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P130. Correlation between serological biomarkers and clinical activity in patients with inflammatory bowel disease (IBD)

M. Chaparro, P. Miranda-García, J.P. Gisbert

Hospital de la Princesa, Madrid, Spain

Background: Biomarkers are used routinely to monitor activity in patients with IBD. However, the correlation between these markers and clinical disease activity is not well established.

Objectives: To evaluate the correlation between several biomarkers and clinical activity in patients with IBD. To identify the serological biomarkers with the best accuracy to assess the clinical activity in patients with IBD.

Methods: Patients followed-up at the IBD Unit from our hospital were prospectively included. A blood sample was obtained from each patient and haematological parameters and several biomarkers were determined: C-reactive protein (CRP), orosomucoid, erythrocyte sedimentation rate (ESR), ferritin, and fibrinogen. The clinical activity was assessed by the Partial Mayo Score in the case of ulcerative colitis (UC) and by the Harvey-Bradshaw activity index in Crohn's disease (CD) patients. The accuracy of each biomarker was assessed by the area under the ROC curve (AUC). The best cut-off value for each biomarker was identified; for it, sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were calculated.

Results: Two-hundred and sixty-three patients were included. The median age was 43 years and the median time of evolution of the disease was 7 years, 52% were male and 60% had CD. The overall accuracy and the accuracy for CD and UC of the best serological biomarkers is shown in the table.

Accuracy data
BiomarkerAUCBest cut-off valueSe (%)Sp (%)PPV (%)NPV (%)
Overall accuracy (CD and UC)
Orosomucoid0.69110 mg/dl65783293
Fibrinogen0.67400 mg/dl62601883
Haemoglobin0.6713 g/dl70622590
CRP0.570.2 mg/l59632190
Haemoglobin0.7713 g/dl63882393
Orosomucoid0.71110 mg/dl70752994
Fibrinogen0.65438 mg/dl59762690
CRP0.650.2 mg/l77622092
Fibrinogen0.73395 mg/dl67622491
Orosomucoid0.66114 mg/dl60864591

Conclusions: The correlation between commonly used serological biomarkers and the clinical activity of IBD is low. The accuracy of these markers is, in general, worse in UC than in CD. Orosomucoid, fibrinogen and haemoglobin have the best correlation with the clinical activity. The usefulness of the measurement of the CPR, both in UC and in CD, is very limited in this setting.