Fecal Calprotectin Test Performed at Home: A Prospective Study of Pediatric Patients with Inflammatory Bowel Disease

Objectives: Measuring fecal calprotectin (FC) in a laboratory is time-consuming and that is why home tests have been developed. We studied the use of an FC home test in pediatric patients with inflammatory bowel disease (PIBD) in real-life settings.

Methods: The patients were asked to perform the IBDoc (R) FC home test monthly for 6 months and to report their clinical disease activity at testing. Clinical decision-making, however, was guided by routine FC enzyme-linked immunosorbent assay (ELISA) for patients with raised IBDoc (R) values. Spare frozen samples were analyzed using ELISA and IBDoc (R) in the laboratory. The participants completed a questionnaire about FC testing at the start and end of the study.

Results: Of the 52 patients, 35 (67%) ages 5 to 18 years completed the study, and 197 home tests were performed. Of these, 15% failed, mainly because of technical reasons. Just under half of the patients (47%) considered home testing comparable or superior to routine testing. In contrast, the parents were unsatisfied (61%), mostly because the IBDoc (R) results were significantly different from ELISA and they found the phone application difficult to handle but whenever the IBDoc (R) was performed by a laboratory professional it was comparable with ELISA, suggesting that practical issues hampered home testing. Despite their reservations, more than 80% of parents felt that home testing would improve disease management.

Conclusions: PIBD patients and their families were interested in FC home monitoring and willing to adopt testing as a part of their disease management, but this approach requires thorough guidance.