Edward V. Loftus Jr., M.D., discusses a recent article published in Clinical Gastroenterology and Hepatology looking at the ability of a drug to drive down calprotectin, a marker of bowel inflammation, in people who have ulcerative colitis This protein can be measured in stool, which gives physicians a proxy of how much inflammation is occurring in the bowel. This multicentered study looked at around 100 ulcerative colitis patients who were symptomatically in remission. A majority of the patients still had markers in the stool, showing there was ongoing inflammation. The patients were on a medium dose of mesalamine, which is a commonly used medication in ulcerative colitis. The researchers randomized the patients to either keep receiving the same medium dose of mesalamine or receive a dose increase. The results showed that by increasing the dose of mesalamine, the stool marker went down to low levels. A lower level of calprotectin is associated with a lower risk of having an ulcerative colitis flare.
In inflammatory bowel disease (IBD), there can be a disconnect between the symptoms a patient experiences and the amount of inflammation he or she may have. One of the decisions a physician has to make is to follow the patient based on the symptoms he or she is experiencing or to use an objective marker.
The results of this study reinforces the idea of using an objective marker to optimize a patient's therapy. Using an objective marker, like a calprotectin, will lead to better controlling the patient's symptoms. Read the full study online here.