How to predict clinical relapse in inflammatory bowel disease patients

Table 4 Fecal calprotectin as a predictor of relapse in inflammatory bowel disease patients

IBD type	Criteria for defining relapse	No. Pt	No. R	Relapse rate	Mean FC values R	Mean FC values NR	P value	FC cut off	Se	Spe	PPV	NPV	HR7
Tibble et al[66], 2000
CD	CDAI > 150 ΔCDAI > 100	43	25	58%	122 mg/L (610 μg/g)	41.5 mg/L (220 μg/g)	< 0.0001
UC	HBI > 4 ΔHBI > 2	37	19	51%	123 mg/L	29 mg/L	< 0.0001
IBD		80	44	55%	123 mg/L	32 mg/L	< 0.0001	50 mg/L (250 μg/g)	90	83
Costa et al[67], 2005
CD	CDAI > 150	38	15	39.5%	220.1 μg/g	220.5 μg/g	0.395	150 μg/g	87	43	50	83	2.20
UC	UCAI > 4	41	19	46.3%	220.6 μg/g	67 μg/g	< 0.0001	150 μg/g	89	82	81	90	14.40
IBD		79	34	43%
D'Incà et al[65], 2008
CD	CDA ≥ 150 ΔCDAI > 50	65	20	31%	207 mg/kg	88 mg/kg	0.055	130 mg/kg	65	62	44	80	1.70
Colonic CD					176.7 mg/kg	75.1 mg/kg	0.041
UC	ET > 4	97	37	38%	190 mg/kg	49 mg/kg	0.001	130 mg/kg	70	70	60	79	2.40
IBD		162	57	35.2%				130 mg/kg	68	67	52	79
Gisbert et al[68], 2009
CD	CDAI > 150	89	13	14.6%	266 μg/g	145 μg/g	0.002	169 μg/g	69	76
UC	TW > 11	74	13		213 μg/g	126 μg/g	0.030	164 μg/g	69	74
IBD		163	26	16%	239 μg/g	136 μg/g	< 0.001	167 μg/g	69	75	35	93	2.80
García-Sánchez et al[69], 2010
CD	CDAI ≥ 150	66	18	27%	524 μg/g	123 μg/g	< 0.010	200 μg/g	80	65	46	88	4.35
UC	TW ≥ 11	69	21	31%	298 μg/g	105 μg/g	< 0.010	120 μg/g	81	63	49	88	6.48
IBD		135	39	30%	444 μg/g	112 μg/g	< 0.010	150 μg/g	75	68	49	68
Kallel et al[62], 2010
CD1	CDAI > 150 ΔCDAI > 100	53	10	18.9%	380.5 μg/g	155 μg/g	< 0.001	340 μg/g	80	90.7			18.80
Naismith et al[70], 2014
CD	Treatment modification, progression disease phenotype, hospitalization, surgery	92	10	11%	414 μg/g	96 μg/g	0.005	240 μg/g	80	74.4	27.6	96.8	12.18
Colonic CD		35	4		424 μg/g	187	0.160
Ileal CD		16	3		371 μg/g	57	0.057
Yamamoto et al[74], 2014
UC		80	21	26%	173.7 μg/g	135.5 μg/g	0.020	170 μg/g	76	76			7.23
Scaioli et al[111]
UC	SCCAI > 3	74	20	27%	218 μg/g	48 μg/g	< 0.010	193 μg/g	65	98	92	88
	Mayo > 1

¹Small bowel CD patients excluded. 12-mo follow-up period in all the studies cited; FC assay was Calprest for all the studies cited, except in the study by Tibble et al[66] (Roseth). R: Relapsers; NR: Non relapsers; FC: Fecal calprotectin; Se: Sensibility; Spe: Specificity; PPV: Positive predictive value; NPV: Negative predictive value; HR: Hazard ratio; CD: Crohn’s disease; UC: Ulcerative Colitis; IBD: Inflammatory bowel diseases; HBI: Harvey Bradshaw Index; CDAI: Crohn’s disease activity index; CAI: Colitis activity index; TW: Modified Truelove-Witt; SCCAI: Simple Clinical Colitis Activity.