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Effect of mucosal healing (Mayo 0) on clinical relapse in patients with ulcerative colitis in clinical remission

Authors
 Jae Hyun Kim  ;  Jae Hee Cheon  ;  Yehyun Park  ;  Hyun Jung Lee  ;  Soo Jung Park  ;  Tae Il Kim  ;  Won Ho Kim 
Citation
 Scandinavian Journal of Gastroenterology, Vol.51(9) : 1069-1074, 2016 
Journal Title
 Scandinavian Journal of Gastroenterology 
ISSN
 0036-5521 
Issue Date
2016
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Azathioprine/therapeutic use ; Colitis, Ulcerative/drug therapy* ; Colonoscopy ; Disease Progression ; Female ; Humans ; Intestinal Mucosa/drug effects* ; Kaplan-Meier Estimate ; Male ; Mesalamine/therapeutic use ; Middle Aged ; Proportional Hazards Models ; Recurrence ; Republic of Korea ; Retrospective Studies ; Severity of Illness Index ; Wound Healing/drug effects* ; Young Adult
Keywords
Clinical relapse ; clinical remission ; mucosal healing ; prognosis ; ulcerative colitis
Abstract
Objective: The aim of this study was to identify the effect of mucosal healing (MH) on clinical relapse in patients with ulcerative colitis (UC) who are in clinical remission, with special reference to Mayo endoscopic subscore 0. Methods: Between November 2005 and December 2013, medical records from a total of 215 patients with UC who underwent colonoscopic examination at the time of clinical remission were retrospectively reviewed. Endoscopic MH was defined as a ‘0 point’ of Mayo endoscopic subscore (Mayo 0). Patients were categorized into two groups according to Mayo endoscopic subscore and then analyzed. Results: The baseline characteristics of both groups (MH vs. no-MH), including age at diagnosis, gender, and initial clinical and colonoscopic findings, were not significantly different. The median follow-up duration was 80 (12?118) months. Factors predictive of longer clinical remission duration were age ≥30 years at diagnosis (≥30 years vs. <30 years; hazard ratio [HR] 3.16, 95% CI 1.88?5.30, p?<?0.001), shorter interval between diagnosis and clinical remission (<15 months vs. ≥15 months; HR 1.93, 95% CI 1.13?3.28, p?=?0.015), and presence of MH at clinical remission (HR 1.95, 95% CI 1.15?3.32, p?=?0.014). With a Cox regression model, patients with MH at clinical remission were more likely to have longer duration of clinical remission than patients without MH. Conclusion: The achievement of MH, Mayo 0 in particular, in patients with UC who are in clinical remission is important in predicting a favorable disease course prognosis.
Full Text
http://www.tandfonline.com/doi/abs/10.3109/00365521.2016.1150503
DOI
10.3109/00365521.2016.1150503
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Park, Soo Jung(박수정)
Park, Yehyun(박예현) ORCID logo https://orcid.org/0000-0001-8811-0631
Lee, Hyun Jung(이현정)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151964
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