| Fecal calprotectin concentration predicts outcome in inflammatory bowel disease after induction therapy with TNFα blocking agents. | |
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MedLine Citation:
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PMID: 22223566 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Fecal calprotectin (FC) concentration is a useful surrogate marker for mucosal healing (MH) during tumor necrosis factor alpha (TNFα)-blocking therapy for inflammatory bowel disease (IBD). Our aim was to evaluate whether a normal FC after induction therapy with TNFα antagonist predicts the outcome of IBD patients during maintenance therapy. METHODS: Sixty IBD patients (34 Crohn's disease [CD], 26 ulcerative colitis [UC]), treated with TNFα antagonists, either infliximab (n = 42) or adalimumab (n = 18), and having a documented FC level at baseline and after induction therapy were included. Disease activity was evaluated by partial Mayo score without endoscopy or Harvey-Bradshaw index at baseline, after induction, and at 12 months during maintenance therapy. RESULTS: After induction, FC was normalized (≤100 μg/g) in 31 patients (52%, median 42 μg/g, range 0-97), whereas the level remained elevated in 29 patients (48%, median 424 μg/g, range 116-5859). At ≈12 months, 26/31 (84%, 18 CD, 8 UC) of the patients with normal FC after induction were in clinical remission, whereas only 11/29 (38%, 9 CD, 2 UC) of those with an elevated (≥100 μg/g) postinduction FC were in clinical remission, P < 0.0001. After induction therapy with TNFα antagonists, a cutoff concentration of 139 μg/g for FC had a sensitivity of 72% and a specificity of 80% to predict a risk of clinically active disease after 1 year. CONCLUSIONS: A normal FC after induction therapy with TNFα antagonists predicts sustained clinical remission in the majority of patients on scheduled therapy with active luminal disease. (Inflamm Bowel Dis 2012;). |
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Authors:
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Pauliina Molander; Clas-Göran Af Björkesten; Harri Mustonen; Johanna Haapamäki; Matti Vauhkonen; Kaija-Leena Kolho; Martti Färkkilä; Taina Sipponen |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-4 |
Journal Detail:
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Title: Inflammatory bowel diseases Volume: - ISSN: 1536-4844 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9508162 Medline TA: Inflamm Bowel Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Crohn's & Colitis Foundation of America, Inc. |
Affiliation:
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Maria Helsinki City Hospital and University of Helsinki, Helsinki, Finland; University of Helsinki, Helsinki, Finland. pauliina.molander@welho.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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