P520 Accuracy of rapid fecal calprotectin test in monitoring Inflammatory Bowel Diseases under treatment with TNF-alpha antagonists
A. Tursi*1, W. Elisei2, M. Picchio3, A. Penna4, G. Giorgetti5, G. Brandimarte6
1Azienda Sanitaria Locale BAT, Servizio di Gastroenterologia Territoriale, Andria, Italy, 2ASL RMH, Division of Gastroenterology,, Albano Laziale (Rome), Italy, 3“P. Colombo” Hospital, ASL RMH, Division of Surgery, Velletri (Rome), Italy, 4“S. Paolo” Hospital, Division of Gastroenterology, Bari, Italy, 5“S. Eugenio” Hospital, Digestive Endoscopy & Nutrition Unit, Rome, Italy, 6“Cristo Re” Hospital, Division of Internal Medicine and Gastroenterology, Rome, Italy
Anti-TNFalpha antibodies are effective in treating IBD (Inflammatory Bowel Diseases) unresponsive to the standard treatments. Information about the role of rapid Fecal calprotectin (FC) in monitoring ambulatory IBD patients under treatment with anti-TNFalpha are lacking. Our aim was to assess the accuracy of rapid FC in monitoring those patients.
72 pts (38 males, 34 females, mean age 42.5 years, range 23-57 years), affected by Ulcerative Colitis (UC) (20 pts) or by Crohn's Disease (CD) (52 pts) were treated with anti-TNFalpha antibodies. FC was assessed by a rapid semi-quantitative test. Clinical, FC and endoscopic assessment was performed every 6 months during a 36-month scheduled follow-up.
All UC patients were treated with IFX, while 32 CD patients were treated with IFX and 20 with ADA. 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%.
Diagnostic accuracy of rapid FC seems better in predicting persistence of endoscopic lesions than clinical remission in IBD patients under treatment with anti-TNFalpha.