This blog has been a fan of calprotectin levels (see related posts below) as both a screening test for inflammatory bowel disease and as a marker of disease activity. Now more data is available indicating that calprotectin levels, much like endoscopic mucosal healing, after induction therapy correlates with long-term response (Inflamm Bowel Dis 2012; 18: 2011-17).
This retrospective study (2005-2010) examined 60 patients with IBD with elevated baseline calprotectin levels. 34 patients had Crohn’s disease (CD) and 26 had ulcerative colitis (UC). 42 patients received infliximab therapy and 18 patients received adalimumab. After induction therapy, therapy was discontinued in primary non responders or continued as scheduled maintenance therapy for at least one year if not relapsing.
The average age at induction for CD patients was 30 and the corresponding age at diagnosis was 21. For UC patients, the average age at induction was 29 and the corresponding age at diagnosis was 26.
Median calprotectin level at baseline was 810 μg/g (n=60). After induction, the median value dropped to 97 μg/g (n=60) and at 1 year the value dropped to 27 μg/g (n=25). The calprotectin level normalized in 31 patients after induction. At 12 months, the sustained remission was present in 84% (26/31). In contrast, only 38% (11/29) who had elevated levels after induction were in remission at 12 months.
Related blog entries:
- How sensitive is Calprotectin? | gutsandgrowth
- Biomarkers identify patients who benefit and how | gutsandgrowth Multiple additional calprotectin references with this link
- Food as medicine | gutsandgrowth