P2111 - Association of Bowel Urgency and Fecal Calprotectin Levels in Patients With Ulcerative Colitis in the Study of a Prospective Adult Research Cohort With Inflammatory Bowel Disease
Shivani Mattay, MD1, Parakkal Deepak, MBBS, MS2 1Washington University in St. Louis, St. Louis, MO; 2Washington University in St. Louis School of Medicine, St. Louis, MO
Introduction: Bowel urgency in ulcerative colitis (UC) patients has a significant impact on quality of life. Achieving Mayo endoscopic score (MES) 0 or 1 is a therapeutic target in UC, however these patients still experience urgency. Fecal calprotectin (FC) is a sensitive test that assesses intestinal inflammation. We assessed the association between urgency and FC levels in UC patients with MES 0 or 1.
Methods: This cross-sectional study used data from Study of a Prospective Adult Research Cohort with IBD (SPARC IBD), a prospectively recruited multicenter longitudinal study from the Crohns & Colitis Foundation. UC patients with MES 0 or 1 with histopathological images, FC levels, and urgency scores within 3 months were included. Urgency was reported on a 3-point scale from none, mild, and moderate to severe. Chi-square (X2) was used to compare FC ≤ 30 µg/g and FC > 30 µg/g across urgency scores. The Mann-Whitney U test was used to compare median FC levels in patients with and without urgency and MES 0.
Results: 134 patients were included (mean age 49, 54% female, 67% MES 0) (Table 1). FC concentration was significantly different across urgency levels in UC patients with MES 0 [X2 (2, N=90), 8.53, p=0.014] and MES 1 [X2 (2, N=43), 6.11, p=0.047] when comparing FC ≤ 30 µg/g and FC > 30 µg/g. FC > 30 µg/g was associated with a nonsignificant increase on comparison of mild relative to no urgency in MES 0 [Odds Ratio (OR), 1.98; 95% Confidence Interval (CI): 0.78-5.02] and when comparing moderate to severe urgency relative to no urgency in MES 0 (OR, 2.25; 95% CI: 0.65-7.79) and MES 1 (OR, 4.80; 95% CI: 0.46-50.16). FC > 30 µg/g was associated with a nonsignificant decrease on comparison of mild relative to no urgency in patients with MES 1 (OR, 0.89; 95% CI: 0.22-3.61). The median FC levels were significantly different when compared by urgency in patients with MES 0 (p=0.024). In patients with no urgency, the median FC was 23.94 [Interquartile Range (IQR), 0-101.19). In patients with urgency, the median FC was 47.10 (IQR, 7.91-224.89) (Figure 1).
Discussion: Calprotectin levels differed significantly when stratified by the level of urgency in patients with MES 0 or 1. FC levels were greater in UC patients with urgency when compared to patients without urgency including in the subset in endoscopic remission (MES 0). This suggests inflammation is a driver of urgency even in patients with UC in endoscopic remission. Further assessment of histological inflammation is underway.
Figure: Figure 1: Association of fecal calprotectin concentrations with bowel urgency in ulcerative colitis patients with Mayo endoscopic score 0. P-value=0.024. *P-value is based on the Mann-Whitney U test (Wilcoxon rank-sum). The lower edge of the box represents the 25th percentile, the upper edge of the box represents the 75th percentile, and the line in the box represents the median. The whiskers represent the upper and lower limits which are within 1.5 times the interquartile range. The “X” represents the mean; the “o” represents the outliers.
Disclosures:
Shivani Mattay indicated no relevant financial relationships.
Shivani Mattay, MD1, Parakkal Deepak, MBBS, MS2. P2111 - Association of Bowel Urgency and Fecal Calprotectin Levels in Patients With Ulcerative Colitis in the Study of a Prospective Adult Research Cohort With Inflammatory Bowel Disease, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
