[en] 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 naive patients with ulcerative colitis predictive for remission of disease.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
De Vos, M.
Dewit, Olivier
D'Haens, G.
Baert, F.
Fontaine, Fabienne
Vermeire, S.
Franchimont, D.
Moreels, T.
Staessen, D.
Terriere, L.
Vander Cruyssen, B.
LOUIS, Edouard ; Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Language :
English
Title :
Fast and sharp decrease in calprotectin predicts remission by infliximab in anti-TNF naive patients with ulcerative colitis.
Publication date :
2012
Journal title :
Journal of Crohn's and Colitis
ISSN :
1873-9946
eISSN :
1876-4479
Publisher :
Elsevier, United Kingdom
Volume :
6
Issue :
5
Pages :
557-62
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
Rutgeerts P., Sandborn W.J., Feagan B.G., Reinisch W., Olson A., Johanns J., et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med Dec 8, 2005, 353(23):2462-2476. Erratum in: N Engl J Med. 2006 May 18;354(20):2200.
Barreiro-de Acosta M., Lorenzo A., Mera J., Dominguez-Muñoz J.E. Mucosal healing and steroid sparing associated with infliximab for steroid-dependent ulcerative colitis. J Crohns Colitis Dec 2009, 3(4):271-276.
Røseth A.G., Aadland E., Jahnsen J., Raknerud N. Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein. Digestion 1997, 58(2):176-180.
Costa F., Mumolo M.G., Ceccarelli L., Bellini M., Romano M.R., Sterpi C., et al. Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease. Gut Mar 2005, 54(3):364-368.
Schoepfer A.M., Trummler M., Seeholzer P., Criblez D.H., Seibold F. Accuracy of four faecal assays in the diagnosis of colitis. Dis Colon Rectum Oct 2007, 50(10):1697-1706.
Gisbert J.P., Bermejo F., Pérez-Calle J.L., Taxonera C., Vera I., McNicholl A.G., et al. Faecal calprotectin and lactoferrin for the prediction of inflammatory bowel relapse. Inflamm Bowel Dis Aug 2009, 15(8):1190-1198.
D'Incà R., Dal Pont E., Di Leo V., Benazzato L., Martinato M., Lamboglia F., et al. Can calprotectin predict relapse risk in inflammatory bowel disease?. Am J Gastroenterol Aug 2008, 103(8):2007-2014.
Ho G.T., Lee H.M., Brydon G., Ting T., Hare N., Drummond H., et al. Faecal calprotectin predicts the clinical course of acute severe colitis. Am J Gastroenterol Mar 2009, 104(3):673-678.
Turner D., Leach S.T., Mack D., Uusoue K., McLernon R., Hyams J., et al. Faecal calprotectin, lactoferrin, M2-pyruvate kinase and S100A12 in severe ulcerative colitis: a prospective multicenter comparison of predicting outcomes and monitoring response. Gut Sep 2010, 59(9):1207-1212.
Targan S.R., Hanauer S.B., van Deventer S.J., Mayer L., Present D.H., Braakman T., et al. A short term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease. N Engl J Med Oct 9, 1997, 337(15):1029-1035.
Jürgens M., Laubender R.P., Hartl F., Weidinger M., Seiderer J., Wagner J., et al. Disease activity, ANCA and IL23R genotype status determine early response to infliximab in patients with ulcerative colitis. Am J Gastroenterol Aug 2010, 105(8):1811-1819.
Ferrante M., Vermeire S., Katsanos K.H., Noman M., Van Assche G., Schnitzler F., et al. Predictors of early response to infliximab in patients with ulcerative colitis. Inflamm Bowel Dis Feb 2007, 13(2):123-128.
Sylvester F.A., Turner D., Draghi A., Uuosoe K., McLernon R., Koproske K., et al. Faecal osteoprotegerin may guide the introduction of second-line therapy in hospitalized children with ulcerative colitis. Inflamm Bowel 2011, 17(8):1726-1730.