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

Jae Hyun Kim, JaeHee Cheon, Yehyun Park, Hyun Jung Lee, Soo Jung Park, Tae Il Kim, Won Ho Kim

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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.

Original languageEnglish
Pages (from-to)1069-1074
Number of pages6
JournalScandinavian Journal of Gastroenterology
Volume51
Issue number9
DOIs
Publication statusPublished - 2016 Sep 1

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Ulcerative Colitis
Recurrence
Proportional Hazards Models
Medical Records

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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Kim, Jae Hyun ; Cheon, JaeHee ; Park, Yehyun ; Lee, Hyun Jung ; Park, Soo Jung ; Kim, Tae Il ; Kim, Won Ho. / Effect of mucosal healing (Mayo 0) on clinical relapse in patients with ulcerative colitis in clinical remission. In: Scandinavian Journal of Gastroenterology. 2016 ; Vol. 51, No. 9. pp. 1069-1074.
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Effect of mucosal healing (Mayo 0) on clinical relapse in patients with ulcerative colitis in clinical remission. / Kim, Jae Hyun; Cheon, JaeHee; Park, Yehyun; Lee, Hyun Jung; Park, Soo Jung; Kim, Tae Il; Kim, Won Ho.

In: Scandinavian Journal of Gastroenterology, Vol. 51, No. 9, 01.09.2016, p. 1069-1074.

Research output: Contribution to journalArticle

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AU - Kim, Jae Hyun

AU - Cheon, JaeHee

AU - Park, Yehyun

AU - Lee, Hyun Jung

AU - Park, Soo Jung

AU - Kim, Tae Il

AU - Kim, Won Ho

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N2 - 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.

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