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Inflammatory biomarkers improve management of Crohn's disease

Nature Reviews Gastroenterology & Hepatology volume 15, pages 4–5 (2018)Cite this article

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Tight control of Crohn's disease using adjunctive biomarkers leads to improved patient outcomes, according to a new trial.

To determine whether biomarker levels can serve as tools to help patients achieve clinical and endoscopic remission, Jean-Frederic Colombel and colleagues conducted a multicentre randomized controlled trial to compare a conventional clinical management algorithm, based on patient CDAI scores, with a 'tight control' algorithm, which utilized CDAI scores and levels of faecal calprotectin and serum CRP. Patients with active Crohn's disease were randomly assigned to each group (n = 122 per arm) following 8 weeks of prednisone induction therapy. Treatment escalation (with increasing doses of adalimumab and addition of azathiopurine) occurred when treatment failure criteria were met (clinical management algorithm arm: CDAI decrease <100 points versus baseline, CDAI ≥200 points or prednisolone use in the past week; tight control arm: faecal calprotectin ≥250 μg/g, CRP ≥5 mg/l, CDAI ≥150 points or prednisolone use in the past week).

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References

  1. Colombel, J.-F. et al. Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet http://dx.doi.org/10.1016/S0140-6736(17)32641-7 (2017)

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  1. Hugh Thomas
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Thomas, H. Inflammatory biomarkers improve management of Crohn's disease. Nat Rev Gastroenterol Hepatol 15, 4–5 (2018). https://doi.org/10.1038/nrgastro.2017.164

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  • DOI: https://doi.org/10.1038/nrgastro.2017.164

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