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P279 Interest of serum calprotectin in inflammatory bowel disease (IBD): a prospective monocentric study

T. Di Bernardo*1, A. Haccourt1, P. Veyrard1, E. Del Tedesco1, J. M. Phelip1, N. Williet1, S. Paul1, X. Roblin1

1Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France

Background

Faecal calprotectin (FC) is the most effective non-invasive biomarker for the diagnosis and monitoring of inflammatory bowel diseases (IBD). It is a major marker in the ‘Treat to Target’ strategy. However, in clinical practice, the faecal sample appears to be restrictive for patients. The aim of our study was to evaluate the diagnostic performance of serum calprotectin (SC) to predict clinical remission (CR) and mucosal healing (MH) in IBD patients.

Methods

It was a prospective monocentric study. We have consecutively included any patient with either ulcerative colitis (UC) or Crohn's disease (CD) and followed in our IBD centre. Exclusion criteria were: inflammatory rheumatism, Clostridium difficile infection, recent treatment with non-steroidal anti-inflammatory, pregnancy, age <16 years, patients with exclusive ano-perineal lesions for CD. The main objective was to search for predictive values of SC for RC and MH and to compare it with other biomarkers (CRP, FC). In secondary analysis, we searched for a correlation between SC, FC, and protein C reactive (CRP). The analysis technique for the SC and FC was performed by the Bühlmann Quantum Blue® rapid test. All measurments (SC, FC, and PCR) were performed at the same time.

Results

From June 2017 to June 2018, 82 patients (60.2% CD, sex ratio M/F = 0.74, mean age 42.19 ± 15.4 years) were included and we performed 123 SC assays. Of the 123 assays of SC, 87 (70.7%) were performed in patients with CR. With respect to the prediction of CR, SC had an area under the curve (AUC) of 0.67. A cut-off value of 5.3 mg/ml predicted a clinical remission with a sensitivity (Se) of 65.6%, a specificity (Sp) of 67.6%, conferring diagnostic performance not inferior to other biomarkers such as CRP (p = 0.80) and CF (p = 0.42). This predictive value was more favourable in UC than in CD. With regard to the prediction of MH, the diagnostic performance of SC was good (AUC = 0.73), with a threshold of 4.8 mg/ml to predict MH with a Se of 61.9% and a Sp of 80.9%. These results were similar to those of CRP (p = 0.48) and CF (p = 0.23). There was a correlation between the endoscopic score during UC and SC levels (r = 0.59) which was greater than with FC (r = 0.46). No significant correlation was reported between SC and FC (r = 0.16) and between SC and CRP (r = 0.35).

Conclusion

This study has shown that SC is a predictive biomarker of CR and MH in IBD patients. This biomarker was not inferior to other biomarkers in terms of prediction. Further studies involving more patients are needed to confirm the future role of SC in IBD management.