THE ROLE OF FECAL CALPROTECTIN IN THE ASSESSMENT OF CLINICAL RELAPSE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE.

Introduction. Fecal calprotectin (FC) is the most popular and well-studied non-invasive biomarker in diagnosing and monitoring inflammatory bowel disease (IBD) patients and it is routinely tested and widely used in clinical practice. Aim. to evaluate the usefulness of FC in predicting clinical relapse in IBD patients treated with anti-TNF agents, during one year of follow-up. Methods. We conducted a retrospective study including 50 IBD patients treated with anti-TNF agents (Infliximab, Adalimumab), in clinical remission (defined according to clinical Mayo and CDAI score) for at least 6 months, evaluated in a tertiary center between April 2021 through April 2022. For each patient, demographic and clinical parameters, data on the extent of the disease, type of treatment and FC value were collected. The patients included in the study were reevaluated 1 year later after the initial evaluation, regarding clinical remission/relapse. Results. There were 29 patients with ulcerative colitis (UC) (58 %) and 21 with Crohn's disease (CD) (42 %)), with a mean age of 42 years (21-63 years). 28 patients (18 with UC and 10 with CD) were treated with Infliximab and 22 (11 UC, 11 CD) with Adalimumab. Out of 50 IBD patients, 28 (56%) had FC <50 μg/g, 15 (30%) had FC between 50 - 150 μg/g and 7 (14%) had FC ≥ 150 μg/g. After 12 months, we observed persistent clinical remission rates of 82.75% (24) for UC and 71.42% (15) for CD. Clinical relapse was present in no patient with FC <50 μg/g, in 47% of patients with FC between 50 - 150 μg/g, and in 71.42% of the patients with FC ≥ 150 μg/g. All UC who relapsed had initial FC value more than 150 μg/g. There were no differences in clinical relapse in patients treated with Infliximab vs Adalimumab. Conclusion. FC more than 150 μg/g is a good noninvasive marker for 1 year clinical relapse in IBD patients treated with anti-TNF. The predictive role is more obvious for patients with UC compared to CD, regardless of the type of anti-TNF used. [ABSTRACT FROM AUTHOR]