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©The Author(s) 2016.
World J Gastroenterol. Jan 21, 2016; 22(3): 1017-1033
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.1017
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.1017
Table 1 Clinical and environmental predictors of relapse in inflammatory bowel diseases patients
CD | UC | |
Clinical factors | ||
Age | Young age at diagnosis[6-8,10] | Young age at diagnosis[11,14,15] |
→Disabling chronic disease | ||
→Rate of relapse | ||
Sex | Female[11,14] | |
→Rate of relapse | ||
Disease location | Perianal disease[7,9] | Extensive colitis[8,14,16] |
→Poor outcome | →risk of colectomy, CRC, mortality | |
Terminal ileal location[8,9] | ||
→Predictor of stricturing/penetrating disease; risk of surgical resection | ||
Proximal small bowel/upper gastro-intestinal tract[10,11] | ||
→risk of relapse; risk of surgical resection | ||
Colonic disease[6] | ||
→risk of develop perianal disease | ||
No. prior relapses | Short period of remission before relapse[5,6] | Greater number of prior relapse |
→poor prognosis | →shorter time to relapse | |
EIM | NS[12] | NS[12] |
Environmental factors | ||
Smoke | Disease severity[19,20] | ↓ disease severity[21] |
Appendectomy | Risk of surgical resection[24] | ↓ risk of colectomy[22,26] |
Drugs | ||
NSAIDs/ COX-2 selective | Contrasting evidences[28] | Contrasting evidences[28] |
OCPs | Risk of relapse[20] | NS[15] |
HRT | ↓ disease severity[29] | ↓ disease severity[29] |
Antibiotics | ↓ risk of relapse[30] | NS[30] |
Stress | Risk of relapse[32] | Risk of relapse[31] |
Table 2 C-reactive protein as predictor of relapse in inflammatory bowel diseases patients
No. Pt | No. R | Relapse rate | Mean CRP values R | Mean CRP values NR | P value | |
Brignola et al[5], 1986 | ||||||
CD | 41 | 17 | 41% | 2.2 mg/dL | 0.7 mg/dL | 0.010 |
Tibble et al[66], 2000 | ||||||
CD | 43 | 25 | 58% | 13.1 mg/L | 9.1 mg/L | 0.100 |
UC | 37 | 19 | 51% | 3 mg/L | 9.7 mg/L | 0.400 |
Bitton et al[15], 2001 | ||||||
UC | 74 | 27 | 36.5% | 0.08 mg/dL | 0.25 mg/dL | NS |
Costa et al[67], 2005 | ||||||
CD | 38 | 15 | 39% | 8 mg/L | 6 mg/L | 0.373 |
UC | 41 | 19 | 46% | 5 mg/L | 4.5 mg/L | 0.450 |
D'Incà et al[65], 2008 | ||||||
CD | 65 | 20 | 31% | 5.49 mg/L | 3.13 mg/L | 0.050 |
UC | 97 | 37 | 38% | 3.15 mg/L | 3.08 mg/L | 0.690 |
García-Sánchez et al[69], 2010 | ||||||
CD | 66 | 18 | 27% | 4.6 mg/L | 5.6 mg/L | 0.790 |
UC | 69 | 21 | 31% | 3.8 mg/L | 1.7 mg/L | 0.060 |
Kallel et al[62], 2010 | ||||||
CD1 | 53 | 10 | 18.9% | 34 mg/L | 4 mg/L | < 0.001 |
Naismith et al[70], 2014 | ||||||
CD | 45 | 5 | 11% | 2 | 2.1 | 0.539 |
Table 3 Erythrocyte sedimentation rate as predictors of relapse in inflammatory bowel diseases patients
No. Pt | No. R | Relapse rate | Mean ESR values R (mm/h) | Mean ESR values NR (mm/h) | P value | |
Brignola et al[5], 1986 | ||||||
CD | 41 | 17 | 41% | 24 | 9 | 0.0006 |
Tibble et al[66], 2000 | ||||||
CD | 43 | 25 | 58% | 21 | 13 | 0.200 |
UC | 37 | 19 | 51% | 13 | 20 | 0.200 |
Bitton et al[15], 2001 | ||||||
UC | 74 | 27 | 36.5% | 13.8 | 11 | NS |
Costa et al[67], 2005 | ||||||
CD | 38 | 15 | 39% | 20 | 15 | 0.077 |
UC | 41 | 19 | 46% | 15 | 11 | 0.056 |
