Predictors of mucosal healing during induction therapy in patients with acute moderate‐to‐severe ulcerative colitis. Issue 6 (4th January 2019)

• Record Type: Journal Article
• Authors: Motobayashi, Maiko; Matsuoka, Katsuyoshi; Takenaka, Kento; Fujii, Toshimitsu; Nagahori, Masakazu; Ohtsuka, Kazuo; Iwamoto, Fumihiko; Tsuchiya, Kiichiro; Negi, Mariko; Eishi, Yoshinobu; Watanabe, Mamoru
• Is Part Of: Journal of gastroenterology and hepatology. Volume 34:Issue 6(2019)
• Page Start: 1004
• Page End: 1010
• Publication Date: 2019-01-04
• Subjects: endoscopy -- prognosis -- ulcerative colitis; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.14565
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: The treat‐to‐target strategy has emerged in ulcerative colitis management. Mucosal healing is the best target, albeit not in induction therapy of acute diseases as clinical conditions vary over a short duration. To determine the targets during induction therapy for acute ulcerative colitis, we identified markers to predict mucosal healing at 3 and 12 months of initiating the induction therapy. Methods: This single‐center prospective observational study enrolling 61 adult patients hospitalized for disease exacerbation collected the partial Mayo scores, ulcerative colitis endoscopic index of severity, fecal markers, and laboratory data (0 day, 2 weeks, and 3 and 12 months) of initiating induction therapy. Results: At 2 weeks, patients with mucosal healing at 3 months had had lower partial Mayo and ulcerative colitis endoscopic index of severity scores and higher white blood cell count and total cholesterol than those without mucosal healing. At 3 months, patients with mucosal healing at 12 months had had lower partial Mayo and ulcerative colitis endoscopic index of severity scores than those without mucosal healing. A kinetic analysis demonstrated a difference in the partial Mayo scores and total cholesterol and albumin levels at 2 weeks and in the ulcerative colitis endoscopic index of severity, fecal calprotectin, and fecal immunochemical tests at 3 months between patients who achieved mucosal healing at 12 months and those who did not. Conclusions: Partial Mayo scores and total cholesterol levels act as short‐term therapeutic targets during induction therapy in patients with acute ulcerative colitis. Mucosal healing at 3 months correlates to longer time mucosal healing.