Calprotectin ‘most useful’ biomarker for IBD during COVID-19
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A presenter at the Crohn’s and Colitis Congress highlighted the importance of biomarkers in determining disease activity in inflammatory bowel disease, especially in the era of COVID-19.
“Calprotectin is the most useful biomarker available certainly for the current COVID-19 pandemic but absolutely also beyond the pandemic,” Britta Siegmond, Dr. Med, from Charité, Berlin University of Medicine, said during her presentation.
One recent study showed calprotectin was a good biomarker when evaluating calprotectin in ulcerative colitis. Another study evaluated different types of Crohn’s disease and their correlation with several biomarkers such as C-reactive protein, interleukin 6, calprotectin and fecal lactoferrin. There was a reasonable association between colonic CD and all biomarkers; however, calprotectin and fecal lactoferrin were considered the best biomarkers.
“The interesting biomarker to me is CRP because if you have increased CRP, and you succeed in decreasing the CRP you will control disease,” she said. “However, if CRP is not increased it doesn’t tell you anything because the sensitivity is very low.”
Siegmond said calprotectin may also be useful in patents who undergo resection.
“Patients in remission have much lower calprotectin compared with patients with disease recurrence and this is true for 6 and 18 months after surgery,” Siegmond said.
In general, Siegmond noted biomarker driven management of IBD demonstrates better outcomes compared with clinical management.
She said in patients with a high-risk profile, during COVID-19 or any upcoming pandemic, patients should not start steroids, they should start biologics to prevent more severe disease.
“The next pandemic will profit from novel markers that use to determine disease course,” she said. “These biomarkers can help distinguish between high risk and low risk groups in regard to long term disease course.”
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Siegmond B, et al. Practical and Optimal Use of Objective Markers to Monitor IBD. Presented at: Crohn’s and Colitis Congress; Feb. 21-24, 2021.
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