Variation of faecal calprotectin level within the first three months after bowel resection is predictive of endoscopic postoperative recurrence in Crohn's disease.
Adult
Anti-Inflammatory Agents, Non-Steroidal
/ therapeutic use
Azathioprine
/ therapeutic use
Biomarkers
/ metabolism
Colectomy
Crohn Disease
/ drug therapy
Curcumin
/ therapeutic use
Feces
/ chemistry
Female
France
Humans
Immunosuppressive Agents
/ therapeutic use
Leukocyte L1 Antigen Complex
/ metabolism
Male
Middle Aged
Postoperative Period
Predictive Value of Tests
ROC Curve
Recurrence
Remission Induction
Severity of Illness Index
Time Factors
Treatment Outcome
Young Adult
Crohn's disease
Faecal calprotectin
Monitoring
Postoperative recurrence
Surgery
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
14
01
2020
revised:
18
03
2020
accepted:
23
03
2020
pubmed:
24
5
2020
medline:
20
7
2021
entrez:
24
5
2020
Statut:
ppublish
Résumé
Early prediction of postoperative recurrence (POR) remains a major concern in Crohn's disease (CD). To assess serial faecal calprotectin (Fcal) monitoring within the first three months to predict CD endoscopic POR. In a multicenter randomized controlled trial, CD patients received azathioprine 2.5 mg/kg/day with oral curcumin (3 g/day) or placebo. Fcal was measured at baseline, one month (M1) and M3. Endoscopic POR at M6 was defined as Rutgeerts' index ≥ i2b (central reading). Among the 48 patients included, there was no significant difference of median Fcal levels at baseline (p = 0.15), M1 (p = 0.44) and M3 (p = 0.28) between patients with or without endoscopic POR at M6. Fcal kinetics during the first 3 months after surgery was significantly different between the patients with or without POR at M6 (p = 0.021). The median variation between Fcal level at baseline and M3 (ΔFcal M3-M0) was significantly higher in patients with endoscopic POR compared to those without POR (p = 0.01). ΔFcal M3-M0 >+10% demonstrated the best performances to predict endoscopic POR at M6 (AUC=0.73, sensitivity=64.7%[41.1-82.7], specificity=87.5%[68.0-96.3], negative predictive value=77.8%[57.5-91.4] and positive predictive value=78.6%[49.2-95.3]). Fcal variation within the first three months after ileocolonic resection is a promising predictor of early endoscopic POR in CD patients.
Sections du résumé
BACKGROUND
Early prediction of postoperative recurrence (POR) remains a major concern in Crohn's disease (CD).
AIMS
To assess serial faecal calprotectin (Fcal) monitoring within the first three months to predict CD endoscopic POR.
METHODS
In a multicenter randomized controlled trial, CD patients received azathioprine 2.5 mg/kg/day with oral curcumin (3 g/day) or placebo. Fcal was measured at baseline, one month (M1) and M3. Endoscopic POR at M6 was defined as Rutgeerts' index ≥ i2b (central reading).
RESULTS
Among the 48 patients included, there was no significant difference of median Fcal levels at baseline (p = 0.15), M1 (p = 0.44) and M3 (p = 0.28) between patients with or without endoscopic POR at M6. Fcal kinetics during the first 3 months after surgery was significantly different between the patients with or without POR at M6 (p = 0.021). The median variation between Fcal level at baseline and M3 (ΔFcal M3-M0) was significantly higher in patients with endoscopic POR compared to those without POR (p = 0.01). ΔFcal M3-M0 >+10% demonstrated the best performances to predict endoscopic POR at M6 (AUC=0.73, sensitivity=64.7%[41.1-82.7], specificity=87.5%[68.0-96.3], negative predictive value=77.8%[57.5-91.4] and positive predictive value=78.6%[49.2-95.3]).
CONCLUSION
Fcal variation within the first three months after ileocolonic resection is a promising predictor of early endoscopic POR in CD patients.
Identifiants
pubmed: 32444250
pii: S1590-8658(20)30122-5
doi: 10.1016/j.dld.2020.03.020
pii:
doi:
Substances chimiques
Anti-Inflammatory Agents, Non-Steroidal
0
Biomarkers
0
Immunosuppressive Agents
0
Leukocyte L1 Antigen Complex
0
Curcumin
IT942ZTH98
Azathioprine
MRK240IY2L
Types de publication
Clinical Trial, Phase III
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
740-744Informations de copyright
Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.