Fecal Calprotectin: Effective Marker In Understanding Progression of Crohn's Disease

Fecal calprotectin, one of the most noninvasive stool markers, was helpful in identifying and risk-stratifying clusters among patients with Crohn's disease (CD), a recent study published in Clinical Gastroenterology and Hepatology found. Based on 4 clusters, fecal calprotectin was significantly associated with smoking and upper gastrointestinal involvement.

While colonoscopy is the gold standard for monitoring inflammatory bowel disease, it is costly, invasive, and not without risk. Fecal calprotectin is increasingly emerging as a valuable noninvasive stool marker for monitoring inflammation.

For the retrospective cohort study, the team analyzed data from from the Edinburgh IBD unit, which included 2856 fecal calprotectin measurements from 356 patients newly diagnosed with CD over a period of 5 years. The results were divided into 4 distinct clusters based on characteristic calprotectin profiles further characterized by downward longitudinal trends.

The findings revealed that “cluster membership was significantly associated with smoking (P = .015), upper gastrointestinal involvement (P < .001), and early biologic therapy (P < .001).”

The largest of these clusters demonstrated consistently high fecal calprotection; these patients were less likely to have received early biologic treatment.

“Instead of only utilizing clinical endpoints, considering fecal calprotectin over time allows an inflammation-driven approach to classification and may enable risk stratification in the future,” the researchers noted.

Reference:
Constantine-Cooke N, Plevris N, Gros B et al. Longitudinal fecal calprotectin profiles characterize disease course heterogeneity in Crohn’s disease. Clin Gastroenterol and Hepatol. Published Online: March 30, 2023. DOI: https://doi.org/10.1016/j.cgh.2023.03.026.