Factors associated with mucosal healing in patients with ulcerative colitis in clinical remission
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AbstractBackground: Mucosal healing (MH) has been associated with improved outcomes in ulcerative colitis but factors associated with MH are not well defined. Methods: Consecutive patients with ulcerative colitis in clinical remission (Mayo symptomatic subscore 0) who had at least 1 colonoscopy since diagnosis from 6 centers were included. For patients who had at least 2 colonoscopies during follow-up, each colonoscopy was reviewed to define whether they had early MH (Mayo endoscopic subscore reduced to 0 within 3 yr of clinical remission). Factors associated with MH and early MH were determined using logistic regression. Results: Two hundred thirty-seven patients with ulcerative colitis (mean age 50.39 ± 14.10 yr; 56.5% male) were included. Independent factors for MH were clinical remission >3 years (odds ratio [OR] 4.0; 95% confidence interval [CI], 1.2-13.1), mild/moderate mucosal inflammation (OR 3.3; 95% CI, 1.3-8.5), and immunosuppressant use (OR 4.6; 95% CI, 1.5-14.6). Among patients who had ≥2 of above factors, 74% achieved MH, whereas only 39% with <2 factors achieved MH (P < 0.001). Of patients in clinical remission <1 year, 1 to 3 years and >3 years, 30%, 45.9%, and 62.9% achieved MH, respectively. Immunosuppressant therapy was associated with early MH (P 0.025). In multivariate analysis, patients with previous mild inflammation were more likely to achieve early MH than those with moderate/severe inflammation (OR 2.8; 95% CI, 1.2-6.2). Conclusions: A longer disease remission, previous less severe mucosal inflammation, and immunosuppressant use are associated with MH. Severity of mucosal inflammation and use of immunosuppressant are also associated with early MH.
All Author(s) ListShi H.Y., Chan F.K.L., Tsang S.W.C., Hui Y.T., Sze S.F., Ching J.Y.L., Chung T., Iu C.Y.Y., Lo F.H., Shan E.H.S., Li M.K.K., Wu J.C.Y., Sung J.J.Y., Ng S.C.
Journal nameInflammatory Bowel Diseases
Volume Number21
Issue Number4
PublisherLippincott Williams & Wilkins Ltd.
Place of PublicationUnited States
Pages840 - 846
LanguagesEnglish-United Kingdom
Keywordsduration of clinical remission, immunosuppressant, mucosal healing, severity of mucosal inflammation, ulcerative colitis

Last updated on 2021-20-09 at 00:07