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Article Dans Une Revue Alimentary Pharmacology and Therapeutics Année : 2011

Prediction of Crohn's disease relapse with fecal calprotectin in infliximab responders: a prospective study

Samir Mesli
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Edouard Chabrun
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Farid El Hajbi
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Elise Chanteloup
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Maylis Capdepont
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Sylvie Razaire
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Victor de Ledinghen
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Frank Zerbib
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Résumé

Background: Fecal calprotectin (FC) is a reliable tool for predicting Crohn's disease (CD) relapse in patients with sustained remission. Prediction of relapse with FC has been less studied in patients with severe CD treated with anti-TNF. Aim: to identify an association between FC concentration and CD clinical relapse in patients achieving remission with infliximab (IFX). Methods: From February 2007 to October 2008, consecutive patients with refractory luminal CD were prospectively included when they received three IFX infusions (5 mg/kg at weeks 0-2-6) followed by maintenance with an immunomodulator alone. FC and CRP were measured at entry and at week 14 (w14). Results: Sixty-five patients (43W; median age: 30.4 years) were included and 50 (77%) were in clinical remission off steroids at w14; 23/50 (46%) experienced CD clinical relapse during the first year of follow up. Median FC level at w14 was similar in patients with and without CD clinical relapse (200 and 150 µg/g, respectively). When considering two suggested FC cut-offs to predict CD relapse, sensitivities and specificities were 61% and 48% for 130 µg/g respectively, and 43% and 57% for 250 µg/g. Neither FC nor CRP at baseline and at w14 could predict relapse even when CD location subgroup analysis was considered. Conclusion: In patients responding to an IFX induction regimen, FC measurement at w14 cannot predict CD clinical relapse at one year.

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Dates et versions

hal-00651664 , version 1 (14-12-2011)

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David Laharie, Samir Mesli, Edouard Chabrun, Farid El Hajbi, Elise Chanteloup, et al.. Prediction of Crohn's disease relapse with fecal calprotectin in infliximab responders: a prospective study. Alimentary Pharmacology and Therapeutics, 2011, 34 (4), pp.462. ⟨10.1111/j.1365-2036.2011.04743.x⟩. ⟨hal-00651664⟩

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