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Copyright ©The Author(s) 2016.
World J Gastroenterol. Jan 21, 2016; 22(3): 1017-1033
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.1017
Table 1 Clinical and environmental predictors of relapse in inflammatory bowel diseases patients
Clinical factors
AgeYoung age at diagnosis[6-8,10]Young age at diagnosis[11,14,15]
Disabling chronic disease
Rate of relapse
Rate of relapse
Disease locationPerianal disease[7,9]Extensive colitis[8,14,16]
Poor outcomerisk of colectomy, CRC, mortality
Terminal ileal location[8,9]
Predictor of stricturing/penetrating disease; risk of surgical resection
Proximal small bowel/upper gastro-intestinal tract[10,11]
risk of relapse; risk of surgical resection
Colonic disease[6]
risk of develop perianal disease
No. prior relapsesShort period of remission before relapse[5,6]Greater number of prior relapse
poor prognosisshorter time to relapse
Environmental factors
SmokeDisease severity[19,20]↓ disease severity[21]
AppendectomyRisk of surgical resection[24]↓ risk of colectomy[22,26]
NSAIDs/ COX-2 selectiveContrasting evidences[28]Contrasting evidences[28]
OCPsRisk of relapse[20]NS[15]
HRT↓ disease severity[29]↓ disease severity[29]
Antibiotics↓ risk of relapse[30]NS[30]
StressRisk of relapse[32]Risk of relapse[31]
Table 2 C-reactive protein as predictor of relapse in inflammatory bowel diseases patients
No. PtNo. RRelapse rateMean CRP values RMean CRP values NRP value
Brignola et al[5], 1986
CD411741%2.2 mg/dL0.7 mg/dL0.010
Tibble et al[66], 2000
CD432558%13.1 mg/L9.1 mg/L0.100
UC371951%3 mg/L9.7 mg/L0.400
Bitton et al[15], 2001
UC742736.5%0.08 mg/dL0.25 mg/dLNS
Costa et al[67], 2005
CD381539%8 mg/L6 mg/L0.373
UC411946%5 mg/L4.5 mg/L0.450
D'Incà et al[65], 2008
CD652031%5.49 mg/L3.13 mg/L0.050
UC973738%3.15 mg/L3.08 mg/L0.690
García-Sánchez et al[69], 2010
CD661827%4.6 mg/L5.6 mg/L0.790
UC692131%3.8 mg/L1.7 mg/L0.060
Kallel et al[62], 2010
CD1531018.9%34 mg/L4 mg/L< 0.001
Naismith et al[70], 2014
Table 3 Erythrocyte sedimentation rate as predictors of relapse in inflammatory bowel diseases patients
No. PtNo. RRelapse rateMean ESR values R (mm/h)Mean ESR values NR (mm/h)P value
Brignola et al[5], 1986
Tibble et al[66], 2000
Bitton et al[15], 2001
Costa et al[67], 2005
D'Incà et al[65], 2008
García-Sánchez et al[69], 2010
Table 4 Fecal calprotectin as a predictor of relapse in inflammatory bowel disease patients
IBD typeCriteria for defining relapseNo. PtNo. RRelapse rateMean FC values RMean FC values NRP valueFC cut offSeSpePPVNPVHR7
Tibble et al[66], 2000
CDCDAI > 150 ΔCDAI > 100432558%122 mg/L (610 μg/g)41.5 mg/L (220 μg/g)< 0.0001
UCHBI > 4 ΔHBI > 2371951%123 mg/L29 mg/L< 0.0001
IBD804455%123 mg/L32 mg/L< 0.000150 mg/L (250 μg/g)9083
Costa et al[67], 2005
CDCDAI > 150381539.5%220.1 μg/g220.5 μg/g0.395150 μg/g874350832.20
UCUCAI > 4411946.3%220.6 μg/g67 μg/g< 0.0001150 μg/g8982819014.40
D'Incà et al[65], 2008
CDCDA ≥ 150 ΔCDAI > 50652031%207 mg/kg88 mg/kg0.055130 mg/kg656244801.70
Colonic CD176.7 mg/kg75.1 mg/kg0.041
UCET > 4973738%190 mg/kg49 mg/kg0.001130 mg/kg707060792.40
IBD1625735.2%130 mg/kg68675279
Gisbert et al[68], 2009
CDCDAI > 150891314.6%266 μg/g145 μg/g0.002169 μg/g6976
UCTW > 117413213 μg/g126 μg/g0.030164 μg/g6974
IBD1632616%239 μg/g136 μg/g< 0.001167 μg/g697535932.80
García-Sánchez et al[69], 2010
CDCDAI ≥ 150661827%524 μg/g123 μg/g< 0.010200 μg/g806546884.35
UCTW ≥ 11692131%298 μg/g105 μg/g< 0.010120 μg/g816349886.48
IBD1353930%444 μg/g112 μg/g< 0.010150 μg/g75684968
Kallel et al[62], 2010
CD1CDAI > 150 ΔCDAI > 100531018.9%380.5 μg/g155 μg/g< 0.001340 μg/g8090.718.80
Naismith et al[70], 2014
CDTreatment modification, progression disease phenotype, hospitalization, surgery921011%414 μg/g96 μg/g0.005240 μg/g8074.427.696.812.18
Colonic CD354424 μg/g1870.160
Ileal CD163371 μg/g570.057
Yamamoto et al[74], 2014
UC802126%173.7 μg/g135.5 μg/g0.020170 μg/g76767.23
Scaioli et al[111]
UCSCCAI > 3742027%218 μg/g48 μg/g< 0.010193 μg/g65989288
Mayo > 1