Endoscopic score vs. fecal biomarkers for predicting relapse in patients with ulcerative colitis after clinical remission and mucosal healing

• Published in: Clinical and translational gastroenterology 2018-02, Vol.9 (3), p.136-8
• Main Authors: Yamamoto, Takayuki, Shimoyama, Takahiro, Umegae, Satoru, Matsumoto, Koichi
• Format: Article
• Language: English
• Subjects: Biomarkers; Endoscopy; Feces; Inflammatory bowel disease; Original Contribution
• ISSN: 2155-384X; 2155-384X
• DOI: 10.1038/s41424-018-0006-7

Achieving endoscopic remission or decreasing the level of fecal biomarkers as an ideal therapeutic goal in ulcerative colitis has not been determined. This prospective study was to compare the clinical relevance of endoscopic score with fecal biomarkers for predicting relapse after clinical remission and mucosal healing (MH). One hundred and sixty-four patients who achieved clinical remission and MH (Mayo endoscopic subscore (MES) 0 or 1) were included. At entry, fecal samples were collected for the measurement of calprotectin, lactoferrin, and hemoglobin. Thereafter patients received masalamine maintenance therapy, and were followed for 12 months. During the 12-month study, 46 patients (28%) relapsed. The relapse rate was not significantly higher in 27/80 patients (34%) with MES 1 than in 19/84 patients (23%) with MES 0 (P = 0.16). The median fecal calprotectin, lactoferrin, and hemoglobin were significantly higher in patients with relapse than those in remission (calprotectin, 182 vs. 94 μg/g; lactoferrin, 185.5 vs. 111 μg/g; hemoglobin, 168 vs. 104 ng/mL; all P