A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn's disease

Graham D. Naismith, Lyn A. Smith, Sarah J.E. Barry, Joanna I. Munro, Susan Laird, Karen Rankin, Allan J. Morris, Jack W. Winter, Daniel R. Gaya

Research output: Contribution to journalArticle

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Abstract

Background: The faecal calprotectin (FC) test is a non-invasive marker for gastrointestinal inflammation. Aim: To determine whether higher FC levels in individuals with quiescent Crohn's disease are associated with clinical relapse over the ensuing 12 months. Methods: A single centre prospective study was undertaken in Crohn's disease patients in clinical remission attending for routine review. The receiver operating characteristic (ROC) curve for the primary endpoint of clinical relapse by 12 months, based on FC at baseline, was calculated. Kaplan-Meier curves of time to relapse were based on the resulting optimal FC cutoff for predicting relapse. Results: Of 97 patients recruited, 92 were either followed up for 12 months without relapsing, or reached the primary endpoint within that period. Of these, 10 (11 had relapsed by 12 months. The median FC was lower for non-relapsers, 96?g/g (IQR 39-237), than for relapsers, 414?g/g (IQR 259-590), (p=0.005). The area under the ROC curve to predict relapse using FC was 77.4 An optimal cutoff FC value of 240?g/g to predict relapse of quiescent Crohn's had sensitivity of 80.0% and specificity of 74.4 Negative predictive value was 96.8% and positive predictive value was 27.6 FC?240mug/g was associated with likelihood of relapse 5.7 (95% CI 1.9-17.3) times higher within 2.3 years than lower values (p=0.002). Conclusions: In this prospective dataset, FC appears to be a useful, non-invasive tool to help identify quiescent Crohn's disease patients at a low risk of relapse over the ensuing 12 months. FC of 240?g/g was the optimal cutoff in this cohort.
LanguageEnglish
Pages1022-1029
Number of pages8
JournalJournal of Crohn's and Colitis
Volume8
Issue number9
DOIs
Publication statusPublished - 1 Sep 2014

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Leukocyte L1 Antigen Complex
Crohn Disease
Recurrence
ROC Curve

Keywords

  • Crohn's disease
  • disease activity measurements
  • inflammation in IBD

Cite this

Naismith, Graham D. ; Smith, Lyn A. ; Barry, Sarah J.E. ; Munro, Joanna I. ; Laird, Susan ; Rankin, Karen ; Morris, Allan J. ; Winter, Jack W. ; Gaya, Daniel R. / A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn's disease. In: Journal of Crohn's and Colitis. 2014 ; Vol. 8, No. 9. pp. 1022-1029.
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title = "A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn's disease",
abstract = "Background: The faecal calprotectin (FC) test is a non-invasive marker for gastrointestinal inflammation. Aim: To determine whether higher FC levels in individuals with quiescent Crohn's disease are associated with clinical relapse over the ensuing 12 months. Methods: A single centre prospective study was undertaken in Crohn's disease patients in clinical remission attending for routine review. The receiver operating characteristic (ROC) curve for the primary endpoint of clinical relapse by 12 months, based on FC at baseline, was calculated. Kaplan-Meier curves of time to relapse were based on the resulting optimal FC cutoff for predicting relapse. Results: Of 97 patients recruited, 92 were either followed up for 12 months without relapsing, or reached the primary endpoint within that period. Of these, 10 (11 had relapsed by 12 months. The median FC was lower for non-relapsers, 96?g/g (IQR 39-237), than for relapsers, 414?g/g (IQR 259-590), (p=0.005). The area under the ROC curve to predict relapse using FC was 77.4 An optimal cutoff FC value of 240?g/g to predict relapse of quiescent Crohn's had sensitivity of 80.0{\%} and specificity of 74.4 Negative predictive value was 96.8{\%} and positive predictive value was 27.6 FC?240mug/g was associated with likelihood of relapse 5.7 (95{\%} CI 1.9-17.3) times higher within 2.3 years than lower values (p=0.002). Conclusions: In this prospective dataset, FC appears to be a useful, non-invasive tool to help identify quiescent Crohn's disease patients at a low risk of relapse over the ensuing 12 months. FC of 240?g/g was the optimal cutoff in this cohort.",
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author = "Naismith, {Graham D.} and Smith, {Lyn A.} and Barry, {Sarah J.E.} and Munro, {Joanna I.} and Susan Laird and Karen Rankin and Morris, {Allan J.} and Winter, {Jack W.} and Gaya, {Daniel R.}",
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Naismith, GD, Smith, LA, Barry, SJE, Munro, JI, Laird, S, Rankin, K, Morris, AJ, Winter, JW & Gaya, DR 2014, 'A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn's disease' Journal of Crohn's and Colitis, vol. 8, no. 9, pp. 1022-1029. https://doi.org/10.1016/j.crohns.2014.01.029

A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn's disease. / Naismith, Graham D.; Smith, Lyn A.; Barry, Sarah J.E.; Munro, Joanna I.; Laird, Susan; Rankin, Karen; Morris, Allan J.; Winter, Jack W.; Gaya, Daniel R.

