TY - JOUR

T1 - The correlation between fecal calprotectin, simple clinical colitis activity index and biochemical markers in ulcerative colitis during high-dose steroid treatment

AU - Theede, Klaus

AU - Kiszka-Kanowitz, Marianne

AU - Nielsen, Anette Mertz

AU - Nordgaard-Lassen, Inge

PY - 2014/4

Y1 - 2014/4

N2 - OBJECTIVE: Monitoring active ulcerative colitis (UC) is essential for making correct and timely treatment decisions. The current monitoring is based on symptom scores and biochemical markers, among which the role of fecal calprotectin (FC) is debated. The aims were to assess the development in FC during steroid treatment and to compare FC with symptom scores and biochemical markers.MATERIAL AND METHODS: A prospective observational study, including 16 patients with active UC requiring high-dose steroid treatment. FC, C-reactive protein (CRP), leukocytes, hemoglobin, albumin, and simple clinical colitis activity index (SCCAI) were assessed before the initiation of treatment, as well as on days 2, 6, 13, and 27. The one-year follow-up data were retrospectively obtained.RESULTS: All patients had significant decreasing levels of FC (-1014 mg/kg, p = 0.0061), CRP (-10 mmol/l, p = 0.0313), and SCCAI (-3, p = 0.0002) during the first 4 days. After 27 days, the FC had decreased to 216 mg/kg (p = 0.002). A significant correlation between the changes in CRP and SCCAI was found (r(s) = 0.65, p = 0.03) but not between FC and CRP or SCCAI. Overall, significant correlations between absolute levels of FC, CRP, and SCCAI were found. Levels of FC on day 0 and day 4 were not predictive of sustained clinical remission at 1-year follow up.CONCLUSIONS: FC, CRP, and SCCAI seem to be reliable markers of treatment response during steroid treatment. High initial levels of FC and a subsequent rapid reduction during steroid treatment were identified. FC levels were not found to be predictive of disease prognosis after one year.

AB - OBJECTIVE: Monitoring active ulcerative colitis (UC) is essential for making correct and timely treatment decisions. The current monitoring is based on symptom scores and biochemical markers, among which the role of fecal calprotectin (FC) is debated. The aims were to assess the development in FC during steroid treatment and to compare FC with symptom scores and biochemical markers.MATERIAL AND METHODS: A prospective observational study, including 16 patients with active UC requiring high-dose steroid treatment. FC, C-reactive protein (CRP), leukocytes, hemoglobin, albumin, and simple clinical colitis activity index (SCCAI) were assessed before the initiation of treatment, as well as on days 2, 6, 13, and 27. The one-year follow-up data were retrospectively obtained.RESULTS: All patients had significant decreasing levels of FC (-1014 mg/kg, p = 0.0061), CRP (-10 mmol/l, p = 0.0313), and SCCAI (-3, p = 0.0002) during the first 4 days. After 27 days, the FC had decreased to 216 mg/kg (p = 0.002). A significant correlation between the changes in CRP and SCCAI was found (r(s) = 0.65, p = 0.03) but not between FC and CRP or SCCAI. Overall, significant correlations between absolute levels of FC, CRP, and SCCAI were found. Levels of FC on day 0 and day 4 were not predictive of sustained clinical remission at 1-year follow up.CONCLUSIONS: FC, CRP, and SCCAI seem to be reliable markers of treatment response during steroid treatment. High initial levels of FC and a subsequent rapid reduction during steroid treatment were identified. FC levels were not found to be predictive of disease prognosis after one year.

KW - Adult

KW - Aged

KW - Albumins

KW - Biological Markers

KW - C-Reactive Protein

KW - Colitis, Ulcerative

KW - Denmark

KW - Feces

KW - Female

KW - Glucocorticoids

KW - Hemoglobins

KW - Humans

KW - Leukocyte Count

KW - Leukocyte L1 Antigen Complex

KW - Male

KW - Middle Aged

KW - Prednisolone

KW - Prospective Studies

U2 - 10.3109/00365521.2014.883427

DO - 10.3109/00365521.2014.883427

M3 - Journal article

C2 - 24495103

VL - 49

SP - 418

EP - 423

JO - Scandinavian Journal of Gastroenterology. Supplement

JF - Scandinavian Journal of Gastroenterology. Supplement

SN - 0085-5928

IS - 4

ER -