Diagnostic Accuracy of Fecal Calprotectin for Predicting Relapse in Inflammatory Bowel Disease: A Meta-Analysis

Fecal calprotectin (FC) levels correlate with the disease activity of inflammatory bowel diseases (IBD); however, the utility of FC in predicting IBD relapse remains to be determined. We aim to evaluate the efficacy of fecal calprotectin in predicting the relapse of inflammatory bowel disease. We searched Pubmed (MEDLINE), Embase, Web of Science, and the Cochrane library databases up to 7 July 2021. Our study estimated the pooled sensitivity and specificity, summary receiver operating characteristic (SROC) curve, and the optimal cut-off value for predicting IBD relapse using a multiple threshold model. A total of 24 prospective studies were included in the meta-analysis. The optimal FC cut-off value was 152 mu g/g. The pooled sensitivity and specificity of FC was 0.720 (0.528 to 0.856) and 0.740 (0.618 to 0.834), respectively. FC is a useful, non-invasive, and inexpensive biomarker for the early prediction of IBD relapse. An FC value of 152 mu g/g is an ideal threshold to identify patients with a high relapse probability.

Automated summary

Fecal calprotectin (FC) levels are correlated with the disease activity of inflammatory bowel diseases (IBD), but its usefulness in predicting IBD relapse is yet to be determined. This study aimed to evaluate the efficacy of FC in predicting IBD relapse. A total of 24 prospective studies were included in the meta-analysis, and the optimal FC cut-off value was found to be 152 μg/g. The pooled sensitivity and specificity of FC were 0.720 (0.528 to 0.856) and 0.740 (0.618 to 0.834), respectively. FC is a valuable non-invasive and cost-effective biomarker for early prediction of IBD relapse, with an ideal threshold of 152 μg/g.