Open AccessPharmacological intervention based on fecal calprotectin levels in patients with ulcerative colitis at high risk of a relapse: A prospective, randomized, controlled study
Author(s) -
Lasson Anders,
Öhman Lena,
Stotzer Per-Ove,
Isaksson Stefan,
Überbacher Otto,
Ung Kjell-Arne,
Strid Hans
Publication year - 2015
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640614560785
Subject(s) - medicine , calprotectin , ulcerative colitis , feces , randomized controlled trial , prospective cohort study , gastroenterology , colonoscopy , inflammatory bowel disease , colorectal cancer , disease , paleontology , biology , cancer
Background Targeted therapy, using biomarkers to assess disease activity in ulcerative colitis (UC), has been proposed. Objective The objective of this study was to evaluate whether pharmacological intervention guided by fecal calprotectin (FC) prolongs remission in patients with UC. Methods A total of 91 adults with UC in remission were randomized to an intervention group or a control group. Analysis of FC was performed monthly, during 18 months. A FC value of 300 µg/g was set as the cut‐off for intervention, which was a dose escalation of the oral 5‐aminosalicylate (5‐ASA) agent. The primary study end‐point was the number of patients to have relapsed by month 18. Results There were relapses in 18 (35.3%) and 20 (50.0%) patients in the intervention and the control groups, respectively ( p = 0.23); and 28 (54.9%) patients in the intervention group and 28 (70.0%) patients in the control group had a FC > 300 µg/g, of which 8 (28.6%) and 16 (57.1%) relapsed, respectively ( p < 0.05). Conclusion Active intervention significantly reduced relapse rates, although no significant difference was reached between the groups overall. Thus, FC‐levels might be used to identify patients with UC at risk for a flare, and a dose escalation of their 5‐ASA agent is a therapeutic option for these patients.