P013 Fecal calprotectin predicts relapse in UC patients with histological remission

Abstract

BACKGROUND: Histological remission has been recognized as the treatment goal of ulcerative colitis (UC). We aim to investigate the factors that predict relapse in UC patients with histological remission. METHODS: We performed a prospective study of patients with UC from March 2014 to February 2016. If patients have mucosal healing during endoscopy, several biopsy specimens were collected from sigmoid colon and rectum. An expert pathologist evaluated colonic biopsies for histological activity (Geboes score). Histological remission was defined as a Geboes score <3.1. Demographic data, serological data including hemoglobin, hematocrit, white blood cell and platelet counts, albumin, C-reactive protein, and fecal calprotectin (FC) within a week of endoscopy were collected. RESULTS: Of the 36 patients in histological remission, 9/36 (25%) relapsed after a median follow-up of 29 months (range 2-45 months). FC was significantly higher in patients who relapsed compared with patients who maintained clinical remission (153.7 μg/g vs 103.4 μg/g; p = 0.047). In multivariate analysis, the FC was only independent predictors of relapse. A receiver operating characteristic analysis estimated a cutoff level of >134.6 μg/g for FC (area under the curve, 0.758 and confidence interval 95%, 0.579–0.937) for predicting relapse during follow-up with 77.8% sensitivity, 74.1% specificity. CONCLUSION(S): High FC levels can predict relapse in patients with UC. Therefore, regular measurement of FC should be considered in UC patients, even if they have histological remission.