Fecal Calprotectin Proves an Effective Biomarker of Endoscopic Inflammation in UC
In patients with ulcerative colitis, a fecal calprotectin cutoff of 60 mcg/g distinguished between a Mayo endoscopic subscore (MES) of 0 and MES 1-3 and predicted clinical remission with high specificity, according to study results published online ahead of print in Inflammatory Bowel Diseases.
“This study supports the reliability and applicability of fecal calprotectin as a valuable marker of endoscopic inflammation,” wrote corresponding author Tanita Suttichaimongkol, MD, of the Mayo Clinic College of Medicine and Science, Rochester, Minnesota, and Khon Kaen University in Thailand, and study coauthors.
The study included 177 adults with ulcerative colitis from the Mayo Clinic in Rochester, Minnesota. Researchers reviewed electronic medical records for clinical data and fecal calprotectin levels before colonoscopy or flexible sigmoidoscopy to ascertain fecal calprotectin cutoffs associated with MES. The median time between fecal calprotectin collection and endoscopy was 2 days.
Fecal calprotectin strongly and positively correlated with MES and clinical data, researchers reported.
Specifically, a fecal calprotectin cutoff of 60 mcg/g distinguished MES 0 from MES 1-3 with 0.78 sensitivity, 0.97 specificity, and an area under the receiver operating characteristic curve (AUC) of 0.901, according to the study. The same cutoff also predicted clinical remission, defined as a total Mayo score of 2 or less with no subscore above 1, with 0.83 sensitivity, 0.98 specificity, and an AUC of 0.921.
Meanwhile, a fecal calprotectin cutoff of 110 mcg/g effectively distinguished MES 0-1 from MES 2-3, with 0.86 sensitivity, 0.87 specificity, and an AUC of 0.915. A cutoff of 310 mcg/g differentiated MES 0-2 from MES 3, with 0.80 sensitivity, 0.76 specificity, and 0.820 AUC, the study showed.
Reference:
Suttichaimongkol T, Coelho-Prabhu N, Bruining DH, Tariq R, Snyder MR, Loftus EV Jr. Diagnostic performance of a fecal calprotectin assay as a biomarker for Mayo endoscopic subscore in ulcerative colitis: result from a tertiary referral center. Inflamm Bowel Dis. Published online February 3, 2024. doi:10.1093/ibd/izae005
