P191. Mucosal healing after clinical remission predicts long-term outcomes in patients with intestinal Behcet's disease
S.M. Yim1, D.H. Kim1, H.J. Lee1, H.W. Jang1, S.H. Jung2, A.R. Choi2, S.J. Park2, S.P. Hong2, T.I. Kim2, W.H. Kim2, J.H. Cheon2, 1Yonsei University College of Medicine, Department of Internal Medicine and Institute of Gastroenterology, Seoul, South Korea, 2Yonsei University College of Medicine, Department of Internal Medicine and Institute of Gastroenterology, Seoul, South Korea
Mucosal healing (MH) has recently emerged as a major therapeutic goal in the treatment of inflammatory bowel diseases (IBD). Intestinal Behcet's disease (BD) has been regarded as a kind of IBD by experts. However, little is known about the clinical impact of MH on the clinical course of intestinal BD. We therefore investigated whether the presence or absence of MH could predict the long-term prognosis of intestinal BD.
We performed a retrospective review of the medical records for a total of 80 patients with intestinal BD who underwent colonoscopy within 3 months after achieving clinical remission. The clinical recurrence rate according to the presence or absence of MH was evaluated using Kaplan–Meier method and the log-rank test. To find out the variable MH as an independent prognostic factor, a multivariate analysis using Cox proportional hazards regression model was performed including other potential factors for the relapse of intestinal BD as well as MH.
The number of patients with active ulcer at the time of clinical remission is 57 (71.3%) and that with healed ulcer being 23 (28.7%) and the median follow up period is 24.7 months (±26.7months). In active ulcer group, 39 patients (68.4%) recurred, whereas 7 patients (30.4%) recurred in healed ulcer group during the follow-up period. The cumulative recurrence rate was significantly higher in the active ulcer group than the healed ulcer group (p < 0.001). A multivariate analysis identified the presence of active ulcer at the time of clinical remission as an independent predictive factor for disease relapse.
Our study demonstrates that MH is an independent factor predictive of long-term prognosis of intestinal BD, similar to IBD cases. MH might be the ultimate therapeutic goal in the treatment of intestinal BD.