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Poster presentations: Clinical: Diagnosis and Outcome 2020

P203 FIT and FC as a surrogate non-invasive marker for mucosal healing in inflammatory bowel disease

M.S. ISMAIL, G. Murphy, C. Kelly, F. O’Riordan, S. Semenov, S. Sihag, N. Breslin, O. Anthony, B. Ryan, D. McNamara, Trinity Academic Gastroenterology Group Trinity College Dublin

Tallaght University Hospital, Gastroenterology, Dublin, Ireland

Background

Mucosal healing (MH) is one of the goals of IBD therapy. Currently, the only way to assess MH is by colonoscopy. Faecal calprotectin (FC) and faecal immunochemical test (FIT) which detect colonic inflammation and bleeding might be useful adjuncts.

Methods

Aim:

To assess FIT and FC as surrogate markers of MH.

Results

Following ethical approval, patients undergoing routine colonoscopy were prospectively recruited. Demographics and colonoscopy findings were documented. A FIT and FC were collected prior to colonoscopy. FIT and FC were processed in our laboratory and reported as µg/g of stool. MH was defined no visible activity on colonoscopy.

Conclusion

Of 105 colonoscopies, FC and FIT results were available in 99 and 88 patients. Mean age 48.8, 52% (55) males, 34% (36) UC, 60% (63) Crohn’s, 0.05% (6) IBDU. In all, MH occurred in 12%, (n = 12). In MH, the mean FIT and FC were 1142 and 353, while in active cases were 750 and 819. Only FC was significantly lower in MH cases (353 vs. 819, p = 0.05). Using standard cut-offs of >50; sensitivity, specificity, PPV and NPV for MH for FIT was poor; 59%, 33%, 89%, 9% and for FC was better at 74%, 73%, 91%, 44%. The overall correlation between the biomarkers was weak r = 0.2, p < 0.01. FC ROC analysis gave a specificity and sensitivity of 75% and 67% for a cut-off of <64µg/g, AUC = 0.65.

MH was uncommon (12%) reflecting our clinical practice. FIT was a poor predictor of MH. FC might be a useful marker albeit ongoing research is needed to set an appropriate cut-off.