Specific Diseases

Specific-Diseases_Publications
Rapid fecal calprotectin test for prediction of mucosal inflammation in ulcerative colitis and Crohn disease: a prospective cohort study

FC levels increased dynamically even with mild signs of intestinal inflammation. The rapid Quantum Blue® test presents a potential alternative to the time‑consuming ELISA, because its diagnostic accuracy is not influenced by disease location. It may be useful in the hospital setting, providing faster diagnosis and allowing cost reduction by lowering the number of endoscopic procedures.

Moniuszko et al. (2017). Polish Archive of Internal Medicine. Vol. 127, no. 5, pp 312-318
Faecal calprotectin correlates well with extent of active endoscopic inflammation in patients with ulcerative colitis

FC is reasonably accurate in predicting active disease location. This may be improved by adding clinical markers such as rectal bleeding and PMS. Pending larger studies validation, FC may be useful to direct topical vs systemic therapy in UC.

Chayut et al. (2016) Inflammatory Bowel Diseases. Congress abstract, P351
High Within-day Variability of Fecal Calprotectin Levels in Patients with Active Ulcerative Colitis: What Is the Best Timing for Stool Sampling?

FC values widely vary between motions in patients with active UC. Stool sample collection from the first bowel movement in the morning does not ensure the highest or lowest within-day FC value. In patients with overt active UC, a single FC determination should not be used as the basis for therapeutic strategies.

Calafat et al. (2015) Inflammatory Bowel Disease
Rapid fecal calprotectin testing predicts mucosal healing better than C-reactive protein and serum tumor necrosis factor α in patients with ulcerative colitis

Rapid calprotectin testing is a better predictor of mucosal healing than serum biomarkers and it could improve the management of ulcerative colitis patients by decreasing the need for invasive investigations.

Voiosu et al. (2015) Romanian Journal of Internal Medicine. Vol. 53, no. 4
Fecal level of calprotectin identifies histologic inflammation in patients with ulcerative colitis in clinical and endoscopic remission

Histologic inflammation is common among patients with UC in clinical and endoscopic remission. Patients with histologic features of inflammation can be identified reliably based on their fecal level of calprotectin.

Guardiola et al. (2014) Clinical Gastroenterology and Hepatology
The Intra-Individual Variability of Faecal Calprotectin: A Prospective Study In Patients With Active Ulcerative Colitis

The present data reveal a great variability in the concentrations of calprotectin in stool samples collected during a single day. Since the levels of calprotectin increased with longer time between the bowel movements, it seems most appropriate to analyse stool from the first bowel movement in the morning.

Lasson et al. (2014) Journal of Crohn’s and Colitis
Consecutive fecal calprotectin measurements to predict relapse in patients with ulcerative colitis receiving infliximab maintenance therapy

Fecal calprotectin can be used in daily practice to monitor patients with UC receiving infliximab maintenance therapy. Two consecutive measurements >300 mg/kg is more specific than a single measurement for predicting relapse.

De Vos et al. (2013) Inflammatory Bowel Disease
Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the Lichtiger Index, C-reactive protein, platelets, hemoglobin, and blood leukocytes.

FC correlated better with endoscopic disease activity than clinical activity, CRP, platelets, hemoglobin, and blood leukocytes. The strong correlation with endoscopic disease activity suggests that FC represents a useful biomarker for noninvasive monitoring of disease activity in UC patients.

Schoepfer et al. (2013) Inflammatory Bowel Disease
A new rapid test for fecal calprotectin (FC) predicts mucosa healing in ulcerative colitis (UC)

Fecal calprotectin is an accurate biomarker of endoscopic activity/mucosa healing. A 250 µg/g cut-off of FC offers a high sensitivity and specificity to predict MH. The good correlation between ELISA and the new rapid quantitative test enables us to use in in order to take fast and adequate decisions.

Ortega et al. (2012) European Crohn’s and Colitis Organisation. Presentation Poster, 2012 Congress Barcelona
Ulcerative Colitis: Correlation of the Rachmilewitz Endoscopic Activity Index with Fecal Calprotectin, Clinical Activity, C-reactive Protein, and Blood Leukocytes

Fecal calprotectin correlated closest with endoscopic disease activity, followed by Clinical Activity Index, CRP, and blood leukocytes. Furthermore, fecal calprotectin was the only marker that reliably discriminated inactive from mild, moderate, and highly active disease, which emphasizes its usefulness for activity monitoring.

Schoepfer et al. (2010) Inflammatory Bowel Disease
Validation of a care pathway for the use of faecal calprotectin in monitoring patients with Crohn's disease

This validation of a pragmatic clinical care pathway demonstrates a safe and effective mechanism by which to use FC to monitor risk of disease activity in patients with Crohn’s disease established on therapy. It provides a framework for prioritising follow-up and for identifying patients at risk of continuing disease activity or those in whom therapy could be stepped down.

