Fecal calprotectin is an early predictor of endoscopic response and histologic remission after the start of vedolizumab in inflammatory bowel disease

• Published in: Therapeutic advances in gastroenterology 2020, Vol.13, p.1756284820979765-1756284820979765
• Main Authors: Pauwels, Renske W. M., van der Woude, Christien J., Erler, Nicole S., de Vries, Annemarie C.
• Format: Article
• Language: English
• Subjects: Crohn's disease; Endoscopy; Gastroenterology; Inflammatory bowel disease; Monoclonal antibodies; Original Research; Remission (Medicine)
• ISSN: 1756-2848; 1756-283X; 1756-2848
• DOI: 10.1177/1756284820979765

Background and aims: Early prediction of the effect of vedolizumab (VDZ) in inflammatory bowel disease (IBD) is of paramount importance to guide clinical decisions. This study assessed whether early fecal calprotectin (FC) can predict endoscopic response and histologic remission after VDZ initiation. Methods: This was a prospective study. Inclusion criteria were endoscopic inflammation and FC >100 µg/g. FC was determined at baseline and weeks 2, 4, 8 and 16. At week 16, endoscopies with ileal and colonic biopsies were performed. FC changes were assessed with Wilcoxon Rank Sum tests. ROC statistics were used to assess the diagnostic accuracy of FC. Results: In total, 45 patients [27 Crohn’s disease (CD), 16/2 ulcerative colitis (UC)/IBD-unclassified] [40% males, median age 39 (28–51) years] were included. Week 16 endoscopic response and histologic remission rates were 58% and 33%. A median 37% decline in FC at week 2 was observed only in endoscopic responders, p = 0.025. FC