Measurement of fecal calprotectin improves monitoring and detection of recurrence of Crohn's disease after surgery

Emily K Wright, Michael Kamm, Peter De Cruz, Amy Louise Hamilton, Kathryn J Ritchie, Efrosinia O Krejany, Steven Leach, Alexandra Gorelik, Danny Liew, Lani Prideaux, Ian Lawrance, Jane M Andrews, Peter A Bampton, Simon L Jakobovits, Timothy Florin, Peter Raymond Gibson, Henry Debinski, Finlay A Macrae, Douglas Samuel, Ian KronborgGraham Radford-Smith, Warwick S Selby, Michael Johnston, Rodney Woods, P Ross Elliott, Sally Bell, Steven J Brown, William R Connell, Andrew S Day, Paul V Desmond, Richard Blair Gearry

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158 Citations (Scopus)

Abstract

Background Aims Crohn s disease (CD) usually recurs after intestinal resection; postoperative endoscopic monitoring and tailored treatment can reduce the chance of recurrence. We investigated whether monitoring levels of fecal calprotectin (FC) can substitute for endoscopic analysis of the mucosa. Methods We analyzed data collected from 135 participants in a prospective, randomized, controlled trial, performed at 17 hospitals in Australia and 1 hospital in New Zealand, that assessed the ability of endoscopic evaluations and step-up treatment to prevent CD recurrence after surgery. Levels of FC, serum levels of C-reactive protein (CRP), and Crohn s disease activity index (CDAI) scores were measured before surgery and then at 6, 12, and 18 months after resection of all macroscopic Crohn s disease. Ileocolonoscopies were performed at 6 months after surgery in 90 patients and at 18 months after surgery in all patients. Results Levels of FC were measured in 319 samples from 135 patients. The median FC level decreased from 1347 ?g/g before surgery to 166 ?g/g at 6 months after surgery, but was higher in patients with disease recurrence (based on endoscopic analysis; Rutgeerts score, =i2) than in patients in remission (275 vs 72 ?g/g, respectively; P
Original languageEnglish
Pages (from-to)938 - 947
Number of pages10
JournalGastroenterology
Volume148
Issue number5
DOIs
Publication statusPublished - 2015

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