Calprotectin testing

Calprotectin, an indirect marker of intestinal inflammation, is a first-line testing option that can help differentiate between IBD and IBS.

Key testing

• CALPR | Calprotectin, Feces

Advantages

• Measures levels of calcium-binding proteins in fecal material as part of the diagnostic evaluation.
• Eliminates the need for additional invasive procedures or imaging studies.
• Reduces costs for patients and improves compliance related to fasting, bowel preparation, and sedation.

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Serologic testing for Crohn’s disease and ulcerative colitis

Serologic testing for IBD is only used when diagnosis made through flexible sigmoidoscopy or colonoscopy with mucosal biopsies and radiographic studies doesn't clearly differentiate between ulcerative colitis and Crohn’s disease. Our data-driven serology panel examines only the characteristic patterns of antibodies with demonstrated clinical utility, including:

• Saccharomyces cerevisiae antibodies, IgA
• Saccharomyces cerevisiae antibodies, IgG
• Neutrophil-specific antibodies (perinuclear anti-neutrophilic cytoplasmic antibody — pANCA)

Key testing

• IBDP2 | Inflammatory Bowel Disease Serology Panel, Serum

Advantages

• Aligns with peer-reviewed literature supporting the use of three serologic tests in limited applications for IBD diagnosis.
• Offers in-depth analysis with detailed reports that include only relevant information, which helps contextualize results and provide clarity on disease presence.
• Provides ordering physicians the autonomy to make a diagnosis based on patient-specific factors.

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C-reactive protein testing to gauge mucosal healing

A focus on mucosal healing reduces the need for steroids and risk of hospitalization and surgery. Unfortunately, complete mucosal healing can be hard to achieve, and agreement has not yet been reached on how much improvement is required for better outcomes.

The CALM trial¹ from 2018 found that an approach geared toward reducing inflammatory markers of calprotectin and serum c-reactive protein, in addition to symptom reduction in patients with Crohn’s disease, improved mucosal healing and led to better clinical and endoscopic outcomes than a conventional approach.

Key testing

• CRP | C-Reactive Protein (CRP), Serum

Advantages

• All markers are clinically actionable.
• More cost-effective than using larger panels.
• Validated in a peer-reviewed study.

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References

1. Colombel JF, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn’s disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet. 2018 Dec 23;390(10114):2779-2789.