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

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

doi:10.1007/s00384-021-04009-2

Cited by 9 publications

(6 citation statements)

References 31 publications

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“…[35][36][37] These composite scores have been reported to exhibit a stronger association with treatment failure and clinical relapse than endoscopic activity scores. [38][39][40] Our findings are in line with these reports, except that severe endoscopic activity was associated with lower remission rates in our study regardless of disease distribution. Whether our findings are related to slower healing in patients with severe endoscopic activity or these patients have poorer outcomes independent of disease distribution should be evaluated in a longitudinal follow-up study.…”

Section: Therapeutic Advances In Gastroenterologysupporting

confidence: 93%

Histologic healing and factors associated with complete remission following conventional treatment in ulcerative colitis

Steinsbø

Carlsen

Aasprong

et al. 2022

Therap Adv Gastroenterol

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Background: Endoscopic and histological activity scores in ulcerative colitis (UC) are associated with clinical outcomes and have become important targets of clinical trials. However, these endpoints have been scarcely investigated in patients receiving only conventional treatment. Objective: We aimed to assess the deep and complete remission rates after 3 months of conventional treatment in patients with newly diagnosed UC with moderate to severe endoscopic activity. We also aimed to investigate whether selected clinical and biochemical variables at baseline were associated with complete remission status after 3 months. Design: This was a prospective cohort study. Methods: Newly diagnosed patients with active UC commencing 5-aminosalicylate, corticosteroid, and/or azathioprine treatment were consecutively included. Clinical, biochemical, endoscopic, and histological data were collected at baseline and after 3 months. Rates of clinical remission (Partial Mayo Score ⩽ 2), mucosal healing (Mayo Endoscopic Score ⩽ 1), and histologic healing (Nancy Index ⩽ 1) were determined. Deep remission was assessed as clinical remission plus mucosal healing and complete remission as deep remission plus histologic healing. Predictors of complete remission were identified by logistic regression. Results: A total of 180 patients were included in the study. Deep remission and complete remission occurred in 62.8% and 42.2% of patients, respectively. Thus, of patients in deep remission one-third had persistent histologic activity. Histologic activity in mucosally healed patients was associated with higher symptom scores and faecal calprotectin levels. Of baseline variables, less endoscopic distribution and disease activity showed strongest association with achieving complete remission, and limited distribution in combination with moderate activity gave highest odds for complete remission (odds ratio: 4.1, 95% confidence interval: 7.69–2.18). Conclusion: In patients with mucosal healing, persistent histologic activity was a common finding and was associated with increased disease activity. Pancolitis and severe inflammatory activity at baseline were associated with lower complete remission rates.

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Section: Therapeutic Advances In Gastroenterologysupporting

confidence: 93%

Histologic healing and factors associated with complete remission following conventional treatment in ulcerative colitis

Steinsbø

Carlsen

Aasprong

et al. 2022

Therap Adv Gastroenterol

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“…A significant correlation was found between the 2 scores (r=0.726, P<0.001). The AUROC of the UCCIS was significantly higher than that of the S-MES, (0.772 and 0.677, respectively; P=0.004) to predict clinical relapse within 5 years of colonoscopy [ 33 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

How to assess endoscopic disease activity in ulcerative colitis in 2022

Ruscio¹

2022

aog

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Endoscopic remission currently represents an important therapeutic goal to reach in the management of patients with ulcerative colitis (UC). The diagnostic and prognostic role of endoscopy, which remains the gold standard for the assessment of disease activity, has been widely reported. Despite being unvalidated and suboptimal at measuring remission, the most widely used scoring system is the Mayo endoscopic subscore (MES). The UC Endoscopic Index of Severity and the UC Colonoscopic Index of Severity represent recent performing indices for the assessment of endoscopic disease activity in the field of white-light endoscopy. However, their use is still very limited, both in trials and clinical practice. The most recent Paddington international virtual chromoendoscopy score was the first validated index to assess vascular and mucosal features in UC using a virtual chromoendoscopy technique and showed good performance. This narrative review aims to describe these validated endoscopic scoring indices, focusing on the development methodology, and the strengths and weaknesses of each one in comparison with the MES for the assessment of UC activity.

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“…Relapse rates were significantly lower in patients with a UCCIS score of ≥ 9.8 than in those with a UCCIS score of < 9.8 (log-rank test, P < 0.001). Therefore, prospective multicenter studies are needed to compare the UCCIS score with biomarkers or histological indices and evaluate its potential prognostic role[ 71 ].…”

Section: Endoscopic Scores and Mh In Patients With Ibdmentioning

confidence: 99%

Fecal calprotectin and endoscopic scores: The cornerstones in clinical practice for evaluating mucosal healing in inflammatory bowel disease

Costa,

Sassaki,

Chebli

2024

World J Gastroenterol

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Managing inflammatory bowel disease (IBD) is becoming increasingly complex and personalized, considering the advent of new advanced therapies with distinct mechanisms of action. Achieving mucosal healing (MH) is a pivotal therapeutic goal in IBD management and can prevent IBD progression and reduce flares, hospitalization, surgery, intestinal damage, and colorectal cancer. Employing proactive disease and therapy assessment is essential to achieve better control of intestinal inflammation, even if subclinical, to alter the natural course of IBD. Periodic monitoring of fecal calprotectin (FC) levels and interval endoscopic evaluations are cornerstones for evaluating response/remission to advanced therapies targeting IBD, assessing MH, and detecting subclinical recurrence. Here, we comment on the article by Ishida et al Moreover, this editorial aimed to review the role of FC and endoscopic scores in predicting MH in patients with IBD. Furthermore, we intend to present some evidence on the role of these markers in future targets, such as histological and transmural healing. Additional prospective multicenter studies with a stricter MH criterion, standardized endoscopic and histopathological analyses, and virtual chromoscopy, potentially including artificial intelligence and other biomarkers, are desired.

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

Cited by 9 publications

References 31 publications

Histologic healing and factors associated with complete remission following conventional treatment in ulcerative colitis

Histologic healing and factors associated with complete remission following conventional treatment in ulcerative colitis

How to assess endoscopic disease activity in ulcerative colitis in 2022

Fecal calprotectin and endoscopic scores: The cornerstones in clinical practice for evaluating mucosal healing in inflammatory bowel disease

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