatic relapse within 6 months from baseline [HR per 1 mg/L (95% CI): 1.10 (1.02–1.19), P = 0.011], with fair predictive accuracy (AUC: 0.72). Optimal CRP cut-off was 1.0 mg/L, with positive and negative predictive value of 21% and 94%. Conclusions: Faecal calprotectin and CRP are predictive of symptomatic relapse and may be valuable in management of paediatric IBD in clinical remission.

UR - http://www.scopus.com/inward/record.url?scp=85011298851&partnerID=8YFLogxK

U2 - 10.1111/apt.13950

DO - 10.1111/apt.13950

M3 - Article

VL - 45

SP - 951

EP - 960

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 7

ER -