Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis - a prospective analysis
<strong>Background</strong> Faecal calprotectin [FCal] levels are used as a surrogate marker for mucosal inflammation, but thresholds for defining endoscopic or histological disease activity in ulcerative colitis [UC] remain unclear. <br/><br/> <strong>Methods</stron...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Oxford University Press
2018
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| _version_ | 1797078039368040448 |
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| author | Walsh, A Kormilitzin, A Hinds, C Sexton, V Brain, O Keshav, S Uhlig, H Geddes, J Goodwin, G Peters, M Collins, G Travis, S |
| author_facet | Walsh, A Kormilitzin, A Hinds, C Sexton, V Brain, O Keshav, S Uhlig, H Geddes, J Goodwin, G Peters, M Collins, G Travis, S |
| author_sort | Walsh, A |
| collection | OXFORD |
| description | <strong>Background</strong> Faecal calprotectin [FCal] levels are used as a surrogate marker for mucosal inflammation, but thresholds for defining endoscopic or histological disease activity in ulcerative colitis [UC] remain unclear. <br/><br/> <strong>Methods</strong> Using validated indices, prospective measurements of FCal, symptoms [Simple Colitis Clinical Activity Index, SCCAI], endoscopic [Ulcerative Colitis Endoscopic Index of Severity, UCEIS] and histological activity [Nancy index] were made over 6 months in patients enrolled into the TrueColours UC web-based monitoring programme. Repeated measurements correlation was performed between FCal and SCCAI, UCEIS, and Nancy indices using definitions for remission and active disease [UCEIS: remission ≤1, active ≥4; Nancy: remission ≤1, active ≥2; combined criteria: remission UCEIS ≤1 and Nancy ≤1, active UCEIS ≥4 and Nancy ≥2]. Receiver operating characteristic curves investigated FCal thresholds after maximising sensitivity for active disease. <br/><br/> <strong>Results</strong> In 39 patients followed prospectively for 6 months, correlation coefficients between FCal and SCCAI, UCEIS, and Nancy indices were 0.271 (95% confidence interval [CI] 0.114–0.415), 0.741 [95% CI 0.289–0.922], and 0.876 [95% CI 0.605–0.965], respectively. Median FCal thresholds for remission using endoscopic, histological, or combined criteria were 71 μg/g [range 8–624], 91 μg/g [range 8–858], and 67 μg/g [range 8–479], respectively. The FCal threshold above which active disease was confirmed was 187 μg/g for UCEIS (area under the curve [AUC] 0.915), 72 μg/g for Nancy [AUC 0.824], and 187 μg/g for combined endoscopic and histological criteria [AUC 0.936]. <br/><br/> <strong>Conclusions</strong> Correlation between FCal and symptoms in UC is weak. In contrast, the correlation between FCal and endoscopic or histological activity is strong. An FCal ≥72 μg/g indicates histological inflammation [Nancy ≥2] and ≥187 μg/g indicates endoscopically active disease [UCEIS ≥4], whether combined with histopathology or not. |
| first_indexed | 2024-03-07T00:26:43Z |
| format | Journal article |
| id | oxford-uuid:7e645d74-4182-4d37-86cb-096b2f5a01ff |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:26:43Z |
| publishDate | 2018 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:7e645d74-4182-4d37-86cb-096b2f5a01ff2022-03-26T21:09:51ZDefining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis - a prospective analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7e645d74-4182-4d37-86cb-096b2f5a01ffEnglishSymplectic Elements at OxfordOxford University Press2018Walsh, AKormilitzin, AHinds, CSexton, VBrain, OKeshav, SUhlig, HGeddes, JGoodwin, GPeters, MCollins, GTravis, S<strong>Background</strong> Faecal calprotectin [FCal] levels are used as a surrogate marker for mucosal inflammation, but thresholds for defining endoscopic or histological disease activity in ulcerative colitis [UC] remain unclear. <br/><br/> <strong>Methods</strong> Using validated indices, prospective measurements of FCal, symptoms [Simple Colitis Clinical Activity Index, SCCAI], endoscopic [Ulcerative Colitis Endoscopic Index of Severity, UCEIS] and histological activity [Nancy index] were made over 6 months in patients enrolled into the TrueColours UC web-based monitoring programme. Repeated measurements correlation was performed between FCal and SCCAI, UCEIS, and Nancy indices using definitions for remission and active disease [UCEIS: remission ≤1, active ≥4; Nancy: remission ≤1, active ≥2; combined criteria: remission UCEIS ≤1 and Nancy ≤1, active UCEIS ≥4 and Nancy ≥2]. Receiver operating characteristic curves investigated FCal thresholds after maximising sensitivity for active disease. <br/><br/> <strong>Results</strong> In 39 patients followed prospectively for 6 months, correlation coefficients between FCal and SCCAI, UCEIS, and Nancy indices were 0.271 (95% confidence interval [CI] 0.114–0.415), 0.741 [95% CI 0.289–0.922], and 0.876 [95% CI 0.605–0.965], respectively. Median FCal thresholds for remission using endoscopic, histological, or combined criteria were 71 μg/g [range 8–624], 91 μg/g [range 8–858], and 67 μg/g [range 8–479], respectively. The FCal threshold above which active disease was confirmed was 187 μg/g for UCEIS (area under the curve [AUC] 0.915), 72 μg/g for Nancy [AUC 0.824], and 187 μg/g for combined endoscopic and histological criteria [AUC 0.936]. <br/><br/> <strong>Conclusions</strong> Correlation between FCal and symptoms in UC is weak. In contrast, the correlation between FCal and endoscopic or histological activity is strong. An FCal ≥72 μg/g indicates histological inflammation [Nancy ≥2] and ≥187 μg/g indicates endoscopically active disease [UCEIS ≥4], whether combined with histopathology or not. |
| spellingShingle | Walsh, A Kormilitzin, A Hinds, C Sexton, V Brain, O Keshav, S Uhlig, H Geddes, J Goodwin, G Peters, M Collins, G Travis, S Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis - a prospective analysis |
| title | Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis - a prospective analysis |
| title_full | Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis - a prospective analysis |
| title_fullStr | Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis - a prospective analysis |
| title_full_unstemmed | Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis - a prospective analysis |
| title_short | Defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis - a prospective analysis |
| title_sort | defining faecal calprotectin thresholds as a surrogate for endoscopic and histological disease activity in ulcerative colitis a prospective analysis |
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