TY - JOUR
T1 - Measurement of fecal calprotectin improves monitoring and detection of recurrence of Crohn's disease after surgery
AU - Wright, Emily K
AU - Kamm, Michael
AU - Cruz, Peter De
AU - Hamilton, Amy Louise
AU - Ritchie, Kathryn J
AU - Krejany, Efrosinia O
AU - Leach, Steven
AU - Gorelik, Alexandra
AU - Liew, Danny
AU - Prideaux, Lani
AU - Lawrance, Ian
AU - Andrews, Jane M
AU - Bampton, Peter A
AU - Jakobovits, Simon L
AU - Florin, Timothy
AU - Gibson, Peter Raymond
AU - Debinski, Henry
AU - Macrae, Finlay A
AU - Samuel, Douglas
AU - Kronborg, Ian
AU - Radford-Smith, Graham
AU - Selby, Warwick S
AU - Johnston, Michael
AU - Woods, Rodney
AU - Elliott, P Ross
AU - Bell, Sally
AU - Brown, Steven J
AU - Connell, William R
AU - Day, Andrew S
AU - Desmond, Paul V
AU - Gearry, Richard Blair
PY - 2015
Y1 - 2015
N2 - 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
AB - 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
UR - http://www.sciencedirect.com/science/article/pii/S0016508515001110
U2 - 10.1053/j.gastro.2015.01.026
DO - 10.1053/j.gastro.2015.01.026
M3 - Article
SN - 0016-5085
VL - 148
SP - 938
EP - 947
JO - Gastroenterology
JF - Gastroenterology
IS - 5
ER -