Frequency of Elevated Fecal Calprotectin Levels in Psoriatic Arthritis.

NCT ID: NCT04190108

Last Updated: 2019-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

259 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-01-02

Study Completion Date

2019-10-31

Brief Summary

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Background.Recent epidemiologic studies have shown an association between psoriasis, psoriatic arthritis (PsA) and inflammatory bowel diseases (IBD). Recently, measurement of fecal calprotectin (FC) demonstrated a good sensitivity and specificity for intestinal inflammation.

Primary objective of present study was to evaluate the presence of occult bowel inflammation in patients with PsA as expressed by elevated levels of FC. Secondary objectives were to investigate the correlation between the levels FC and clinical and laboratory features, and the outcome of CF-positive patients in terms of IBD development.

Detailed Description

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A number of studies evaluated the presence of occult intestinal inflammation by using FC assay in patients with axial SpA. In 2000, a study conducted in PsA patients without bowel symptoms showed at mucosa biopsies the presence of microscopic changes, increase in lamina propria cellularity, consisting of plasma cells and lymphocytes, and lymphoid aggregates.Present prospective case-control study was designed to investigate occult intestinal inflammation by using FC assay in consecutive patients with PsA at onset, and who had no abdominal symptoms. Five Italian Centers contributed to patients recruitment adopting the same inclusion and exclusion criteria over a 3 year period.

FC levels were measured at baseline with Bühlmann fCAL Turbo, Switzerland® kit. This automated method is a particle enhanced turbidimetric immunoassay employing polyclonal antibodies. The manufacturer cut-off for FC positivity was 50 μg/g, with a sensitivity of 100% and a specificity of 53.1%.

The number of patients developing IBD was evaluated at the end of follow-up. Clinical and laboratory data collection was centralized and two experts statisticians performed the data analysis.

Statistical analysis. All demographic, clinical, and laboratory data were collected and descriptive statistics, presented as mean value and standard deviation, were calculated using Microsoft ® Office Excel for Windows and ©2019 Minitabs, LLC for Windows. Chi-square test was used for categorical variables. FC test sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. Bayes's theorem was used to calculate the 95% confidence interval (95%CI). Correlations were calculated using Spearman's correlation (rs). P values ≤ 0.05 were accepted as statistically significant.

The median follow-up was 30 months.

Conditions

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Psoriatic Arthritis Inflammatory Bowel Diseases

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Case patients

All consecutive, new patients older than 18 years with PsA (CASPAR criteria) at onset observed over 3-year period, who had any abdominal symptoms.

Fecal calprotectin assay

Intervention Type DIAGNOSTIC_TEST

FC levels were measured at baseline with Bühlmann fCAL Turbo, Switzerland® kit.

Controls

All consecutive new patients meeting the ACR/EULAR 2010 classification criteria for rheumatoid arthritis (RA) at onset.

Fecal calprotectin assay

Intervention Type DIAGNOSTIC_TEST

FC levels were measured at baseline with Bühlmann fCAL Turbo, Switzerland® kit.

Interventions

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Fecal calprotectin assay

FC levels were measured at baseline with Bühlmann fCAL Turbo, Switzerland® kit.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* age \>18 years
* absence of any abdominal symptoms or diarrhoea
* non-steroidal anti-inflammatory drug (NSAIDs) interruption 10 days before enrollment
* Corticosteroids (CS) at stable low dose (prednisone 10 mg/day or equivalent) during the preceding 2 weeks were permitted in both groups.

Exclusion Criteria

* age \< 18 years
* previous diagnosis of CD or UC or current diagnosis of infectious colitis
* previous therapy with traditional DMARDs or any biologic therapies
* CS at high doses.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Giulia Franchi,Department of Rheumatology, Hospital of Prato

UNKNOWN

Sponsor Role collaborator

Maurizio Benucci,S.Giovanni di Dio Hospital

UNKNOWN

Sponsor Role collaborator

Raffaele Scarpa, Rheumatology Unit, University of Naples Federico II, Naples

UNKNOWN

Sponsor Role collaborator

Francesco Caso, Rheumatology Unit, University of Naples Federico II, Naples

UNKNOWN

Sponsor Role collaborator

Rosario Foti,Rheumatology Unit, A.O.U. Policlinico Vittorio Emanuele, Catania

UNKNOWN

Sponsor Role collaborator

Antonio Carletto,Rheumatology Unit, AOUI, Verona.

UNKNOWN

Sponsor Role collaborator

Elisa Visalli,Rheumatology Unit, A.O.U. Policlinico Vittorio Emanuele, Catania

UNKNOWN

Sponsor Role collaborator

Laura Niccoli,Department of Rheumatology, Hospital of Prato

UNKNOWN

Sponsor Role collaborator

Hospital of Prato

OTHER

Sponsor Role lead

Responsible Party

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Fabrizio Cantini

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Fabrizio Cantini

Prato, Tuscany, Italy

Site Status

Countries

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Italy

References

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Fu Y, Lee CH, Chi CC. Association of Psoriasis With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. JAMA Dermatol. 2018 Dec 1;154(12):1417-1423. doi: 10.1001/jamadermatol.2018.3631.

Reference Type BACKGROUND
PMID: 30422277 (View on PubMed)

Scher JU, Ubeda C, Artacho A, Attur M, Isaac S, Reddy SM, Marmon S, Neimann A, Brusca S, Patel T, Manasson J, Pamer EG, Littman DR, Abramson SB. Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis, resembling dysbiosis in inflammatory bowel disease. Arthritis Rheumatol. 2015 Jan;67(1):128-39. doi: 10.1002/art.38892.

Reference Type BACKGROUND
PMID: 25319745 (View on PubMed)

Klingberg E, Strid H, Stahl A, Deminger A, Carlsten H, Ohman L, Forsblad-d'Elia H. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. Arthritis Res Ther. 2017 Feb 2;19(1):21. doi: 10.1186/s13075-017-1223-2.

Reference Type BACKGROUND
PMID: 28148281 (View on PubMed)

Adarsh MB, Dogra S, Vaiphei K, Vaishnavi C, Sinha SK, Sharma A. Evaluation of subclinical gut inflammation using faecal calprotectin levels and colonic mucosal biopsy in patients with psoriasis and psoriatic arthritis. Br J Dermatol. 2019 Aug;181(2):401-402. doi: 10.1111/bjd.17745. Epub 2019 May 6. No abstract available.

Reference Type BACKGROUND
PMID: 30729502 (View on PubMed)

Scarpa R, Manguso F, D'Arienzo A, D'Armiento FP, Astarita C, Mazzacca G, Ayala F. Microscopic inflammatory changes in colon of patients with both active psoriasis and psoriatic arthritis without bowel symptoms. J Rheumatol. 2000 May;27(5):1241-6.

Reference Type BACKGROUND
PMID: 10813294 (View on PubMed)

Other Identifiers

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HPrato-2

Identifier Type: -

Identifier Source: org_study_id