Pilot Study Assessing the Utility of Faecal Calprotectin in Routine Clinical Practice in an Irish IBD Centre
S Naimimohasses, F MacNamara2, F MacCarthy, S McKiernan, V Crowley2, N Mahmud, M Healy2, D Kevans
Department of Gastroenterology, St. James Hospital, Dublin
Faecal calprotectin reflects intestinal leukocyte migration and has been shown to be a highly sensitive non-invasive biochemical marker for the diagnosis of inflammatory bowel disease with strong correlation with disease activity.
To assess the performance of FC as a biomarker of intestinal inflammation in real life clinical practice in an Irish IBD centre.
N=87 Consecutive IBD Patients attending a specialist IBD clinic had a faecal calprotectin (FC) estimation was performed using a commercially available assay. N=29 with endoscopic assessment within 2 months of FC assay were included in this preliminary analysis. FC was expressed in μg / g of faeces and was considered as a continuous variable. Baseline demographic data and medication were defined for each subject. Endoscopic assessments were reviewed and the cohort was dichotomized based on the presence or absence of significant mucosal inflammation. Blood biomarkers, Hb, CRP, platelet count and serum Albumin, determined at the time of FC estimation, were collected. The association between the presence of mucosal inflammation and FC, Hb, platelet count, CRP and Albumin was determined. Multivariate logistic regression was performed to determine variables independently associated with the presence of mucosal inflammation.
42.9% (12) had Crohns disease, 3.6% (1) had indeterminate IBD and the remaining 53.5% (15) had a diagnosis of UC. FC was significantly increased in the presence of mucosal inflammation, median FC 362 μg / g vs. 1000 μg / g in group with absent versus present mucosal inflammation (p=0.004). Serum Albumin was significantly decreased in the presence of mucosal inflammation, median serum Albumin 45 vs. 40 g / L in the group with absent versus present mucosal inflammation (p=0.02). Hb was significantly decrease in the presence of mucosal inflammation, median Hb 13.9 vs. 13.0 g / L (p=0.04) in absent versus present mucosal inflammation. CRP and platelet count were not associated with the presence of mucosal inflammation. FC demonstrated a weak independent association with the presence of mucosal inflammation, Odds ratio 1.01 (95% CI 1.00 – 1.01), p=0.04.
In these preliminary data FC has been shown to be a valuable non-invasive biomarker of intestinal inflammation. Blood biomarkers such as Hb, Albumin and CRP remain important in the assessment of inflammatory burden in IBD cohorts. Increasing use of FC in routine clinical practice has the potential to reduce the requirement for endoscopic assessments in IBD cohorts.