The Role of Faecal Calprotectin in the Evaluation of Disease Activity in Spondyloarthritis Patients: A Cross-sectional Study

Abstract

Aim: Spondyloarthritis (SpA) is a group of chronic, inflammatory diseases characterized by involvement of the axial and peripheral joints, as well as extra-articular manifestations. It is important to assess disease activity (DA) for treatment and follow-up. Although there are commonly used scoring systems, they may lack sensitivity and specificity in determining DA. One potential biomarker for DA is calprotectin, a calcium-binding protein released from monocytes and macrophages during inflammation. Faecal calprotectin (fCal) is frequently used in the diagnosis and follow-up of inflammatory bowel diseases. Significant intestinal inflammation has also been shown in active SpA. The aim of this study was to test the utility of fCal as a marker of DA. Materials and Methods: The study included patients with ankylosing spondylitis and psoriatic arthritis, admitted to our hospital between October 2019 and February 2020. Patients with gastrointestinal symptoms were excluded. Demographic data, DA scores, and laboratory test results were obtained from patient records. The correlation between fCal levels and DA parameters was analysed. Results: fCal levels were correlated with the erythrocyte sedimentation rate (ESR) but not with C-reactive protein levels. Among the DA scores, only the AS Disease Activity Score (ASDAS)-ESR was found to be correlated. Non-steroid users and cigarette smokers exhibited lower levels of fCal. Conclusion: fCal levels were found to be associated with ESR but not with C-reactive protein levels. fCal is only correlated with ASDAS-ESR, and lower fCal levels were observed in those using non-steroidal drugs and smokers.

Keywords

• ankylosing spondylitis
• biomarker
• fecal calprotectin
• inflammatory bowel disease
• spondyloarthritis