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Prognostic Role of Post-Induction Fecal Calprotectin Levels in Patients with Inflammatory Bowel Disease Treated with Biological Therapies

Background: There is currently scarce knowledge about markers of early therapeutic response in patients with inflammatory bowel disease (IBD) treated with biologics. The aim of this study was to evaluate the role of fecal calprotectin (FC) as an early predictor of mucosal healing and clinical remiss...

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Autores principales: Facciorusso, Antonio, Ramai, Daryl, Ricciardelli, Cristina, Paolillo, Rosa, Maida, Marcello, Chandan, Saurabh, Mohan, Babu P., Domislovic, Viktor, Sacco, Rodolfo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9496232/
https://www.ncbi.nlm.nih.gov/pubmed/36140408
http://dx.doi.org/10.3390/biomedicines10092305
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author Facciorusso, Antonio
Ramai, Daryl
Ricciardelli, Cristina
Paolillo, Rosa
Maida, Marcello
Chandan, Saurabh
Mohan, Babu P.
Domislovic, Viktor
Sacco, Rodolfo
author_facet Facciorusso, Antonio
Ramai, Daryl
Ricciardelli, Cristina
Paolillo, Rosa
Maida, Marcello
Chandan, Saurabh
Mohan, Babu P.
Domislovic, Viktor
Sacco, Rodolfo
author_sort Facciorusso, Antonio
collection PubMed
description Background: There is currently scarce knowledge about markers of early therapeutic response in patients with inflammatory bowel disease (IBD) treated with biologics. The aim of this study was to evaluate the role of fecal calprotectin (FC) as an early predictor of mucosal healing and clinical remission. Methods: Data from a multicenter series of 172 IBD patients treated with biologics between 2017 and 2020 were analyzed. Treatment outcomes were mucosal healing and clinical remission assessed at 2 years. FC levels were assessed at 14 weeks (post-induction), at 6 months, and yearly. The receiver operating characteristic (ROC) curve analysis was performed to calculate the best cut-off in % change of FC levels between post-induction and baseline predicting treatment outcomes. Sensitivity, specificity, and accuracy for several post-induction FC cut-off points were also calculated. Results: At 2 years, mucosal healing was noted in 77 patients (44.7%), of whom were 41 Crohn’s disease (CD) and 36 ulcerative colitis (UC) patients, whereas 106 patients experienced clinical remission (61.6%), of whom were 59 CD and 47 UC patients. Both baseline and post-induction FC levels were significantly higher in non-responders as compared to responders. On the other hand, FC decrease was less pronounced in non-responders. Similar results were observed in all subgroups, namely according to disease (CD vs. UC), or treatment used (TNF-inhibitors vs. vedolizumab). The best cut-off points were −86% in % change in FC levels to predict mucosal healing and −83% for clinical remission. Conclusions: The current study suggests a predictive role of post-induction FC assessment to predict treatment response in IBD patients treated with biologics.
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spelling pubmed-94962322022-09-23 Prognostic Role of Post-Induction Fecal Calprotectin Levels in Patients with Inflammatory Bowel Disease Treated with Biological Therapies Facciorusso, Antonio Ramai, Daryl Ricciardelli, Cristina Paolillo, Rosa Maida, Marcello Chandan, Saurabh Mohan, Babu P. Domislovic, Viktor Sacco, Rodolfo Biomedicines Article Background: There is currently scarce knowledge about markers of early therapeutic response in patients with inflammatory bowel disease (IBD) treated with biologics. The aim of this study was to evaluate the role of fecal calprotectin (FC) as an early predictor of mucosal healing and clinical remission. Methods: Data from a multicenter series of 172 IBD patients treated with biologics between 2017 and 2020 were analyzed. Treatment outcomes were mucosal healing and clinical remission assessed at 2 years. FC levels were assessed at 14 weeks (post-induction), at 6 months, and yearly. The receiver operating characteristic (ROC) curve analysis was performed to calculate the best cut-off in % change of FC levels between post-induction and baseline predicting treatment outcomes. Sensitivity, specificity, and accuracy for several post-induction FC cut-off points were also calculated. Results: At 2 years, mucosal healing was noted in 77 patients (44.7%), of whom were 41 Crohn’s disease (CD) and 36 ulcerative colitis (UC) patients, whereas 106 patients experienced clinical remission (61.6%), of whom were 59 CD and 47 UC patients. Both baseline and post-induction FC levels were significantly higher in non-responders as compared to responders. On the other hand, FC decrease was less pronounced in non-responders. Similar results were observed in all subgroups, namely according to disease (CD vs. UC), or treatment used (TNF-inhibitors vs. vedolizumab). The best cut-off points were −86% in % change in FC levels to predict mucosal healing and −83% for clinical remission. Conclusions: The current study suggests a predictive role of post-induction FC assessment to predict treatment response in IBD patients treated with biologics. MDPI 2022-09-16 /pmc/articles/PMC9496232/ /pubmed/36140408 http://dx.doi.org/10.3390/biomedicines10092305 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Facciorusso, Antonio
Ramai, Daryl
Ricciardelli, Cristina
Paolillo, Rosa
Maida, Marcello
Chandan, Saurabh
Mohan, Babu P.
Domislovic, Viktor
Sacco, Rodolfo
Prognostic Role of Post-Induction Fecal Calprotectin Levels in Patients with Inflammatory Bowel Disease Treated with Biological Therapies
title Prognostic Role of Post-Induction Fecal Calprotectin Levels in Patients with Inflammatory Bowel Disease Treated with Biological Therapies
title_full Prognostic Role of Post-Induction Fecal Calprotectin Levels in Patients with Inflammatory Bowel Disease Treated with Biological Therapies
title_fullStr Prognostic Role of Post-Induction Fecal Calprotectin Levels in Patients with Inflammatory Bowel Disease Treated with Biological Therapies
title_full_unstemmed Prognostic Role of Post-Induction Fecal Calprotectin Levels in Patients with Inflammatory Bowel Disease Treated with Biological Therapies
title_short Prognostic Role of Post-Induction Fecal Calprotectin Levels in Patients with Inflammatory Bowel Disease Treated with Biological Therapies
title_sort prognostic role of post-induction fecal calprotectin levels in patients with inflammatory bowel disease treated with biological therapies
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9496232/
https://www.ncbi.nlm.nih.gov/pubmed/36140408
http://dx.doi.org/10.3390/biomedicines10092305
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