New AGA Guidelines on Biomarkers for Ulcerative Colitis
This blog covers the new American Gastroenterological Association (AGA) guidelines on biomarkers for ulcerative colitis (UC). The guidelines focus on commonly-available biomarkers in the outpatient setting and are designed to help predict remission and improve UC outcomes.
American Gastroenterological Association (AGA)
Our mission is to empower clinicians and researchers to improve digestive health. Also follow @AGA_Gastro @AGA_CGH @AGA_CMGH @AGA_TIGE @AGA_GHAdvances @AGA_GIHN
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📢 New AGA guidelines on biomarkers for ulcerative colitis (UC).https://t.co/k28pKmRnoi
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
🔥A Tweetorial for #GITwitter by @AmerGastroAssn and @AGA_Gastro. #IBD@AshwinMDIBD @IBDBen @Realcecum @SultanShazi @ShaziaMSiddique @JeremyAdlerMD
Follow this🧵 pic.twitter.com/KazuZQ6X6a -
Endoscopic remission is associated w/ improved UC outcomes:
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
⬇︎ Steroid use💊
⬇︎ Risk relapse🧻
⬇︎ Risk hospitalization🏥
⬇︎ Risk colectomy😷
⬇︎ Risk colon cancer💉
Symptoms plus common non-invasive biomarkers can serve as surrogates for endoscopic monitoring. pic.twitter.com/sZh4jAEnWZ -
Why focus on biomarkers?
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
🚫Presence/absence of symptoms does not predict remission
🚫Frequent scopes often not acceptable
Guidelines designed for commonly-available biomarkers in outpatient setting
Not for suspected UC or hospitalized pts w/ severe UC. https://t.co/k28pKmRnoi pic.twitter.com/ZyNgQbNGEE -
Guidelines made recommendations for 3️⃣ groups of patients with UC:
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
🟢 Symptomatic remission
⚠️ Mild symptoms
🚨 Moderate-severe symptoms
🎯 fecal calprotectin <150 μg/g, normal lactoferrin and/or normal CRPhttps://t.co/k28pKmRnoi pic.twitter.com/S8Omcw6vCI -
UC in 🟢 symptomatic remission 🟢 suggest ✔biomarkers q6-12mo:
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
🎯calpro <150, normal lactoferrin/CRP
💩may be better than🩸for detecting active UC
🧐calpro <50 may be less likely to miss active UC
👎if any abnormal biomarker
➡️Suggest scope or
➡️May consider repeat in 3-6mo pic.twitter.com/xPahJtNs2A -
⚠️mild symptoms⚠️ suggest ✔︎biomarkers
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
Same🎯
👍If biomarkers normal
➡️Suggest scope before Rx Δ
➡️Or consider repeat in 3-6mo
👎If any biomarker abnormal
➡️May be less informative if mild sx
➡️Suggest scope before Rx Δ
➡️If recent flare may use biomarker to inform Rx Δ pic.twitter.com/6TSIRwtQ9k -
🚨Mod-severe symptoms🚨 suggest ✔︎biomarkers
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
Same🎯
👍 If biomarkers normal
➡️ Suggest scope before Rx Δ
👎 If any biomarker abnormal
➡️ Suggest Rx Δ (no scope)
➡️ May consider scope if value confirmation or big Rx decisionhttps://t.co/k28pKmRnoi pic.twitter.com/wFsDBocK0C -
🔎Other considerations:
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
➡️Biomarkers may be ⬆︎ for non-UC reasons
➡️May be less reliable for limited extent UC
➡️Calpro assays may not be interchangeable
➡️In some patients biomarkers correlate poorly w/ scope. Longitudinal trend can help understand individual reliability. pic.twitter.com/ipUxAzu8lC -
😖Unanswered questions
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
🤔Need future researchhttps://t.co/k28pKmRnoi pic.twitter.com/CTI0RJkitk -
Full @AmerGastroAssn Biomarker Guidelines for UC is available in @AGA_Gastro: https://t.co/k28pKmRnoi.
— American Gastroenterological Association (AGA) (@AmerGastroAssn) June 12, 2023
Thanks to our authors, including @AshwinMDIBD, @IBDBen, @Realcecum, @SultanShazi, @ShaziaMSiddique and @JeremyAdlerMD. pic.twitter.com/ZpjFHl3d6V