IS FECAL CALPROTECTIN AN ACCURATE MARKER IN THE MANAGEMENT OF CROHN’S DISEASE?
J Gastroenterol Hepatol. 2019 Dec 03;:
Authors: Vernia F, Di Ruscio M, Stefanelli G, Viscido A, Frieri G, Latella G
Although lacking validated cut-off values, fecal calprotectin (FC), besides C-reactive protein, is considered the standard test for assessing disease activity in CD. Aim of the present review is to provide a general overview of the literature addressing the role of FC in the clinical and endoscopic assessment of disease activity in CD, seeking correlations with capsule endoscopy, response to therapy, prediction of relapse and post-operative recurrence (POR). A systematic search of the literature up to September 2019 was performed using Medline, Embase, and the Cochrane Library. Only papers written in English concerning FC in adult patients affected by CD were included. Pediatric studies, in vitro studies, animal studies, studies on blood/serum samples, and studies analysing FC in ulcerative colitis (UC) or in both CD and UC were excluded. Out of 713 citations, 65 eligible studies were identified. FC showed high accuracy in the assessment of intestinal inflammation and response to therapy, in particular in colonic disease, thus proving a good surrogate marker for these aims. FC is useful in identifying patients at high risk for endoscopic relapse or post-operative recurrence, for optimizing or downstage therapy. Unfortunately, FC performs less well in small bowel CD. FC is an effective fecal marker in the management of CD patients, optimizing the use of endoscopic procedures. Due to its diagnostic accuracy, FC may represent a cornerstone of the “Treat-To-Target” management strategy of CD patients.
PMID: 31795013 [PubMed – as supplied by publisher]