The American Gastroenterological Association (AGA) has released a new guideline, published in Gastroenterology, recommending the use of blood and stool-based biomarkers for managing Crohn’s disease. This guideline marks a significant advancement in the non-invasive monitoring of this condition.
Key points from the guideline include:
- Use of Biomarkers: Biomarkers like C-reactive protein (CRP) in blood and fecal calprotectin (FCP) in stool are emphasized for their ability to measure inflammation levels. These indicators help assess whether Crohn’s disease is active or in remission.
- Frequency of Testing: For patients in remission, it’s recommended to check CRP and FCP every six to twelve months. In cases of active symptoms, these tests should be conducted every two to four months to guide treatment adjustments.
- Post-Surgery Monitoring: FCP may be useful for monitoring patients at low risk for disease recurrence post-surgery. However, in cases of suspected recurrence, radiologic or endoscopic assessment is preferred over relying solely on biomarkers.
- Role in Treatment Plans: Before making major treatment plan changes, repeating endoscopic or radiologic assessments is advised.
The guideline underscores that biomarkers are no longer experimental and should be an integral part of IBD care. They offer a less invasive, more cost-effective alternative to frequent colonoscopies and allow for more frequent assessments for tighter disease control and better long-term outcomes in Crohn’s disease patients.