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P103. Correlation between serological biomarkers and clinical activity in patients with inflammatory bowel disease (IBD)


P. Miranda-García1, M. Chaparro2, J.P. Gisbert2

1Hospital De La Princesa, Madrid, Spain; 2Hospital De La Princesa, IP, Gastroenterology and CIBEREHD, 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 serological 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: Three-hundred and fifty patients were included. The median age was 46 years and the median time of evolution of the disease was 3 years, 52% were female and 59% had CD. The overall accuracy and the accuracy for CD and UC of the best serological biomarkers are shown in the tables.

CD
BiomarkerAUCBest cut-off valueSe (%)Sp (%)PPV (%)NPV (%)
Haemoglobin0.7512.1 g/dl56822295
CRP0.710.75 mg/l53832195
Fibrinogen0.70469 mg/dl64802296
Platelets0.69285,000/ml75711896
Orosomucoid0.68110 mg/dl76711797
ESR0.6616.576611396
UC
BiomarkerAUCBest cut-off valueSe (%)Sp (%)PPV (%)NPV (%)
Fibrinogen0.69389 mg/dl72622691
ESR0.6721.547803188
Orosomucoid0.64103 mg/dl57753090
Platelets0.62238,000/ml61552187
Haemoglobin0.6012 g/dl23965785
CRP0.470.19 mg/l57441783

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. CRP, fibrinogen and haemoglobin have the best correlation with the clinical activity in CD.