Gastroenterology 2023;164:344-372GUIDELINESAGA Clinical Practice Guideline on the Role of Biomarkers for theManagement of Ulcerative ColitisSiddharth Singh,1.2 Ashwin N.Ananthakrishnan,3.4 Nghia H.Nguyen,Benjamin L.Cohen,5 Fernando S.Velayos,5 Jennifer M.Weiss,?Shahnaz Sultan,8.9Shazia M.Siddique,0.11 Jeremy Adler,2.13and Karen A.Chachu,14 on behalf of the AGAClinical Guidelines CommitteeDivision of Gastroenterology and Hepatology,Department of Medicine,University of Califomia San Diego,La Jolla,Califomia;2Division of Biomedical Informatics,Department of Medicine,University of Califomia San Diego,La Jolla,Califomia;Division ofGastroenterology,Massachusetts General Hospital,Boston,Massachusetts;Harvard Medical School,Boston,Massachusetts;Division of Gastroenterology,Hepatology,and Nutrition,Digestive Disease and Surgery Institute,ClevelandClinic,Cleveland,Ohio;5Division of Gastroenterology,Kaiser Permanente Medical Group,San Francisco,Califomia;7Divisionof Gastroenterology and Hepatology,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin;Division of Gastroenterology,Hepatology,and Nutrition,University of Minnesota,Minneapolis,Minnesota;Veterans AffairsHealthcare System,Minneapolis,Minnesota;10Division of Gastroenterology,Department of Medicine,University ofPennsylvania Perelman School of Medicine,Philadelphia,Pennsylvania;1Center for Evidence-Based Practice,University ofPennsylvania Health System,Philadelphia,Pennsylvania;12Division of Pediatric Gastroenterology,CS Mott Children's Hospital,Michigan Medicine,University of Michigan,Ann Arbor,Michigan;13Susan B.Meister Child Health Evaluation and ResearchCenter,University of Michigan,Ann Arbor,Michigan;and 14Division of Gastroenterology,Department of Medicine,DukeUniversity,Durham,North CarolinaBACKGROUND AIMS:Biomarkers are used frequently formonitoring strategy over an endoscopy-based monitoringnoninvasive monitoring and treatment decision making in thestrategy as a knowledge gap.The panel also proposed keymanagement of patients with ulcerative colitis (UC).Thisimplementation considerations for optimal use of biomarkers,American Gastroenterological Association (AGA)guideline isand identified areas for future research.CONCLUSIONS:Inintended to support practitioners in decisions about the use ofpatients with UC,noninvasive biomarkers,including fecal cal-biomarkers for the management of UC.METHODS:A multi-protectin,fecal lactoferrin,and serum CRP can inform diseasedisciplinary panel of content experts and guideline methodol-monitoring and management.ogists used the Grading of Recommendations Assessment,Development and Evaluation framework to prioritize clinicalquestions,identify patient-centered outcomes,and conduct anKeywords:Inflammatory Bowel Disease;Monitoring:Endo-evidence synthesis on the clinical performance of serum C-scopic Remission;Treat to Target;Evidence Synthesis.reactive protein (CRP),fecal calprotectin,and fecal lactoferrinas biomarkers of disease activity i
