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Shujiro Yazumi 1 Article
The predictive variable regarding relapse in patients with ulcerative colitis after achieving endoscopic mucosal healing
Takuya Yoshino, Kohei Yamakawa, Satoshi Nishimura, Koutaro Watanabe, Shujiro Yazumi
Intest Res 2016;14(1):37-42.   Published online January 26, 2016
DOI: https://doi.org/10.5217/ir.2016.14.1.37
AbstractAbstract PDFPubReaderePub
<b>Background/Aims</b><br/>

Mucosal healing (MH) is a proposed therapeutic goal for patients with ulcerative colitis (UC). Whether MH is the final goal for UC, however, remains under debate. Therefore, to elucidate clinical variables predicting relapse after MH in UC could be useful for establishing further therapeutic strategy. The aim of this study is to evaluate the predictive variables for relapse in UC-patients after achieving MH.

Methods

From April 2010 to February 2015, 298 UC-patients treated at Kitano Hospital were retrospectively analyzed. MH was defined as Mayo endoscopic subscore of 0 or 1. The cumulative relapse free rate after achieving MH was evaluated. Predictive variables for relapse in UC-patients were assessed by Cox regression analysis.

Results

Of 298 UC-patients, 88 (29.5%) achieved MH. Of the 88 UC patients who achieved MH, 21 (23.9%) experienced UC-relapse. Based on Kaplan-Meier analysis, the cumulative relapse free rate at 1, 3, and 5 years after achieving MH was 87.9%, 70.2%, and 63.8%, respectively. The cumulative relapse free rate tended to be higher in the Mayo-0 group (76.9%) than in the Mayo-1 group (54.1%) at 5 years, although the difference was not statistically significant (P=0.313). Cox regression analysis indicated that the use of an immunomodulator was a predictive variable for relapse in UC-patients after achieving MH (P=0.035).

Conclusions

Our data demonstrated that the prognosis of UC patients after achieving endoscopic MH could be based on UC refractoriness requiring an immunomodulator.

Citations

Citations to this article as recorded by  
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  • Middle-term prognosis in patients with ulcerative colitis who achieved clinical and endoscopic remission by budesonide rectal foam
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    PLOS ONE.2019; 14(8): e0220413.     CrossRef
  • Endoscopic score vs. fecal biomarkers for predicting relapse in patients with ulcerative colitis after clinical remission and mucosal healing
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    Clinical and Translational Gastroenterology.2018; 9(3): e136.     CrossRef
  • European Crohn’s and Colitis Organisation Topical Review on Treatment Withdrawal [‘Exit Strategies’] in Inflammatory Bowel Disease
    Glen Doherty, Konstantinos H Katsanos, Johan Burisch, Matthieu Allez, Konstantinos Papamichael, Andreas Stallmach, Ren Mao, Ingrid Prytz Berset, Javier P Gisbert, Shaji Sebastian, Jarosław Kierkuś, Loris Lopetuso, Edyta Szymanska, Edouard Louis
    Journal of Crohn's and Colitis.2018; 12(1): 17.     CrossRef
  • Evaluation of the Potential Antioxidant Role of High-Density Lipoprotein-Cholesterol (HDL-C) in Patients with Ulcerative Colitis
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