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P643. Faecal calprotectin: correlation with the Harvey–Bradshaw Index in patients with Crohn's disease

C. Dobrzanski1, N. Pedersen1, J. Burisch1, V. Voxen Hansen2, H. Fuglsang2, P. Munkholm1, 1Herlev University Hospital, Department of Gastroenterology, Copenhagen, Denmark, 2Herlev University Hospital, Gastroenterology Research Laboratory, Copenhagen, Denmark

Background

Faecal calprotectin (FC) has shown to correlate well with symptom scores in ulcerative colitis (UC) but not in Crohn's disease (CD) [1], however so far only small sample sizes have been studied. The aim of this study is to investigate whether FC levels correlate with Harvey–Bradshaw Index (HBI) scores in a large FC-HBI sample size and thus clarify the usefulness of FC in monitoring of symptom intensity in CD patients.

Methods

A total of 838 FC samples from 43 CD patients (58% female), with a median of 19 samples (range 1–44) per patient, and corresponding HBI scores were recorded during 2009–2011 in the out-patient clinic at Herlev University Hospital of Copenhagen. Following each patient visit, faeces for FC measurement were collected and sent by the patients to the research laboratory and analysed by a quantitative scanning test (CALPRO Inc.) while HBI scores were registered using a patient self-administered HBI questionnaire. Correlation analysis was done by non-parametric Spearman statistics.

Results

Median FC was 237 mg/kg (range 30–7050) and HBI score was 3 (range 0–15). 26% of the patients had ileal disease (L1), 74% suffered from colonic or ileocolonic disease (L2+L3), 48% had non-penetrating, non-stricturing disease behavior (B1) while 52% had stricturing and/or penetrating disease (B2+B3). For FC-HBI correlation analyses results please see Table 1.

Table 1.
  Spearman's rho
correlation coefficient
p
(2-tailed)
n
Corresponding FC samples – HBI scores
No. of patients
All samples 0.0670.05183843
GenderFemales0.1140.01149724
 Males0.0060.90534119
Disease locationLl0.0490.47521211
 L2+L30.0600.13462632
Disease behaviorB10.230<0.000139118
 B2+B3−0.0550.25243422
 B1    
  Females only0.383<0.00011859
  Males only0.0490.4822069
  +L10.2940.0021115
  +(L2+L3)0.1940.00128013
 +L1, females only0.618<0.0001643
 +(L2+L3), females only0.1950.0321216

Conclusion

There was no significant overall correlation between FC values and HBI scores in CD patients. Sub analyses suggest that FC in CD correlates with HBI scores in female patients with B1 disease behavior only, with a stronger correlation when the disease is confined to the ileum. However, considering the small number of patients in this group, this finding can at this time only be described as a peculiarity.

1. D'Haens G, Ferrante M, Vermeire S, et al., (2012), Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease. Inflamm Bowel Dis., 18: 2218–2224.