For a study, it was determined that inflammatory bowel disease (IBD) treatment goals were shifting from symptom management to total intestinal mucosal healing. A fecal calprotectin concentration within the intended range was the most often utilized noninvasive surrogate measure of mucosal repair. Researchers wanted to determine if there was a link between the time it took to achieve the goal of calprotectin and the occurrence of the first flare for a study.
Researchers enrolled new-onset IBD patients aged 17 and under in a cloud-based registry and tracked them for at least 52 weeks. They were treated in accordance with Dutch national standards, which advocate for a progressive approach. The first calprotectin value below 250 μg/g following the commencement of induction treatment was used to calculate the time to achieve the goal. The time from the first calprotectin measurement below 250 μg/g to the return of symptoms with calprotectin values above 250 μg/g was defined as the time from the first calprotectin measurement below 250 μg/g to the reappearance of symptoms with calprotectin values above 250 μg/g.
The study had 76 patients (43 with luminal Crohn’s disease [CD] and 33 with ulcerative colitis [UC]). The median age upon diagnosis was 14.5 and 14.1, respectively. The median duration to attain goal calprotectin in CD patients was 37 weeks and 11 weeks in UC patients (Log-rank test, P=0.001). When the calprotectin target was attained, the duration of the first flare in CD patients was considerably longer than in UC patients (Log-rank test, P=0.001). CD patients with a goal calprotectin time of less than or equal to 12 weeks following standard induction treatment (ie, exclusive enteral nutrition or steroids) had a better disease course in the first year than those with a target calprotectin time of greater than 12 weeks (Log-rank test, P=0.057). The time to attain the goal calprotectin level of less than or equal to 12 weeks in UC patients was not connected with a good clinical course in the first year.
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