D'Incà et al[65], 2008 | ||||||
CD | 65 | 20 | 31% | 25 | 15 | 0.005 |
UC | 97 | 37 | 38% | 14 | 11 | 0.690 |
García-Sánchez et al[69], 2010 | ||||||
CD | 66 | 18 | 27% | 17.5 | 16.2 | 0.230 |
UC | 69 | 21 | 31% | 14.1 | 7.6 | 0.180 |
Table 4 Fecal calprotectin as a predictor of relapse in inflammatory bowel disease patients
IBD type | Criteria for defining relapse | No. Pt | No. R | Relapse rate | Mean FC values R | Mean FC values NR | P value | FC cut off | Se | Spe | PPV | NPV | HR7 |
Tibble et al[66], 2000 | |||||||||||||
CD | CDAI > 150 ΔCDAI > 100 | 43 | 25 | 58% | 122 mg/L (610 μg/g) | 41.5 mg/L (220 μg/g) | < 0.0001 | ||||||
UC | HBI > 4 ΔHBI > 2 | 37 | 19 | 51% | 123 mg/L | 29 mg/L | < 0.0001 | ||||||
IBD | 80 | 44 | 55% | 123 mg/L | 32 mg/L | < 0.0001 | 50 mg/L (250 μg/g) | 90 | 83 | ||||
Costa et al[67], 2005 | |||||||||||||
CD | CDAI > 150 | 38 | 15 | 39.5% | 220.1 μg/g | 220.5 μg/g | 0.395 | 150 μg/g | 87 | 43 | 50 | 83 | 2.20 |
UC | UCAI > 4 | 41 | 19 | 46.3% | 220.6 μg/g | 67 μg/g | < 0.0001 | 150 μg/g | 89 | 82 | 81 | 90 | 14.40 |
IBD | 79 | 34 | 43% | ||||||||||
D'Incà et al[65], 2008 | |||||||||||||
CD | CDA ≥ 150 ΔCDAI > 50 | 65 | 20 | 31% | 207 mg/kg | 88 mg/kg | 0.055 | 130 mg/kg | 65 | 62 | 44 | 80 | 1.70 |
Colonic CD | 176.7 mg/kg | 75.1 mg/kg | 0.041 | ||||||||||
UC | ET > 4 | 97 | 37 | 38% | 190 mg/kg | 49 mg/kg | 0.001 | 130 mg/kg | 70 | 70 | 60 | 79 | 2.40 |
IBD | 162 | 57 | 35.2% | 130 mg/kg | 68 | 67 | 52 | 79 | |||||
Gisbert et al[68], 2009 | |||||||||||||
CD | CDAI > 150 | 89 | 13 | 14.6% | 266 μg/g | 145 μg/g | 0.002 | 169 μg/g | 69 | 76 | |||
UC | TW > 11 | 74 | 13 | 213 μg/g | 126 μg/g | 0.030 | 164 μg/g | 69 | 74 | ||||
IBD | 163 | 26 | 16% | 239 μg/g | 136 μg/g | < 0.001 | 167 μg/g | 69 | 75 | 35 | 93 | 2.80 | |
García-Sánchez et al[69], 2010 | |||||||||||||
CD | CDAI ≥ 150 | 66 | 18 | 27% | 524 μg/g | 123 μg/g | < 0.010 | 200 μg/g | 80 | 65 | 46 | 88 | 4.35 |
UC | TW ≥ 11 | 69 | 21 | 31% | 298 μg/g | 105 μg/g | < 0.010 | 120 μg/g | 81 | 63 | 49 | 88 | 6.48 |
IBD | 135 | 39 | 30% | 444 μg/g | 112 μg/g | < 0.010 | 150 μg/g | 75 | 68 | 49 | 68 | ||
Kallel et al[62], 2010 | |||||||||||||
CD1 | CDAI > 150 ΔCDAI > 100 | 53 | 10 | 18.9% | 380.5 μg/g | 155 μg/g | < 0.001 | 340 μg/g | 80 | 90.7 | 18.80 | ||
Naismith et al[70], 2014 | |||||||||||||
CD | Treatment modification, progression disease phenotype, hospitalization, surgery | 92 | 10 | 11% | 414 μg/g | 96 μg/g | 0.005 | 240 μg/g | 80 | 74.4 | 27.6 | 96.8 | 12.18 |
Colonic CD | 35 | 4 | 424 μg/g | 187 | 0.160 | ||||||||
Ileal CD | 16 | 3 | 371 μg/g | 57 | 0.057 | ||||||||
Yamamoto et al[74], 2014 | |||||||||||||
UC | 80 | 21 | 26% | 173.7 μg/g | 135.5 μg/g | 0.020 | 170 μg/g | 76 | 76 | 7.23 | |||
Scaioli et al[111] | |||||||||||||
UC | SCCAI > 3 | 74 | 20 | 27% | 218 μg/g | 48 μg/g | < 0.010 | 193 μg/g | 65 | 98 | 92 | 88 | |
Mayo > 1 |
- Citation: Liverani E, Scaioli E, Digby RJ, Bellanova M, Belluzzi A. How to predict clinical relapse in inflammatory bowel disease patients. World J Gastroenterol 2016; 22(3): 1017-1033
- URL: https://www.wjgnet.com/1007-9327/full/v22/i3/1017.htm
- DOI: https://dx.doi.org/10.3748/wjg.v22.i3.1017