Vendel Kristensen1, Arne Røseth2, Tahir Ahmad2, Viggo Skar1, Bjørn Moum3, 4
1Unger-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
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.
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.
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.
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.