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Proactive Fecal Calprotectin Home Monitoring in Ulcerative Colitis: Results of a Prospective Randomized Control Trial
Gregory Rosenfeld1, Neeraj Narula2, Yvette Leung1
1IBD Centre of British Columbia, Vancouver, British Columbia, Canada.
Gastroenterology
|June 23, 2026
Summary
Proactive home-based fecal calprotectin (FC) monitoring did not prevent symptomatic flares in ulcerative colitis (UC) patients. Further research is needed to determine the optimal use of FC testing for early intervention in UC management.
Area of Science:
- Gastroenterology
- Clinical Trials
- Inflammatory Bowel Disease
Background:
- Elevated fecal calprotectin (FC) indicates intestinal inflammation and can precede ulcerative colitis (UC) flares.
- Home-based FC monitoring is a potential strategy for early detection of UC activity.
Purpose of the Study:
- To evaluate if proactive home-based FC monitoring prevents symptomatic flares in UC patients in remission.
- To assess the impact of FC monitoring on healthcare utilization, medication use, and quality of life.
Main Methods:
- A prospective, multicenter clinical trial randomized UC patients to standard care or routine FC testing.
- Confirmatory FC testing and physician-guided therapy adjustments were performed for elevated levels (≥250 μg/g).
- The primary endpoint was time to symptomatic flare over 18 months.
Main Results:
- No significant difference in symptomatic flare risk was observed between the standard care and FC monitoring groups (HR 1.05).
- Flare frequency was similar across both arms, regardless of disease extent or advanced therapy use.
- No differences were found in secondary endpoints, including healthcare utilization and quality of life.
Conclusions:
- Proactive home-based FC monitoring, without a protocolized escalation strategy, did not prevent symptomatic flares in UC patients.
- Further studies are required to establish the optimal application of FC monitoring and the benefits of early therapeutic interventions in UC.
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