Mucosal Healing Predicts the Long-Term Prognosis of Intestinal Behçet’s Disease

Abstract

BACKGROUND: Mucosal healing (MH) has emerged as a therapeutic goal in the treatment of inflammatory bowel disease; however, little is known about the impact of MH on the prognosis of intestinal Behçet's disease (BD). AIM: We investigated whether MH could predict the prognosis of intestinal BD. METHODS: We retrospectively reviewed the medical records of 80 patients with intestinal BD who underwent colonoscopy within 3 months after clinical remission. The clinical recurrence rate according to the presence or absence of MH was evaluated using the Kaplan-Meier method and the log-rank test. In order to evaluate MH as an independent prognostic factor, a multivariate analysis using Cox proportional hazards regression model was performed including other potential factors for the relapse of intestinal BD. RESULTS: The number of patients with active ulcers at the time of clinical remission was 57 (71.3%), while 23 patients (28.7%) were experiencing MH. In the active ulcer group, 39 patients (68.4%) experienced recurrence during the follow-up period, whereas 7 patients (30.4%) recurred in the MH group. The cumulative recurrence rate was significantly higher in the active ulcer group than in the MH group (P < 0.001). A multivariate analysis identified active ulcers at the time of clinical remission as an independent predictive factor for relapse. CONCLUSION: Our study demonstrates that MH is an independent factor predictive of long-term prognosis of intestinal BD. MH might be the ultimate therapeutic goal in the treatment of intestinal BD.