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P185 Correlation of patient-reported outcome measure with clinical disease activity and faecal calprotectin in patients with ulcerative colitis

N. Kamat1, S. Kedia*1, V. Ahuja1, G. Makharia1, V. Sachdev1

1All India Institute of Medical Sciences, Gastroenterology, Delhi, India

Background

Patient-reported outcome measures (PROM) have been developed to evaluate patients’ perspective of disease control in inflammatory bowel disease (IBD). Measures of clinical disease activity (simple clinical colitis activity index [SCCAI]) have shown moderate correlation with faecal calprotectin (FCP), a marker of mucosal healing. However, no study has correlated FCP with PROM. Present study aimed to correlate FCP with SCCAI and PROM, and evaluate the role of PROM in predicting clinical remission and mucosal healing.

Methods

This prospective study included consecutive patients with ulcerative colitis of any disease extent/severity under follow-up at All India Institute of Medical Sciences, New Delhi India from June 2018 to July 2018. A detailed evaluation was done for demographics, disease duration, extent, and activity (SCCAI), FCP and IBD control questionnaire. IBD control-8, IBD control visual analogue scale (IBD-VAS) and SCCAI were correlated with FCP. Clinical remission was defined as SCCAI < 3, and mucosal healing was defined as FCP < 150 mg/kg of stool.

Results

Of 57 patients (mean age: 37.5 + 12.1 years, 58% males, median disease duration 5 (3–9) years, 15.8% proctitis, 45.6% left sided colitis, 38.6% pancolitis) 32 were in clinical remission and 28 had mucosal healing. There was a significant correlation between FCP and IBD control-8 (0.57, p < 0.001), IBD-VAS (0.46, p < 0.001), and SCCAI (0.68, p < 0.001) and between SCCAI and IBD control-8 (0.65, p < 0.001) and IBD-VAS (0.64, p < 0.001). IBD control-8 had a moderate diagnostic accuracy to identify patients in clinical remission (area under curve: 0.82[0.69–0.84]) and mucosal healing (area under curve: 0.86[0.77–0.96]), with a score of 13 having a sensitivity and specificity of 69% and 84%, and 72% and 82% to identify patients in clinical remission and mucosal healing, respectively.

Conclusion

IBD control-8, and IBD-VAS, correlates with markers of disease activity and mucosal healing, and has a reasonable diagnostic accuracy to identify clinical remission and mucosal healing.