Article Text

PDF
PWE-024 Early Change in Faecal Calprotectin Predicts Primary Non- Response to Anti-TNFΑ Therapy in Inflammatory Bowel Disease
  1. P Pavlidis1,
  2. S Gulati1,
  3. P Dubois1,
  4. G Chung-Faye1,
  5. J Tumova1,
  6. L Medcalf1,
  7. LM Choong1,
  8. R Sherwood2,
  9. I Bjarnason1,
  10. B Hayee1
  1. 1Department of Gastroenterology
  2. 2Department of Biochemistry, King’s College Hospital, London, UK

Abstract

Introduction The early identification of primary non-response to anti-TNFα therapy facilitates the timely management of patients with inflammatory bowel disease (IBD). A recent, pilot study to detect prognostic markers of early response to anti-TNFα therapy identified the two genes coding for the calprotectin subunits (S100A8, S100A9) to be among the most highly expressed gene transcripts in non-responders. This study tests the hypothesis that measurements of faecal calprotectin (FCAL) pre- and post- anti-TNFα induction can predict primary non-response in both Crohn’s disease (CD) and ulcerative colitis (UC)

Methods Retrospective study of 32 CD and 18 UC patients treated over a two-year period. Outcomes were assessed using Harvey-Bradshaw Index (HBI) or Simple Clinical Colitis Activity Index (SCCAI) (response: drop in HBI/SCCAI >3, remission: HBI < 5, SCCAI <3, steroid free) at 6 months. ΔFCAL was calculated as (FCALpost induction – FCALpre induction)*100/FCAL pre induction.

Results At 6 months, 23 (72%) CD and 10 (56%) UC patients had responded. In remission were 17 (53%) and 5 (28%) respectively. Comparing non-responders to combined response and remission groups, the area under the curve of ΔFCAL to predict outcomes at 6 months was 0.97 for CD and 0.96 for UC. Using ROC analysis, a decrease of 70% returned a sensitivity and specificity of 99% and 96%, respectively (likelihood ratio, LR = 23) in CD. For UC a a decrease of 70% had a sensitivity and specificity of 88% and 86%, respectively (LR = 6).

Conclusion A drop in FCAL < 70% after induction predicts primary non-response to anti-TNFα in both CD and UC.

Disclosure of Interest None Declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.