Vendel Kristensen1, Arne Røseth2, Tahir Ahmad2, Viggo Skar1, Bjørn Moum3, 4
1
Unger-Vetlesen`s institute, Lovisenberg Diaconal Hospital, Norway, 2Department of Medicine, Lovisenberg Diaconal Hospital, Norway, 3Department of Gastroenterology, Oslo University Hospital, Norway, 4Institute of Clinical Medicine, University of Oslo, Norway
vendel@vikenfiber.no

Background
Mucosal healing has become the new goal of treatment in ulcerative colitis. Faecal (f-) calprotectin has been demonstrated to differentiate between mucosal inflammation and mucosal healing. With this project we investigated if a fall in f-calprotectin to < 250 µg/g after treatment for active ulcerative colitis was a reliable surrogate marker of mucosal healing.

Methods
After a baseline endoscopy, 20 patients with active ulcerative colitis were followed with consecutive f-calprotectin measurements monthly until the level dropped to < 250 µg/g or maximum 12 months. A second endoscopy was then performed. Mayo endoscopic subscore was used for evaluation of endoscopic disease activity.

Results
A total of 16 patients achieved a fall in f-calprotectin to < 250 µg/g during the follow-up period. All of these 16 patients had endoscopic remission defined as Mayo endoscopic subscore of ≤ 1 on the second endoscopy. The remaining four patients had persistently high f-calprotectin levels and the second endoscopy was performed after a year. One had Mayo endoscopic subscore of 2, two had a score of 1 and one patient had Mayo endoscopic subscore of 0.

Conclusions
F-calprotectin < 250 µg/g after treatment for active ulcerative colitis is a reliable surrogate marker of mucosal healing. However, persistently f-calprotectin ≥ 250 µg/g does not exclude endoscopic mucosal healing.

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