Faecal calprotectin in primary care: is its current use supported by the evidence?
File(s)
Accepted version
Author(s)
Perry, Robert
Mummery, david
Alexander, james
Hicks, lucy
Williams, horace
Type
Journal Article
Abstract
Faecal calprotectin (FC) is a calcium-binding cytosolic protein which is secreted by neutrophils (1). Its use is well-established as a screening test for gastrointestinal inflammation with multiple studies showing elevated levels in patients with inflammatory bowel disease (IBD) compared to control groups, such as patients with irritable bowel syndrome (IBS). It also has a role in the management of IBD due to its correlation with markers of disease activity (2). Its low cost and potential ability to reduce unnecessary secondary care referrals have led to its widespread adoption in primary care (3).
However, concerns have previously been raised that patients with a borderline elevated calprotectin may be referred for unnecessary investigation (4). In addition, many of the initial FC research studies were performed in a secondary care setting, despite its widespread use in primary care. In this article the guidelines for FC use will be reviewed, as well as its evidence in primary care. We will make suggestions for best practice and highlight areas in which outstanding questions and uncertainties remain.
However, concerns have previously been raised that patients with a borderline elevated calprotectin may be referred for unnecessary investigation (4). In addition, many of the initial FC research studies were performed in a secondary care setting, despite its widespread use in primary care. In this article the guidelines for FC use will be reviewed, as well as its evidence in primary care. We will make suggestions for best practice and highlight areas in which outstanding questions and uncertainties remain.
Date Issued
2024-03-01
Date Acceptance
2024-01-25
Citation
British Journal of General Practice, 2024, 74 (740), pp.134-136
ISSN
0960-1643
Publisher
Royal College of General Practitioners
Start Page
134
End Page
136
Journal / Book Title
British Journal of General Practice
Volume
74
Issue
740
Copyright Statement
© British Journal of General Practice 2024. This is the author’s accepted manuscript made available under a CC-BY licence in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy)
License URL
Identifier
https://bjgp.org/content/74/740/134
Publication Status
Published
Date Publish Online
2024-02-29