Turvill et al. (2017). BMJ Journals
Rapid fecal calprotectin test for prediction of mucosal inflammation in ulcerative colitis and Crohn disease: a prospective cohort study

FC levels increased dynamically even with mild signs of intestinal inflammation. The rapid Quantum Blue® test presents a potential alternative to the time‑consuming ELISA, because its diagnostic accuracy is not influenced by disease location. It may be useful in the hospital setting, providing faster diagnosis and allowing cost reduction by lowering the number of endoscopic procedures.

Moniuszko et al. (2017). Polish Archive of Internal Medicine. Vol. 127, no. 5, pp 312-318
Cost-effectiveness of Crohn’s disease post-operative care

Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated.

Wright et al. (2016) World Journal of Gastroenterology
Comparison of Fecal Inflammatory Markers in Crohn’s Disease

FC was the optimal fecal marker for monitoring disease activity in postoperative CD and was superior to CRP and CDAI. FL offered modest sensitivity for detecting recurrent disease, whereas S100A12 was sensitive but had low specificity and NPV.

Wright et al. (2016) Inflammatory Bowel Disease Volume 22, Number 5, May 
Early change in faecal calprotectin predicts primary non-response to anti-TNFα therapy in Crohn’s disease

A drop in FCAL <70% after induction predicts primary non-response to anti-TNFα in CD.

Pavlidis et al. (2016) Scandinavian Journal of Gastroenterology
Measurement of Fecal Calprotectin Improves Monitoring and Detection of Recurrence of Crohn’s Disease After Surgery

In this analysis of data from a prospective clinical trial, FC measurement has sufficient sensitivity and NPV values to monitor for CD recurrence after intestinal resection. Its predictive value might be used to identify patients most likely to relapse. After treatment for recurrence, the FC level can be used to monitor response to treatment. It predicts which patients will have disease recurrence with greater accuracy than CRP level or CDAI score.

Wright et al. (2015) Gastroenterology vol. 148
Mapping of Crohn’s disease outcomes to faecal calprotectin levels in patients maintained on biologic therapy

FC is an accurate marker of Crohn’s disease activity and predicts for relapse, thus providing the clinician time to optimise therapy. FC is a more sensitive marker of Crohn’s disease activity than CRP.

Turvill (2015) British Medical Journal
A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn's disease

In this prospective dataset, FC is a useful tool to help identify quiescent Crohn’s disease patients at a low risk of relapse over the ensuing 12 months. FC of 240 μg/g was the optimal cutoff in this cohort.

Naismith et al. (2014) Journal of Crohn’s and Colitis
A new rapid test for fecal calprotectin predicts endoscopic remission and postoperative recurrence in Crohn's disease

A new rapid test for fecal calprotectin predicts endoscopic remission and postoperative recurrence in Crohn’s disease

 Lobatón et al. (2013) Journal of Crohn’s & Colitis. Vol. 12 pp. 641-51
Role of endoscopy, cross-sectional imaging and biomarkers in Crohn's disease monitoring

The use of biomarkers as surrogate markers of intestinal and systemic inflammation might help. Two biomarkers have been most broadly assessed in Crohn’s disease: C-reactive protein and faecal calprotectin. These markers correlate significantly with endoscopic lesions, with the risk of relapse and with response to therapy. They could be used to help make decisions about diagnostic procedures and treatment.

 Benitez et al. (2013) GUT
A new rapid test for fecal calprotectin (FC) predicts mucosa healing in Crohn’s Disease (CD)

Fecal calprotectin predict MH more accurately than CRP and the rest of biomarkers. The good correlation between ELISA and this quantitative rapid test enables us to use the rapid one in order to take fast and adequate decisions.

 Ortega et al. (2012) European Crohn’s and Colitis Organisation. Presentation Poster, 2012 Congress Barcelona
Fecal calprotectin is equally sensitive in Crohn's disease affecting the small bowel and colon

Levels and sensitivities of fCal are equal in patients with colonic and small bowel CD. Due to its high sensitivity and negative predictive value, fCal is a useful marker to rule out CD and select patients for endoscopy.

Jensen, et al. (2011) Scandinavian Journal of Gastroenterology 
Low-Dose Maintenance Therapy With Infliximab Prevents Postsurgical Recurrence of Crohn's Disease

Long-term maintenance therapy with infliximab is required to maintain mucosal integrity in patients after surgery for Crohn’s disease. However, a dose of 3 mg/kg (a 40% reduction from the standard dose) was sufficient to avoid disease recurrence, determined by endoscopy, in all patients at 1 year. FC levels correlate with mucosal status at different infliximab doses.

