Variation of faecal calprotectin level within the first three months after bowel resection is predictive of endoscopic postoperative recurrence in Crohn's disease.
Dig Liver Dis
; 52(7): 740-744, 2020 07.
Article
em En
| MEDLINE
| ID: mdl-32444250
ABSTRACT
BACKGROUND:
Early prediction of postoperative recurrence (POR) remains a major concern in Crohn's disease (CD).AIMS:
To assess serial faecal calprotectin (Fcal) monitoring within the first three months to predict CD endoscopic POR.METHODS:
In a multicenter randomized controlled trial, CD patients received azathioprine 2.5â¯mg/kg/day with oral curcumin (3â¯g/day) or placebo. Fcal was measured at baseline, one month (M1) and M3. Endoscopic POR at M6 was defined as Rutgeerts' index ≥ i2b (central reading).RESULTS:
Among the 48 patients included, there was no significant difference of median Fcal levels at baseline (pâ¯=â¯0.15), M1 (pâ¯=â¯0.44) and M3 (pâ¯=â¯0.28) between patients with or without endoscopic POR at M6. Fcal kinetics during the first 3 months after surgery was significantly different between the patients with or without POR at M6 (pâ¯=â¯0.021). The median variation between Fcal level at baseline and M3 (ΔFcal M3-M0) was significantly higher in patients with endoscopic POR compared to those without POR (pâ¯=â¯0.01). ΔFcal M3-M0 >+10% demonstrated the best performances to predict endoscopic POR at M6 (AUC=0.73, sensitivity=64.7%[41.1-82.7], specificity=87.5%[68.0-96.3], negative predictive value=77.8%[57.5-91.4] and positive predictive value=78.6%[49.2-95.3]).CONCLUSION:
Fcal variation within the first three months after ileocolonic resection is a promising predictor of early endoscopic POR in CD patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doença de Crohn
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Colectomia
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Complexo Antígeno L1 Leucocitário
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Fezes
Tipo de estudo:
Clinical_trials
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article