Introduction Background Mucosal healing (MH) is an increasingly important therapeutic goal in inflammatory bowel disease. Monoclonal antibody (MA) therapy aims to achieve this and faecal calprotectin (FC) concentration has been shown as a surrogate marker for MH.
Aims Our aim was to study the profile of Crohn’s disease (CD) patients on MA therapy and evaluate whether FC levels after induction therapy with MA predicts the medium-term outcome.
Methods Thirty-two CD patients: infliximab n = 11, adalimumab n = 21 were identified from our MA database. Data on demography and disease characteristics were extracted from case records. A subset of CD patients with FC levels measured both at baseline and after induction therapy were analysed further for response to therapy and disease course during follow-up (n = 10). Disease activity was evaluated by modified Harvey-Bradshaw index at baseline, after induction, and at 6 and 12 months during maintenance therapy.
Results Of 32 patients, 22 patients were female, medium age 39.5 (range: 19–65 year), medium age at diagnosis 30.2 (range: 16–61year), mean disease duration prior to MA was 6.1 (range: 10 –22 year) and 21.8% has family history of inflammatory bowel disease. Of these, 56.2% had history of surgery prior to MA and 71.7% had concurrent immunomodulation. Disease phenotypes are shown in table. Of the 10 patients with full FC data, 6 patients normalised FC after induction (median levels 67 mg/kg, median 64 mg/ks, range 30–72). All remained in remission during follow-up median- 22 months (range 13–33 months). Four patients failed to normalise FC levels with induction therapy (median 11 months, range 6–39). Of these, 2 had operation, 2 had multiple relapses (1 treated with prolonged enteral therapy and 1 with additional oral corticosteroid courses).
Conclusion MA therapy is used in CD patients with aggressive disease course who are treated/intolerant to immunomodulatory therapy. Normalisation of FC after induction therapy with MA is a useful marker to predict sustained clinical remission.
Disclosure of Interest None Declared.