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Journal of Crohn's and Colitis: 9 (6)

Editor-in-Chief

Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium

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Published on behalf of

Fast and sharp decrease in calprotectin predicts remission by infliximab in anti-TNF naïve patients with ulcerative colitis

M. De Vos , O. Dewit , G. D'Haens , F. Baert , F. Fontaine , S. Vermeire , D. Franchimont , T. Moreels , D. Staessen , L. Terriere , B. Vander Cruyssen , E. Louis ,
DOI: http://dx.doi.org/10.1016/j.crohns.2011.11.002 557-562 First published online: 1 June 2012

Abstract

Aim: To evaluate the effect of infliximab induction therapy on calprotectin levels in patients with ulcerative colitis (UC).

Patients and Methods: In this prospective study 53 patients with active UC from 17 centers were treated with infliximab therapy (5 mg/kg) at baseline, week 2, and week 6. Faecal calprotectin was measured every week. Sigmoidoscopies were performed at baseline, week 6 and week 10.

Results: Median calprotectin levels decreased from 1260 (IQR 278.5- 3418 ) at baseline to 72.5 (IQR 18.5 - 463) at week 10 (p < 0.001). After 10 weeks, infliximab therapy induced endoscopic remission and a decrease in calprotectin to < 50 mg/kg or at least a 80% decrease from baseline level in 58% of patients.

A significant and steep decrease of calprotectin levels was seen at week 2 for patients with an endoscopic remission at week 10 as compared to patients who did not show a remission. (p < 0.001).

At week 10 an excellent correlation was found between endoscopic remission and clinical Mayo score reflected by an AUC of ROC analyses of 0.94 (0.87-1) and with calprotectin measurements (AUC 0.91 (0.81-1)) : all patients with calprotectin levels < 50 mg/kg, and a normal clinical Mayo score (= 0) were in endoscopic remission.

Conclusions: Infliximab induces a fast and significant decrease of faecal calprotectin levels in anti-TNF naïve patients with ulcerative colitis predictive for remission of disease

Keywords
  • Ulcerative Colitis
  • Infliximab
  • Calprotectin
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