Further research on the clinical relevance of the ulcerative colitis colonoscopic index of severity for predicting 5-year relapse

Natsuki Ishida,Mihoko Yamade,Takahisa Furuta,Shunya Onoue,Takahiro Miyazu,Yasushi Hamaya,Ken Sugimoto,Satoshi Tamura,Moriya Iwaizumi,Shinya Tani,Satoshi Osawa

doi:10.1007/s00384-021-04009-2

Natsuki Ishida, Mihoko Yamade + Show 9 more

Open Access

https://doi.org/10.1007/s00384-021-04009-2

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Abstract

PurposeThe ulcerative colitis colonoscopic index of severity (UCCIS) evaluates the state of the entire colonic mucosa in ulcerative colitis. However, no cut-off values of scores for predicting clinical relapse in patients with ulcerative colitis have been established. This study aimed to determine the cut-off values for predicting clinical relapse in patients with ulcerative colitis.MethodsThe endoscopic scores (sum of Mayo endoscopic subscores (S-MES) and UCCIS) of 157 patients with ulcerative colitis experiencing clinical remission and their subsequent clinical course were retrospectively reviewed. The optimal cut-off values for predicting relapse and relapse-free rates were analyzed by receiver operating characteristic analysis.ResultsForty patients with ulcerative colitis experienced relapse within 24 months. The median UCCIS for these patients at the time of study enrollment was significantly higher than that for patients with clinical remission (P < 0.001). The cut-off value of the UCCIS for predicting relapse was 9.8. The relapse-free rate was significantly lower in patients with UCCIS ≥ 9.8 than in those with UCCIS < 9.8 (log-rank test P < 0.001). For patients who experienced relapse within 5 years, the optimal cut-off values for the UCCIS and S-MES were 10.2 and 1, respectively (P = 0.004).ConclusionsThe data from this study indicate that the USSIC is a more relevant score than the S-MES for predicting the time to relapse in patients with ulcerative colitis in remission.

Highlights

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by repeated relapses and remissions [1]
The receiver operating characteristic (ROC) analyses of the clinical course of patients who experienced relapse in the 2-year follow-up period and those of patients who experienced remission showed that the S-Mayo endoscopic subscore (MES) and ulcerative colitis colonoscopic index of severity (UCCIS) cut-off scores for predicting clinical relapse were 1 and 9.8, respectively, and the area under the ROC curve (AUC) were 0.718 (95% confidence interval [CI] 0.630–0.806) and 0.727, respectively
This study investigated whether clinical relapse can be predicted by the UCCIS, an endoscopic score that reflects the inflammation of the entire colon

Summary

Introduction

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by repeated relapses and remissions [1]. The evaluation of UC using an endoscopic score is important for. The MES is a score that identifies the area with the most severe colitis in patients with UC. The ulcerative colitis endoscopic index of severity (UCEIS), often used in clinical. International Journal of Colorectal Disease Characteristics N = 157. Age (years) Male/female, n (%) Disease duration (years) Disease extent, n (%). CAI (Rachmilewitz index) M-MES S-MES UCEIS UCCIS Medication at study, n (%). Oral 5-ASA Suppository 5-ASA Systemic steroids Immunomodulators Biologics.

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