FIT, fecal calprotectin effectively predict mucosal healing in ulcerative colitis
Fecal immunochemical testing and fecal calprotectin effectively predict mucosal healing in patients with ulcerative colitis, although a fecal immunochemical test appears to have superior sensitivity for predicting Mayo endoscopic subscore alone, according to new research data.
Aiming to compare the accuracy of a fecal immunochemical test (FIT) vs. fecal calprotectin (Fcal) in predicting mucosal healing in patients with UC, Sakiko Hiraoka, MD, from the department of gastroenterology and hepatology at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences in Japan, and colleagues prospectively studied the two modalities simultaneously using stool samples from patients who underwent colonoscopy between October 2012 and February 2014.
A total of 105 colonoscopies were performed in 92 patients with UC (53 men; 69% pancolitis, 25% left-sided colitis and 6% proctitis) whose mucosal status was assessed in conjunction with FIT and Fcal. FIT and Fcal results were both correlated with Mayo endoscopic subscore (MES) and the total inflammation score (all P < .0001), with slightly higher correlation coefficients of FIT vs. Fcal values. FIT with a standard cutoff value predicted MES 0 with 0.95 (95% CI, 0.89-1.02) sensitivity and 0.62 (95% CI, 0.5-0.74) specificity, and Fcal with a standard cutoff value predicted MES 0 with 0.82 (95% CI, 0.7-0.93) sensitivity and 0.62 (95% CI, 0.5-0.74) specificity. Sensitivities were more comparable when mucosal healing was defined as MES 0 or 1 and optimal cutoff values were used.
“FIT predicts mucosal status of UC equivalently or more efficiently compared to Fcal,” Hiraoka told Healio Gastroenterology. “Most highlighted for FIT is its very low cost; FIT can be measured approximately 10 times by the cost of one-time Fcal. Closely measurable FIT enables [inflammatory bowel disease] physicians to survey the clinical status of UC more meticulously.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.