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Association between Fecal Calprotectin and Mucosal Healing in Pediatric Patients with Crohn's Disease Who Have Achieved Sustained Clinical Remission with Anti-Tumor Necrosis Factor Agents

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Author(s)
Yoo Min LeeSujin ChoiByung-Ho ChoeHyo-Jeong JangSeung KimHong KohEun Sil KimMi Jin KimYon Ho ChoeBen Kang
Keimyung Author(s)
Jang, Hyo Jeong
Department
Dept. of Pediatrics (소아청소년학)
Journal Title
Gut Liver
Issued Date
2022
Volume
16
Issue
1
Keyword
Crohn diseaseInfliximabAdalimumabChildAdolescent
Abstract
Background/Aims:
Although mucosal healing (MH) is acknowledged as the treatment target in the treat-to-target era, there are limitations on repeated endoscopic examinations, especially in pediatric patients. We aimed to investigate whether fecal calprotectin (FC) could serve as a surrogate marker for the assessment of MH in pediatric patients with Crohn's disease (CD) who have achieved sustained clinical remission (CR) while treated with anti-tumor necrosis factor (TNF) agents.

Methods:
This multicenter retrospective cross-sectional study included pediatric CD patients who had sustained a CR for at least 6 months with anti-TNF agents and who simultaneously underwent ileocolonoscopy and FC tests during follow-up. MH was defined as the absence of any ulcer on ileocolonoscopy.

Results:
A total of 131 patients were included in this study. MH was observed in 87 patients (66.7%). The FC level was significantly lower in patients with MH than in those without MH (median 49.0 mg/kg vs 599.0 mg/kg; p<0.001). According to the multivariate logistic regression analysis, FC was the only factor associated with MH (odds ratio, 0.62; 95% confidence interval [CI], 0.52 to 0.73; p<0.001). According to the receiver operating characteristic curve analysis, the optimal cutoff value for FC for the association with MH was <140 mg/kg (area under the curve 0.890, 95% CI 0.829 to 0.951, sensitivity 78.2%, specificity 88.6%, p<0.001).

Conclusions:
FC was associated with MH in pediatric patients with CD who had achieved a sustained CR for at least 6 months with anti-TNF agents. In these patients, FC can be used to stratify patients and guide decisions regarding ileocolonoscopy in the treat-to-target era.
Keimyung Author(s)(Kor)
장효정
Publisher
School of Medicine (의과대학)
Citation
Yoo Min Lee et al. (2022). Association between Fecal Calprotectin and Mucosal Healing in Pediatric Patients with Crohn’s Disease Who Have Achieved Sustained Clinical Remission with Anti-Tumor Necrosis Factor Agents. Gut Liver, 16(1), 62–70. doi: 10.5009/gnl20300
Type
Article
ISSN
2005-1212
Source
https://www.gutnliver.org/journal/view.html?pn=ahead&uid=1833&vmd=Full#n
DOI
10.5009/gnl20300
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44004
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pediatrics (소아청소년학)
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