SAT0394 CAN FECAL CALPROTECTIN PREDICT FUTURE DEVELOPMENT OF INFLAMMATORY BOWEL DISEASE IN AXIAL SPONDYLOARTHRITIS PATIENTS? – TREASURE REAL-LIFE DATA

Abstract

Background:Patients with active inflammatory bowel diseases (IBD) fecal calprotectin (FC) levels are high and FC can be used for diagnosis [1].Objectives:This study aimed to investigate whether fecal calprotectin levels could predict future development of IBD in axSpA patients.Methods:This study was practiced in three centers using TReasure database and that are able to measure FC. Fecal calprotectin levels were measured in 137 axSpA patients as of September 2018 and FC level ≥200 µg/g was considered significant. All study subjects were evaluated for IBD symptoms (loose defecation, mucous diarrhea, bloody defecation, bloody diarrhea, abdominal pain, obstruction, or pseudo-obstruction) at beginning of the study and every 3 months for the first year. 25 RA patients and 24 healthy volunteers were included as a control group. Disease activity was evaluated by the ASDAS CRP, BASDAI,BASFI, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analog scale (VAS)-pain, VAS-fatigue, and tender and swollen joint count for axSpA patients.Results:This study included 137 axSpA patients and all patients followed for 1 year. Of the 137 axSpA patients 33.6% were females and median (Q1-Q3) age was of 43 years (33-50 years), median (Q1-Q3) disease duration was 8.9 years (5.0-13.9 years). The median (Q1-Q3) fecal calprotectin level was 48 µg/g (30-122 µg/g) and FC level was ≥200 µg/g in 23/137 (16.8%) in axSpA patients. FC level was elevated in 15/24 (62.5%) RA patients and none of the healthy volunteers. Patients median (Q1-Q3) BASDAI was 2.2 (1.0-3.6) / 1.4 (0.4-2.2), median (Q1-Q3) BASFI 1.55 (0.4-3.4) / 1.5 (0.3-3.0) and median (Q1-Q3) ASDAS CRP 1.63 (1.3-2.2) / 1.5 (1.3-1.9) at baseline and first year respectively and there was no difference regarding fecal calprotectin level. In 1 year follow-up 9 (6.5%) patient had abdominal pain, 2 (1.4%) had bloody defecation, 1 (0.7%) had loose defecation and Crohn disease developed in an axSpA patient with high FC (266 µg/g) (Table 1). IBD occurrence rate was 0.73/100 patient-year for all SpA patients, and IBD occurrence rate was 4.34/100 patients year for SpA patients with ≥200 µg/g FC level.Table 1.IBD symptom inquiry and development of IBD in the first yearn (%)Loose defecation1 (0.73)Mucous diarrhea0Bloody defecation2 (1.45)Bloody diarrhea0Abdominal pain9 (6.56)Obstruction0Pseudo-obstruction0Inflammatory bowel disease1 (0.73)Conclusion:In one year follow-up, IBD occurrence rate was 0.73/100 patient-year, at a similar rate with DESIR cohort [2]. However, FC level may be a predictor for the development of IBD in SpA patients (occurrence rate 4.34/100 patients year). Further follow up duration and more patients may be needed to make conclusion in these field.