Update on C-reactive protein and fecal calprotectin: are they accurate measures of disease activity in Crohn's disease?

Expert Review of Gastroenterology & Hepatology
Christopher MaBrian G Feagan

Abstract

'Treat-to-target' paradigms in Crohn's disease (CD) directed at suppressing intestinal inflammation require accurate and reliable measures of disease activity. Although endoscopy has traditionally been considered a gold standard, cost, complexity, resource limitations, and invasiveness are important limitations. Hence, substantial interest exists for non-invasive serum and fecal biomarkers, namely C-reactive protein (CRP) and fecal calprotectin (FC), in the diagnosis, monitoring, and treatment of CD. Areas covered: We review the evidence for using serum CRP and FC in distinguishing patients with CD from those with irritable bowel syndrome, categorizing disease activity among patients with an established diagnosis of CD, predicting the likelihood of treatment response, identifying asymptomatic patients in medically or surgically induced remission who are at risk for disease relapse, and as treatment targets. Expert commentary: Accurate interpretation of CRP and FC is dependent on several factors including the clinical context, the performance characteristics of the assay, the specified test cut-offs, and the pre-test probability of disease. Emerging evidence indicates that CRP and FC are valuable adjuncts for the management of C...Continue Reading

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Citations

Dec 19, 2019·European Journal of Gastroenterology & Hepatology·Anand Kumar, Dana J Lukin
Oct 7, 2019·Inflammatory Bowel Diseases·Olga Maria NardoneMarietta Iacucci
Sep 29, 2020·Frontiers in Medicine·Raja AtreyaBritta Siegmund
Oct 20, 2020·Gastroenterología y hepatología·Paulina Nuñez FPatricio Ibañez
Mar 27, 2021·Current Opinion in Gastroenterology·M S IsmailDeirdre McNamara
May 6, 2021·Therapeutic Advances in Gastroenterology·Rune WilkensTorsten Kucharzik
Jul 27, 2021·Gastroenterology Clinics of North America·Edith Pérez de ArceEamonn M M Quigley
Dec 14, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Fernando MagroUNKNOWN GEDII

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