In: Journal of Crohn's and Colitis, Vol. 8, No. 9, 01.09.2014, p. 1022-1029.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn's disease

AU - Naismith, Graham D.

AU - Smith, Lyn A.

AU - Barry, Sarah J.E.

AU - Munro, Joanna I.

AU - Laird, Susan

AU - Rankin, Karen

AU - Morris, Allan J.

AU - Winter, Jack W.

AU - Gaya, Daniel R.

PY - 2014/9/1

Y1 - 2014/9/1

N2 - Background: The faecal calprotectin (FC) test is a non-invasive marker for gastrointestinal inflammation. Aim: To determine whether higher FC levels in individuals with quiescent Crohn's disease are associated with clinical relapse over the ensuing 12 months. Methods: A single centre prospective study was undertaken in Crohn's disease patients in clinical remission attending for routine review. The receiver operating characteristic (ROC) curve for the primary endpoint of clinical relapse by 12 months, based on FC at baseline, was calculated. Kaplan-Meier curves of time to relapse were based on the resulting optimal FC cutoff for predicting relapse. Results: Of 97 patients recruited, 92 were either followed up for 12 months without relapsing, or reached the primary endpoint within that period. Of these, 10 (11 had relapsed by 12 months. The median FC was lower for non-relapsers, 96?g/g (IQR 39-237), than for relapsers, 414?g/g (IQR 259-590), (p=0.005). The area under the ROC curve to predict relapse using FC was 77.4 An optimal cutoff FC value of 240?g/g to predict relapse of quiescent Crohn's had sensitivity of 80.0% and specificity of 74.4 Negative predictive value was 96.8% and positive predictive value was 27.6 FC?240mug/g was associated with likelihood of relapse 5.7 (95% CI 1.9-17.3) times higher within 2.3 years than lower values (p=0.002). Conclusions: In this prospective dataset, FC appears to be a useful, non-invasive tool to help identify quiescent Crohn's disease patients at a low risk of relapse over the ensuing 12 months. FC of 240?g/g was the optimal cutoff in this cohort.

AB - Background: The faecal calprotectin (FC) test is a non-invasive marker for gastrointestinal inflammation. Aim: To determine whether higher FC levels in individuals with quiescent Crohn's disease are associated with clinical relapse over the ensuing 12 months. Methods: A single centre prospective study was undertaken in Crohn's disease patients in clinical remission attending for routine review. The receiver operating characteristic (ROC) curve for the primary endpoint of clinical relapse by 12 months, based on FC at baseline, was calculated. Kaplan-Meier curves of time to relapse were based on the resulting optimal FC cutoff for predicting relapse. Results: Of 97 patients recruited, 92 were either followed up for 12 months without relapsing, or reached the primary endpoint within that period. Of these, 10 (11 had relapsed by 12 months. The median FC was lower for non-relapsers, 96?g/g (IQR 39-237), than for relapsers, 414?g/g (IQR 259-590), (p=0.005). The area under the ROC curve to predict relapse using FC was 77.4 An optimal cutoff FC value of 240?g/g to predict relapse of quiescent Crohn's had sensitivity of 80.0% and specificity of 74.4 Negative predictive value was 96.8% and positive predictive value was 27.6 FC?240mug/g was associated with likelihood of relapse 5.7 (95% CI 1.9-17.3) times higher within 2.3 years than lower values (p=0.002). Conclusions: In this prospective dataset, FC appears to be a useful, non-invasive tool to help identify quiescent Crohn's disease patients at a low risk of relapse over the ensuing 12 months. FC of 240?g/g was the optimal cutoff in this cohort.

KW - Crohn's disease

KW - disease activity measurements

KW - inflammation in IBD

UR - http://eprints.gla.ac.uk/90530/

U2 - 10.1016/j.crohns.2014.01.029

DO - 10.1016/j.crohns.2014.01.029

M3 - Article

VL - 8

SP - 1022

EP - 1029

JO - Journal of Crohn's and Colitis

T2 - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

SN - 1873-9946

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ER -