Sorrentino et al. (2010) Clinical Gastroenterology and Hepatology
Crohn’s Disease Activity Assessed by Fecal Calprotectin and Lactoferrin: Correlation with Crohn’s Disease Activity Index and Endoscopic Findings

For evaluation of Crohn’s disease activity, based on endoscopic findings, more sensitive surrogate markers than is CDAI or CRP are fecal calprotectin and lactoferrin. These prove to be useful tools for estimation of disease activity in Crohn’s disease.

Sipponen et al. (2008) Inflammatory Bowel Disease
A simple method for assessing intestinal inflammation in Crohn's disease

The calprotectin method may be a useful adjuvant for discriminating between patients with Crohn’s disease and irritable bowel syndrome.

Tibble et al. (2000) BMJ Journals – GUT

Paediatrics

Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease

These guidelines are intended to give practical (whenever possible evidence-based) answers to (pediatric) gastroenterologists who take care of children and adolescents with CD; they are not meant to be a rule or legal standard, since many different clinical scenario exist requiring treatment strategies not covered by or different from these guidelines.

 Ruemmele et al. 2014. Journal of Crohn’s and Colitis
Efficacy and safety of adalimumab in the treatment of Crohn’s disease in children

ADA has been shown to be effective in children with moderate-to-severe CD. Treatment benefits  should be weighed against side effects. Multicenter longitudinal studies with longer follow-up periods are required to determine the true efficacy and safety of long-term ADA treatment

Navas-Lopez et al. (2013) Revista Española de Enfermedades Digestivas
Rapid Test for Fecal Calprotectin Levels in Children With Crohn's Disease

Using a cut-off of 100 μg/g for normal values, the percentage agreement between the 2 tests was 87%. The optimal cut-off values to guide clinical decisions in the therapy of inflammatory bowel disease have yet to be determined.

Kolho et al. (2012) Journal of Pediatric gastroenterology and nutrition. Vol. 55, no. 4, pp. 436-439 
Serial fecal calprotectin changes in children with Crohn's disease on treatment with exclusive enteral nutrition

In this pilot study calprotectin decreased in patients who achieved clinical remission and may be useful to predict response to treatment.

 Gerasimidis et al. (2011) Journal of Clinical Gastroenterology
SIGNEC U.K. and the Second International Conference on Necrotising Enterocolitis

While researchers grapple with the various avenues for prevention, early diagnosis and treatment of NEC,  parallel efforts are required to improve practice based on current evidence and to precisely delineate the intermediate and long-term impact of NEC.

Khashu et al. (2015) Stansted News Limited 2015, Infant Supplement
Rapid Fecal Calprotectin (FC) analysis: point of care testing for diagnosing early necrotizing enterocolitis

We present the first data showing that rapid assay FC levels are potentially useful in the bedside diagnosis of NEC.

Bin-Nun et al. (2015) American Journal of Perinatology
SIGNEC U.K. and the First International Conference on Necrotising Enterocolitis

The SIGNEC U.K. conference represents an important first-step in providing an international platform for a focused discussion on NEC.

 Khashu et al. (2013) Stansted News Limited 2013, Infant Supplement
Mapping the New World of Necrotizing Enterocolitis (NEC): Review and Opinion

The separation of NEC from SIP (Gordon’s classification) and the subsequent reduction of NEC into subgroups (NEC reductionism) together represent an improved operational framework for more accurately assessing NEC incidence and origin.

Gordon et al. (2013). European Journal of Neonatal Research
Fecal calprotectin concentration in neonatal necrotizing enterocolitis

Fecal calprotectin levels were significantly increased in premature infants with NEC. The fecal calprotectin test is a non-invasive, easy, and useful tool for the diagnosis of NEC.

 Yoon et al. (2012) Korean Journal of Pediatrics
Fecal calprotectin levels are increased in infants with necrotizing enterocolitis

Fecal calprotectin increases in infants with NEC and serial measurements may be useful as a noninvasive prognostic marker for progression of disease

 Aydemir et al. (2012) Journal of Maternity, fetal and neonatal medicine
Incidence and Timing of Presentation of Necrotizing Enterocolitis in Preterm Infants

Among infants <33 weeks’ gestation, NEC appears to present at mean age of 7 days in more mature infants, whereas onset of NEC is delayed to 32 days of age in smaller, lower GA infants. Further studies are required to understand the etiology of this disease process.

Yee et al. (2011) Pediatrics
Necrotising Enterocolitis

An overview of; clinical presentation, prevention, staging, management, treatments, complications and prognosis, along with further reading.

Draper et al. (2011) PatientPlus Online