Validity of activity indices in ulcerative colitis: Comparison of clinical and endoscopic indices

Aim : Various different clinical indices (CI) and endoscopic indices (EI) have been used to evaluate the clinical disease activity of ulcerative colitis (UC). However, no standardized CI or EI of UC has been established. The aim of the present study was to determine whether or not any of the CI and/or EI for assessing the disease activity of UC could be established as a standard. Methods : The most frequently used CI and EI were identified from 100 published clinical trials dealing with UC, and representative CI and EI were selected. Seventy-four patients were enrolled in this study and their CI and EI were assessed prior to treatment and at 2, 4 and 8 weeks after treatment. Furthermore, changes over time and relationships among the indices were analyzed. In this study, the clinical activity index (CAI), the disease activity index (DAI), the Lichtiger index (LI) and the Seo index were selected as the representative CI, and the Baron score and the Rachmilewitz endoscopic index (REI) were selected as the representative EI. Results : A significant decrease in all the CI and EI was observed after treatment, as compared with the baseline values. Moreover, there were positive relationships among the CI and between the CI and EI. Conclusion : Our results demonstrated that all the CI and EI examined were almost equally useful for evaluating disease activity in UC patients. Further studies may help to determine which of the indices is the most suitable for use in UC clinical trials.