Document Detail

Fecal calprotectin concentration predicts outcome in inflammatory bowel disease after induction therapy with TNFα blocking agents.
MedLine Citation:
PMID:  22223566     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-01-04
Journal Detail:
Title:  Inflammatory bowel diseases     Volume:  18     ISSN:  1536-4844     ISO Abbreviation:  Inflamm. Bowel Dis.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-16     Completed Date:  2013-04-04     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9508162     Medline TA:  Inflamm Bowel Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2011-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Crohn's & Colitis Foundation of America, Inc.
Maria Helsinki City Hospital and University of Helsinki, Helsinki, Finland.
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MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized / therapeutic use*
Antirheumatic Agents / therapeutic use
Biological Markers / metabolism
Colitis, Ulcerative / drug therapy*,  metabolism
Crohn Disease / drug therapy*,  metabolism
Disease Management
Feces / chemistry*
Leukocyte L1 Antigen Complex / metabolism*
Middle Aged
ROC Curve
Remission Induction
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Young Adult
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antirheumatic Agents; 0/Biological Markers; 0/Leukocyte L1 Antigen Complex; 0/Tumor Necrosis Factor-alpha; 0/infliximab; FYS6T7F842/adalimumab

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