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New AGA guidelines back biomarkers for ulcerative colitis

Experts say non-invasive biomarkers are more cost-efficient than endoscopy for many UC patients.
AGA Guideline Spotlight: Biomarkers in Ulcerative Colitis
AGA Guideline Spotlight: Biomarkers in Ulcerative Colitis

AGA released new evidence-based guidelines recommending non-invasive biomarkers as a first-line strategy for monitoring many patients with ulcerative colitis (UC).

The guidelines, published in March’s issue of Gastroenterology, outline use cases for three biomarkers that provide accurate insights into ulcerative colitis disease activity: serum C-reactive protein (CRP) (blood), fecal calprotectin (stool) and fecal lactoferrin (stool).

Patients with ulcerative colitis in symptomatic remission:

  • Perform interval biomarker monitoring every six to 12 months.
  • AGA recommends stool-based biomarkers over blood testing.
  • If biomarkers are normal, AGA suggests continuing biomarker monitoring and avoiding routine endoscopic assessment.
  • If biomarkers are elevated, AGA suggests endoscopic assessment.
 

Patients with symptomatically active ulcerative colitis:

  • Biomarker testing should be the first step to determine the need for endoscopic assessment.
  • For patients with mild symptoms who have normal or elevated biomarkers, AGA suggests endoscopic assessment.
  • For patients with moderate to severe symptoms who have normal biomarkers, AGA suggests endoscopic assessment.
  • For patients with moderate to severe symptoms and elevated biomarkers, AGA suggests treatment adjustment and avoiding endoscopic assessment.

Additional resources:

AGA Clinical Guidance
Evidence-based recommendations.

AGA clinical guidance

Find the latest evidence-based recommendations for treating your patients.

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