1055 Recommendations for Creating a High Quality Endoscopy Report for Inflammatory Bowel Disease Patients: Results From a RAND-Appropriateness Panel

G A A b st ra ct s for Crohn's Disease (SES-CD). In UC or IBDU, clinical and endoscopic relapse was defined by Mayo score. Results: Forty-nine patients (16 CD, 33 UC/IBDU) provided the requested stool samples and comprised the study group. Of the 49 patients 15 (31%, 4 CD [25%], 11 UC/IBDU [33%]) relapsed during the one year follow-up and 34 (69%, 12 CD [75%], 22 UC/IBDU [66%]) remained in remission. Significant increase in median FC levels was seen two (120 μg/g, 0-1867, n = 15, p = 0.0014), four (108 μg/g, 7-650, n = 8, p = 0.0056), and six (120 μg/g, 0-431, n = 6, p = 0.0029) months before the actual relapse. In contrast to those with sustained endoscopic remission, patients relapsing showed constantly elevated FC levels. A cutoff of > 140 μg/g (ROC analysis) predicted relapse with a 79% specificity and a 53% sensitivity. At the moment of clinical and endoscopic relapse 4 out of 15 patients (27%, 1 CD, 3 UC) had FC < 100 μg/g. Interestingly, no difference was found in the relapse rates in patients with FC concentration under 50 or 50-100 at baseline, (p = 0.325) nor in patients with or without acute or chronic inflammatory infiltrate in biopsy specimens at baseline (p = 0.221). No significant difference was seen in median FC levels in patients having endoscopic remission and those with mild endoscopic activity at follow-up colonoscopies. Conclusion: FC seems to rise and remain elevated before the actual clinical or endoscopic relapse, suggesting that FC can be used as a surrogate marker for predicting relapse in patients with IBD, and to identifying patients requiring a close follow-up in clinical practice.