Accuracy of Rapid Fecal Calprotectin Test in Monitoring Inflammatory Bowel Diseases Under Treatment with TNFα Antagonists.

Abstract

BACKGROUND:

Anti-TNFα antibodies are effective in treating inflammatory bowel diseases (IBDs) unresponsive to the standard treatments. Information about the role of rapid fecal calprotectin (FC) in monitoring ambulatory IBD patients under treatment with anti-TNFα is lacking. Our aim was to assess the accuracy of rapid FC in monitoring those patients.

METHODS:

Seventy-two patients (38 males, 34 females, mean age 42.5 years, range 23-57 years), affected by ulcerative colitis (UC) (20 patients) or by Crohn's disease (CD) (52 patients) were treated with anti-TNFα antibodies. FC was assessed by a rapid semiquantitative test.

RESULTS:

With respect to the absence of clinical remission, FC test showed sensitivity of 71.8 %, specificity of 65.2 %, PPV of 41.8 %, and NPV of 86.9 %. In UC patients, FC test showed a sensitivity of 66.7 %, a specificity of 56.1 %, a PPV of 18.2 %, and a NPV of 92.0 %. In CD patients, FC test showed sensitivity of 70.6 %, specificity of 65.2 %, PPV of 50.0 %, and NPV of 81.8 %. With respect to the presence of endoscopic lesions, FC test showed sensitivity of 73.5 %, specificity of 96.0 %, PPV of 96.2 %, and NPV of 72.7 %. In UC patients, FC test showed sensitivity of 47.2 %, specificity of 84.6 %, PPV of 89.5 %, and NPV of 36.7 %. In CD patients, FC test showed sensitivity of 90.1 %, specificity of 79.7 %, PPV of 71.9 %, and NPV of 93.3 %.

CONCLUSIONS:

Diagnostic accuracy of rapid FC seems better in predicting persistence of endoscopic lesions than clinical remission in IBD patients under treatment with anti-TNFα.

• Authors: Antonio Tursi, Walter Elisei, Marcello Picchio, GianMarco Giorgetti, Giovanni Brandimarte
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 60 Issue 5 Pg. 1406-13 (May 2015) ISSN: 1573-2568 [Electronic] United States
• PMID: 25445163 (Publication Type: Evaluation Study, Journal Article, Multicenter Study)

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Biomarkers
• Leukocyte L1 Antigen Complex
• Tumor Necrosis Factor-alpha
• Infliximab
• Adalimumab

Topics

• Adalimumab
• Adult
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Biomarkers (analysis)
• Colitis, Ulcerative (diagnosis, drug therapy, immunology)
• Colonoscopy
• Crohn Disease (diagnosis, drug therapy, immunology)
• Drug Monitoring (methods)
• Feces (chemistry)
• Female
• Humans
• Infliximab
• Italy
• Leukocyte L1 Antigen Complex (analysis)
• Male
• Middle Aged
• Predictive Value of Tests
• Prospective Studies
• Remission Induction
• Reproducibility of Results
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors, immunology)
• Young Adult