Efficacy of Therapeutic Intervention for Patients With an Ulcerative Colitis Mayo Endoscopic Score of 1

被引：31

作者：

Fukuda, Tomohiro ^{[1
]}

Naganuma, Makoto ^{[1
]}

Sugimoto, Shinya ^{[1
]}

Ono, Keiko ^{[1
]}

Nanki, Kosaku ^{[1
]}

Mizuno, Shinta ^{[1
]}

Kimura, Kayoko ^{[3
]}

Mutaguchi, Makoto ^{[1
]}

Nakazato, Yoshihiro ^{[3
]}

Takabayashi, Kaoru ^{[3
]}

Inoue, Nagamu ^{[2
]}

Ogata, Haruhiko ^{[3
]}

Iwao, Yasushi ^{[2
]}

Kanai, Takanori ^{[1
]}

机构：

[1] Keio Univ, Sch Med, Div Gastroenterol & Hepatol, Dept Internal Med, Tokyo, Japan

[2] Keio Univ, Sch Med, Ctr Prevent Med, Tokyo, Japan

[3] Keio Univ, Sch Med, Ctr Diagnost & Therapeut Endoscopy, Tokyo, Japan

来源：

INFLAMMATORY BOWEL DISEASES | 2019年 / 25卷 / 04期

关键词：

ulcerative colitis; Mayo endoscopic score; treat to target; MAINTENANCE THERAPY; MESALAZINE; DISEASE; MANAGEMENT; INDUCTION; INFLIXIMAB; REMISSION; OUTCOMES; PENTASA;

D O I：

10.1093/ibd/izy300

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Mucosal healing (MH) is proposed as a therapeutic target for ulcerative colitis (UC). Recent studies have indicated that the rate of clinical relapse in patients with a Mayo endoscopic score (MES) of 1 is higher than that of patients with an MES of 0. However, no study has yet investigated whether therapeutic intervention prevents clinical relapse in patients with an MES of 1. Methods: Patients with UC with an MES of 1 and partial Mayo score <= 2 were included in this study. All patients were followed from first colonoscopy (CS) until follow-up CS. Differences in the rate of clinical relapse (requiring additional treatment for UC) or endoscopic exacerbation (MES >= 2 and proximal extension) were compared between the therapeutic intervention (immediately after first CS) group and the nontherapeutic intervention group; risk factors for relapse were also assessed. Results: Among 1523 patients with UC who underwent CS between 2013 and 2016, 220 patients were included in this study. The rate of clinical relapse (P = 0.005) and endoscopic exacerbation (P = 0.11) in patients with therapeutic intervention was lower than that in patients without therapeutic intervention. Multivariable analysis indicated that absence of therapeutic intervention (P = 0.001 for clinical relapse, P = 0.050 for endoscopic exacerbation) and a higher Ulcerative Colitis Endoscopic Index of Severity vascular pattern score immediately after first CS (P = 0.021 for clinical relapse, P = 0.019 for endoscopic exacerbation) were risk factors for both clinical relapse and endoscopic exacerbation. Conclusions: Therapeutic intervention for patients with UC with an MES of 1 might prevent disease relapse.

引用

页码：782 / 788

页数：7

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