Comparison of Fecal Calprotectin and Myeloperoxidase in Predicting Outcomes in Inflammatory Bowel Disease.
Inflamm Bowel Dis
; 2024 Feb 28.
Article
em En
| MEDLINE
| ID: mdl-38417068
ABSTRACT
BACKGROUND:
Biomarkers have been proposed as surrogate treatment targets for the management of inflammatory bowel disease (IBD); however, their relationship with IBD-related complications remains unclear. This study investigated the utility of neutrophil biomarkers fecal calprotectin (fCal) and fecal myeloperoxidase (fMPO) in predicting a complicated IBD course.METHODS:
Participants with IBD were followed for 24 months to assess for a complicated IBD course (incident corticosteroid use, medication escalation for clinical disease relapse, IBD-related hospitalizations/surgeries). Clinically active IBD was defined as Harvey-Bradshaw index >4 for Crohn's disease (CD) and simple clinical colitis activity index >5 for ulcerative colitis (UC). Area under the receiver-operating-characteristics curves (AUROC) and multivariable logistic regression assessed the performance of baseline symptom indices, fCal, and fMPO in predicting a complicated disease IBD course at 24 months.RESULTS:
One hundred and seventy-one participants were included (CD, nâ =â 99; female, nâ =â 90; median disease duration 13 years [interquartile range, 5-22]). Baseline fCal (250 µg/g; AUROCâ =â 0.77; 95% confidence interval [CI], 0.69-0.84) and fMPO (12 µg/g; AUROCâ =â 0.77; 95% CI, 0.70-0.84) predicted a complicated IBD course. Fecal calprotectin (adjusted OR =â 7.85; 95% CI, 3.38-18.26) and fMPO (adjusted OR =â 4.43; 95% CI, 2.03-9.64) were associated with this end point after adjustment for other baseline variables including clinical disease activity. C-reactive protein (CRP) was inferior to fecal biomarkers and clinical symptoms (pdifference < .05) at predicting a complicated IBD course. A combination of baseline CRP, fCal/fMPO, and clinical symptoms provided the greatest precision at identifying a complicated IBD course.CONCLUSIONS:
Fecal biomarkers are independent predictors of IBD-related outcomes and are useful adjuncts to routine clinical care.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Inflamm Bowel Dis
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Nova Zelândia