Faecal lactoferrin a useful, cheap marker for assessing IBD activity

Faecal lactoferrin (FL) shows high sensitivity and modest specificity in the assessment of inflammatory bowel disease (IBD) activity, with greater ability to evaluate ulcerative colitis (UC) rather than Crohn’s disease (CD), according to the results of a systematic review and meta-analysis.

The investigators searched databases from inception to May 2018 for studies that assessed IBD activity and evaluated the methodological quality of each according to the Quality Assessment of Diagnostic Accuracy Studies checklist.

A summary receiver operating characteristic curve model was used to pool the extracted data and a random-effects model to summarize the diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio.

Only 10 studies comprising 773 IBD patients met the eligibility criteria. For the assessment of UC activity, pooled sensitivity value was 0.81 (95 percent confidence interval [CI], 0.64–0.92) and specificity 0.82 (95 percent CI, 0.61–0.93). For CD activity, the pooled values were 0.82 (95 percent CI, 0.73–0.88) and 0.71 (95 percent CI, 0.63–0.78), respectively.

Of note, the diagnostic performance of the FL assay in UC patients was superior to that in CD patients.

“Our meta-analysis has found that FL is an inexpensive, simple, stable, and useful screening marker with high sensitivity and modest specificity for assessing IBD activity,” the investigators concluded.

“Persistent disease activity is associated with a poor prognosis in IBD patients; [t]herefore, monitoring of IBD activity can avoid [such] prognosis,” they noted.