Does Medical Acceleration Improve Outcomes in Ulcerative Colitis Patients Who Are in Clinical Remission but Have Endoscopic Inflammation? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-07-09

AUTHORS

Ji Young Chang, Jae Hee Cheon, Yehyun Park, Soo Jung Park, Tae-Il Kim, Won-Ho Kim

ABSTRACT

BackgroundDiscrepancies between clinical symptoms and mucosal inflammation have been reported in up to 50% of patients with ulcerative colitis (UC). However, there are no guidelines and only limited information for appropriate treatment manipulation.AimWe aimed to evaluate long-term outcomes according to treatment strategies and determine predictive factors for disease relapse in UC patients who are in clinical remission (CR) but still have endoscopic inflammation.MethodsA total of 204 patients who were confirmed as achieving CR but still had mucosal inflammation were included. CR was defined as “partial Mayo score ≤ 1” with no changes in medications or use of any corticosteroids during the past 3 months. An active mucosal lesion was defined as “endoscopic Mayo subscore > 0.”ResultsThe mean patient age was 43.5 years, and 53.9% were male. The mean disease duration was 89.9 months. During a mean follow-up of 34 months, 90 patients (44%) experienced disease relapse. The cumulative relapse-free rate did not differ by treatment strategy (maintenance of current therapy vs. dose elevation or step-up therapy). Multivariate analysis revealed that left-side colitis or pancolitis at diagnosis (OR 2.10; 95% CI 1.04–4.27; P = 0.040) and number of extraintestinal manifestations ≥ 2 (OR 5.62; 95% CI 1.10–28.68; P = 0.038) were independent predictive factors for disease relapse.ConclusionsThe current medical acceleration treatment strategy did not have a significant influence on the long-term outcomes of UC patients in CR but with active mucosal inflammation. Disease extent at diagnosis and extraintestinal manifestations were independently predictive of disease relapse. More... »

PAGES

3041-3048

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10620-018-5193-2

DOI

http://dx.doi.org/10.1007/s10620-018-5193-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105439918

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29987626


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