DOP051. Usefulness of a faecal calprotectin rapid semiquantitative test in predicting relapse in patients with ulcerative colitis in remission
E. Garcia-Planella1, M. Manyosa2,3, M. Chaparro4, M. Barreiro-de-Acosta5, B. Beltrán6, E. Ricart7, V. García-Sánchez8, M. Esteve9, M. Piqueras10, F. Bermejo11, A. López-Sanromán12, C. Taxonera12, J. Llaó13, J.P. Gisbert4, E. Cabré3, E. Domènech3, 1Hospital de la Santa Creu i Sant Pau, Gastroenterology, Barcelona, Spain, 2Hospital Universitari Germans Trias i Pujol and CIBERehd, Gastroenterology Unit, Badalona, Spain, 3Hospital Universitari Germans Trias i Pujol, Gastroenterology, Badalona, Spain, 4Hospital La Princesa, Gastroenterology, Madrid, Spain, 5Hospital Universitario de Santiago, Gastroenterology, Santiago de Compostela, Spain, 6IIS Hospital La Fe, Gastroenterology, Valencia, Spain, 7Hospital Clínic, Gastroenterology, Barcelona, Spain, 8Hospital Reina Sofía, Gastroenterology, Córdoba, Spain, 9Hospital Mútua Terrassa, Gastroenterology, Terrassa, Spain, 10Consorci Sanitari Terrassa, Gastroenterology, Terrassa, Spain, 11Hospital de Fuenlabrada, Gastroenterology, Fuenlabrada, Spain, 12Hospital Ramón y Cajal, Gastroenterology, Madrid, Spain, 13Xarxa Hospitalària Althaia, Gastroenterology, Manresa, Spain
Faecal calprotectin (CALf) is fairly correlated with clinical and endoscopic activity in ulcerative colitis (UC), and it has also demonstrated to be a good predictor of relapse. However, the routinely use of CALf measurement is constrained by the need for the patient to carry stool samples, as well as handling and processing them in the laboratory. The availability of hand held, single-use devices for CALf measurement that could be performed by the patient himself, might spread the use of CALf in clinical practice. Aim: To evaluate the usefulness of a rapid semi-quantitative test of CALf in predicting relapse in patients with UC in remission.
A prospective, multicentre study that included patients with left-sided or extensive UC in clinical remission for at least 6 months on maintenance treatment with mesalazine. At baseline and every 3 months, patients were evaluated clinically and semi-quantitative CALf was measured using a monoclonal immunochromatography rapid test (PreventID Caldetect, Immunodiagnostic AG, Germany) without manipulation of stools or laboratory analysis, until relapse or 12 months of follow-up.
At least one determination of CALf with clinical follow-up was available in 192 out 206 patients initially included in the study. 55% with extensive UC, 62% required corticosteroids in the past, and 88% were non-smokers. From a total of 695 measurements of CALf, 81 (12%) were above the upper threshold of normality of the test (>60 µg/g) and 57 (8%) had limiting values (15–60 µg/g). During follow-up, 32 relapses (17% of patients) occurred. Having a CALf >60 µg/g was significantly associated with relapse at follow-up (35% vs. 12%, p < 0.0001), with a PPV of 35% and a NPV of 88%. 644 CALf determinations with a three-month follow-up were available; undetectable CALf was significantly associated with absence of recurrence, with a PPV of 100% and a NPV of 93% (0% vs. 6%, p = 0.002).
Rapid semi-quantitative measurement of CALf, with no need for laboratory analysis and faecal samples handling, may be useful for monitoring patients with UC in remission.