P271 Fecal calprotectin at diagnosis is associated with oral steroid use first year of Inflammatory Bowel Disease.

Strande, V.(1,2);Småstuen, M.C.(3,4);Huppertz-Hauss, G.(5);Perminow, G.(6);Henriksen, M.(7);Bengtson, M.B.(8);Høie, O.(9);Ricanek, P.(10);Opheim, R.(3,11);Cetinkaya, R.B.(12);Torp, R.(13);Vatn, S.(1,10);Aabrekk, T.B.(8);Detlie, T.E.(1,10);Hovde, Ø.(14,15);Høivik, M.L.(3,15);Kristensen, V.A.(2,3);

(1)University of Oslo, Faculty of Medicine, Oslo, Norway;(2)Lovisenberg Diaconal Hospital, Unger-Vetlesen Institute, Oslo, Norway;(3)Oslo University Hospital, Department of Gastroenterology, Oslo, Norway;(4)Oslo Metropolitan University, Department of Public Health, Oslo, Norway;(5)Telemark Hospital, Department of Gastroenterology, Skien, Norway;(6)Oslo University Hospital, Pediatric Department, Oslo, Norway;(7)Østfold Hospital Trust, Department of Gastroenterology, Grålum, Norway;(8)Vestfold Hospital Trust, Medical Department, Tønsberg, Norway;(9)Sørlandet Hospital Arendal, Department of Internal Medicine, Arendal, Norway;(10)Akershus University Hospital, Department of Gastroenterology, Lørenskog, Norway;(11)University of Oslo, Department of Nursing Science- Institute of Health and Society, Oslo, Norway;(12)Diakonhjemmet Hospital, Department of Medicine, Oslo, Norway;(13)Innlandet Hospital Trust, Medical Department, Hamar, Norway;(14)Innlandet Hospital Trust, Department of Medicine, Gjøvik, Norway;(15)University of Oslo, Institute of Clinical Medicine, Oslo, Norway;

Background

Fecal (f-) calprotectin is demonstrated to predict forthcoming flares in Inflammatory Bowel Disease (IBD). Predictive value in newly diagnosed IBD is scarcely studied. The aim of this study was to investigate if high or low f-calprotectin at time of diagnosis of IBD was associated with need of steroids during first year of disease in a population-based inception cohort study (IBSEN III).

Methods

Newly diagnosed IBD patients >18 years, enrolled from the South-Eastern Health Region of Norway in the period of 2017-2019, were studied. Age, gender, smoking status, CRP and level of f-calprotectin were registered at diagnosis. At one-year follow-up, oral and intravenous (IV) steroid use during first year of disease were registered. Associations between high levels of f-calprotectin (≥ 500 mg/kg) at diagnosis and steroid use were tested using logistic regression analyses. A p-value of 0.05 was considered statistically significant.

Results

At baseline, 352 adult patients with Crohn's disease (CD) and 702 patients with ulcerative colitis (UC) provided samples for f-calpotectin and were included in this study. Steroid use (both IV and oral) was associated with higher levels of f-calprotectin. When adjusted for CRP, age, gender and smoking status, the association remained statistically significant for oral steroid use (CD: OR=2.21, 95%CI [1.25; 3.93], p=0.007. UC: OR=1.87, 95%CI [1.26;2.78], p=0.002), however not for IV steroid use.

Conclusion

High level of f-calprotectin at time of diagnosis is associated with oral steroid use during the first year of disease for patients with IBD.