The ulcerative colitis endoscopic index of severity is useful to predict medium- to long-term prognosis in ulcerative colitis patients with clinical remission

Mari Arai, Makoto Naganuma, Shinya Sugimoto, Hiroki Kiyohara, Keiko Ono, Kiyoto Mori, Keiichiro Saigusa, Kosaku Nanki, Makoto Mutaguchi, Shinta Mizuno, Rieko Bessho, Yoshihiro Nakazato, Naoki Hosoe, Katsuyoshi Matsuoka, Nagamu Inoue, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai

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Abstract

Background: The ulcerative colitis endoscopic index of severity [UCEIS] is a validated scoring system. Nevertheless, few studies have investigated its usefulness in clinical settings. In this study, we aimed to predict the clinical prognosis of patients with ulcerative colitis [UC] in clinical remission using the UCEIS. Methods: A total of 285 UC patients who underwent a colonoscopy between April 2012 and March 2013 were enrolled. We reviewed clinical characteristics and endoscopic scores at the time of the colonoscopy and checked the clinical remission rate of the patients until September 2015. Clinical remission and recurrence were defined as a partial Mayo score of =1 and =3, respectively. Results: UCEIS was strongly correlated with the Mayo endoscopic score [r=0.93], moderately correlated with clinical severity [r=0.64] and mildly correlated with C-reactive protein [r=0.34]. The recurrence rate increased gradually as it became more endoscopically severe [5.0% for UCEIS=0, 22.4% for UCEIS=1, 27.0% for UCEIS=2, 35.7% for UCEIS=3 and 75.0% for UCEIS=4-5] in patients with clinical remission. UCEIS and the concomitant use of thiopurine were independent factors predicting clinical recurrence. A multivariate analysis indicated that the absence of bleeding [p=0.001] and the absence of mucosal damage [p < 0.001] in a colonoscopy were independent factors for prolongation of clinical remission. Conclusion: The UCEIS is useful to predict the medium- to long-term outcomes of UC patients with clinical remission. The absence of bleeding or mucosal damage is important for maintaining clinical remission.

Original languageEnglish
Pages (from-to)1303-1309
Number of pages7
JournalJournal of Crohn's and Colitis
Volume10
Issue number11
DOIs
Publication statusPublished - 2016

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Ulcerative Colitis
Colonoscopy
Recurrence
Hemorrhage
C-Reactive Protein
Multivariate Analysis

Keywords

  • Endoscopic indice
  • Long-term prognosis
  • UCEIS
  • Ulcerative colitis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{1e88adb7113a441d940534de92248b04,
title = "The ulcerative colitis endoscopic index of severity is useful to predict medium- to long-term prognosis in ulcerative colitis patients with clinical remission",
abstract = "Background: The ulcerative colitis endoscopic index of severity [UCEIS] is a validated scoring system. Nevertheless, few studies have investigated its usefulness in clinical settings. In this study, we aimed to predict the clinical prognosis of patients with ulcerative colitis [UC] in clinical remission using the UCEIS. Methods: A total of 285 UC patients who underwent a colonoscopy between April 2012 and March 2013 were enrolled. We reviewed clinical characteristics and endoscopic scores at the time of the colonoscopy and checked the clinical remission rate of the patients until September 2015. Clinical remission and recurrence were defined as a partial Mayo score of =1 and =3, respectively. Results: UCEIS was strongly correlated with the Mayo endoscopic score [r=0.93], moderately correlated with clinical severity [r=0.64] and mildly correlated with C-reactive protein [r=0.34]. The recurrence rate increased gradually as it became more endoscopically severe [5.0{\%} for UCEIS=0, 22.4{\%} for UCEIS=1, 27.0{\%} for UCEIS=2, 35.7{\%} for UCEIS=3 and 75.0{\%} for UCEIS=4-5] in patients with clinical remission. UCEIS and the concomitant use of thiopurine were independent factors predicting clinical recurrence. A multivariate analysis indicated that the absence of bleeding [p=0.001] and the absence of mucosal damage [p < 0.001] in a colonoscopy were independent factors for prolongation of clinical remission. Conclusion: The UCEIS is useful to predict the medium- to long-term outcomes of UC patients with clinical remission. The absence of bleeding or mucosal damage is important for maintaining clinical remission.",
keywords = "Endoscopic indice, Long-term prognosis, UCEIS, Ulcerative colitis",
author = "Mari Arai and Makoto Naganuma and Shinya Sugimoto and Hiroki Kiyohara and Keiko Ono and Kiyoto Mori and Keiichiro Saigusa and Kosaku Nanki and Makoto Mutaguchi and Shinta Mizuno and Rieko Bessho and Yoshihiro Nakazato and Naoki Hosoe and Katsuyoshi Matsuoka and Nagamu Inoue and Haruhiko Ogata and Yasushi Iwao and Takanori Kanai",
year = "2016",
doi = "10.1093/ecco-jcc/jjw104",
language = "English",
volume = "10",
pages = "1303--1309",
journal = "Journal of Crohn's and Colitis",
issn = "1873-9946",
publisher = "Elsevier",
number = "11",

