22 Feb 2023 • American Gastroenterological Society Experts provide the following recommendations to support practitioners in decisions about the use of biomarkers for the Mx of ulcerative colitis(UC)

• In patients with UC in symptomatic remission, AGA suggests a monitoring strategy that combines biomarkers and symptoms, rather than symptoms alone.
• In patients with UC in symptomatic remission, AGA suggests using fecal calprotectin <150 μg/g, normal fecal lactoferrin, or normal C-reactive protein (CRP) to rule out active inflammation and avoid routine endoscopic assessment of disease activity.
• In patients with UC in symptomatic remission but elevated stool or serum markers of inflammation (fecal calprotectin >150 μg/g, elevated fecal lactoferrin, elevated CRP), AGA suggests endoscopic assessment of disease activity rather than empiric treatment adjustment.
• In patients with UC with mild symptoms, with normal stool or serum markers of inflammation (fecal calprotectin <150 μg/g, normal fecal lactoferrin, normal CRP), AGA suggests endoscopic assessment of disease activity rather than empiric treatment adjustment.
• In patients with symptomatically active UC, AGA suggests an evaluation strategy that combines biomarkers and symptoms, rather than symptoms alone, to inform treatment adjustments.
• In patients with UC with moderate to severe symptoms suggestive of flare, AGA suggests using fecal calprotectin >150 μg/g, elevated fecal lactoferrin, or elevated CRP to rule in active inflammation and inform treatment adjustment and avoid routine endoscopic assessment solely for establishing presence of active disease.
• In patients with UC with mild symptoms, with elevated stool or serum markers of inflammation (fecal calprotectin >150 μg/g, elevated fecal lactoferrin, or elevated CRP), AGA suggests endoscopic assessment of disease activity rather than empiric treatment adjustment.
• In patients with UC, AGA makes no recommendation in favor of, or against, a biomarker-based monitoring strategy over an endoscopy-based monitoring strategy to improve long-term outcomes.

Source: AGA | Read full story