973 Patient-Driven Six-Point Mayo Score Correlates With Disease Severity Indices and Patient-Defined Symptom Activity in Ulcerative Colitis

Abstract

Background: Assessing disease activity in ulcerative colitis (UC) in an efficient manner is critical for clinical trials. The Simple Clinical Colitis Activity Index (SSCAI) can be cumbersome for repeated measures; and the Partial Mayo Score requires contact with a physician. We sought to assess the correlation of the six-point patient-driven Mayo score and a single question asking patient-defined remission with these indices. Methods: 209 adult patients with UC responded to a questionnaire-based survey assessing preferences for medical versus surgical therapy for UC. We assessed their responses to the SSCAI, the six-point Mayo score and a single patient-driven disease activity question that stated “Please check what you would describe as your UC disease activity over the past 3 days” with the following responses: perfect (no symptoms); very good (very little symptoms); good (mild symptoms); moderately active; moderately severe; or severe. Remission was defined as an SSCAI < 2.5, a six-point Mayo score < 1.5 or a patient-driven response of “perfect” or “very good.” Spearman's correlation coefficient (rho) was used to examine the association between the three indices. Sensitivity and specificity of defined remission was assessed for the six-point Mayo. Results: The mean SSCAI score was 2.6 and the median SSCAI score was 2. 56% of patients had a SSCAI score of < 2.5. The mean six-point Mayo score was 1.3 and the median six-point Mayo score was 1.0. 64% of patients had a six-point Mayo score of <1.5. 62% of patients answered “perfect” or “very good” to the patient-driven disease activity question, which had a mean score of 2.2 and a median score of 2. The six-point Mayo score was strongly correlated with the SSCAI (rho = 0.69, p<0.0001) and the single patient-driven disease activity question (rho = 0.63, p < 0.0001). A similarly significant correlation was seen with the SSCAI and the single patient-driven disease activity question (rho = 0.63, p<0.0001). The six-point Mayo remission (score < 1.5) had a sensitivity of 80% and specificity of 62.3% for patient-driven remission; and a sensitivity of 87.1% and specificity of 65.6% for SSCAI remission (SSCAI < 2.5). Conclusion: The six-point Mayo score strongly correlates with the SSCAI and patient-driven reported disease activity. This score represents a simple option for assessing disease activity in UC in clinical trials and observation studies without direct physician contact.