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TY - JOUR

T1 - The ulcerative colitis endoscopic index of severity is useful to predict medium- to long-term prognosis in ulcerative colitis patients with clinical remission

AU - Arai, Mari

AU - Naganuma, Makoto

AU - Sugimoto, Shinya

AU - Kiyohara, Hiroki

AU - Ono, Keiko

AU - Mori, Kiyoto

AU - Saigusa, Keiichiro

AU - Nanki, Kosaku

AU - Mutaguchi, Makoto

AU - Mizuno, Shinta

AU - Bessho, Rieko

AU - Nakazato, Yoshihiro

AU - Hosoe, Naoki

AU - Matsuoka, Katsuyoshi

AU - Inoue, Nagamu

AU - Ogata, Haruhiko

AU - Iwao, Yasushi

AU - Kanai, Takanori

PY - 2016

Y1 - 2016

N2 - Background: The ulcerative colitis endoscopic index of severity [UCEIS] is a validated scoring system. Nevertheless, few studies have investigated its usefulness in clinical settings. In this study, we aimed to predict the clinical prognosis of patients with ulcerative colitis [UC] in clinical remission using the UCEIS. Methods: A total of 285 UC patients who underwent a colonoscopy between April 2012 and March 2013 were enrolled. We reviewed clinical characteristics and endoscopic scores at the time of the colonoscopy and checked the clinical remission rate of the patients until September 2015. Clinical remission and recurrence were defined as a partial Mayo score of =1 and =3, respectively. Results: UCEIS was strongly correlated with the Mayo endoscopic score [r=0.93], moderately correlated with clinical severity [r=0.64] and mildly correlated with C-reactive protein [r=0.34]. The recurrence rate increased gradually as it became more endoscopically severe [5.0% for UCEIS=0, 22.4% for UCEIS=1, 27.0% for UCEIS=2, 35.7% for UCEIS=3 and 75.0% for UCEIS=4-5] in patients with clinical remission. UCEIS and the concomitant use of thiopurine were independent factors predicting clinical recurrence. A multivariate analysis indicated that the absence of bleeding [p=0.001] and the absence of mucosal damage [p < 0.001] in a colonoscopy were independent factors for prolongation of clinical remission. Conclusion: The UCEIS is useful to predict the medium- to long-term outcomes of UC patients with clinical remission. The absence of bleeding or mucosal damage is important for maintaining clinical remission.

AB - Background: The ulcerative colitis endoscopic index of severity [UCEIS] is a validated scoring system. Nevertheless, few studies have investigated its usefulness in clinical settings. In this study, we aimed to predict the clinical prognosis of patients with ulcerative colitis [UC] in clinical remission using the UCEIS. Methods: A total of 285 UC patients who underwent a colonoscopy between April 2012 and March 2013 were enrolled. We reviewed clinical characteristics and endoscopic scores at the time of the colonoscopy and checked the clinical remission rate of the patients until September 2015. Clinical remission and recurrence were defined as a partial Mayo score of =1 and =3, respectively. Results: UCEIS was strongly correlated with the Mayo endoscopic score [r=0.93], moderately correlated with clinical severity [r=0.64] and mildly correlated with C-reactive protein [r=0.34]. The recurrence rate increased gradually as it became more endoscopically severe [5.0% for UCEIS=0, 22.4% for UCEIS=1, 27.0% for UCEIS=2, 35.7% for UCEIS=3 and 75.0% for UCEIS=4-5] in patients with clinical remission. UCEIS and the concomitant use of thiopurine were independent factors predicting clinical recurrence. A multivariate analysis indicated that the absence of bleeding [p=0.001] and the absence of mucosal damage [p < 0.001] in a colonoscopy were independent factors for prolongation of clinical remission. Conclusion: The UCEIS is useful to predict the medium- to long-term outcomes of UC patients with clinical remission. The absence of bleeding or mucosal damage is important for maintaining clinical remission.

KW - Endoscopic indice

KW - Long-term prognosis

KW - UCEIS

KW - Ulcerative colitis

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U2 - 10.1093/ecco-jcc/jjw104

DO - 10.1093/ecco-jcc/jjw104

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JO - Journal of Crohn's and Colitis

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