Efficacy of therapeutic intervention for patients with an ulcerative colitis mayo endoscopic score of 1

Tomohiro Fukuda, Makoto Naganuma, Shinya Sugimoto, Keiko Ono, Kosaku Nanki, Shinta Mizuno, Kayoko Kimura, Makoto Mutaguchi, Yoshihiro Nakazato, Kaoru Takabayashi, Nagamu Inoue, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background Mucosal healing (MH) is proposed as a therapeutic target for ulcerative colitis (UC). Recent studies have indicated that the rate of clinical relapse in patients with a Mayo endoscopic score (MES) of 1 is higher than that of patients with an MES of 0. However, no study has yet investigated whether therapeutic intervention prevents clinical relapse in patients with an MES of 1. Methods Patients with UC with an MES of 1 and partial Mayo score ≤2 were included in this study. All patients were followed from first colonoscopy (CS) until follow-up CS. Differences in the rate of clinical relapse (requiring additional treatment for UC) or endoscopic exacerbation (MES ≥2 and proximal extension) were compared between the therapeutic intervention (immediately after first CS) group and the nontherapeutic intervention group; risk factors for relapse were also assessed. Results Among 1523 patients with UC who underwent CS between 2013 and 2016, 220 patients were included in this study. The rate of clinical relapse (P = 0.005) and endoscopic exacerbation (P = 0.11) in patients with therapeutic intervention was lower than that in patients without therapeutic intervention. Multivariable analysis indicated that absence of therapeutic intervention (P = 0.001 for clinical relapse, P = 0.050 for endoscopic exacerbation) and a higher Ulcerative Colitis Endoscopic Index of Severity vascular pattern score immediately after first CS (P = 0.021 for clinical relapse, P = 0.019 for endoscopic exacerbation) were risk factors for both clinical relapse and endoscopic exacerbation. Conclusions Therapeutic intervention for patients with UC with an MES of 1 might prevent disease relapse.

Original languageEnglish
Pages (from-to)782-788
Number of pages7
JournalInflammatory bowel diseases
Volume25
Issue number4
DOIs
Publication statusPublished - 2019 Mar 14

Keywords

  • Mayo endoscopic score
  • treat to target
  • ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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