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P407. Mucosal healing during the clinical remission in patients with ulcerative colitis

A. Atanassova1, I. Kotzev2, P. Genev3, V. Velikova4, 1Medical University, Gastroenterology, Varna, Bulgaria, 2Medical University Varna, Gastroenterology, Varna, Bulgaria, 3Medical University Varna, Patology, Varna, Bulgaria, 4University of Economics, Department of Statistics, Varna, Bulgaria

Background

The goal of the treatment in UC patients is to reduce the signs and symptoms of the disease, to induce and maintain a clinical response and remission with mucosal healing (MH). MH seems to be associated with lower relapse rate.

Methods

From May 2010 to May 2012 one hundred forty-four (144) consecutive patients underwent colonoscopy, multiple biopsies and evaluation of MH according to the Baron score (Bs), the Mayo score (Ms), the Ulcerative colitis Endoscopic Index (UCEIS), the Montreal classification of extension-E and severity-S and morphological evaluation of remission.

Results

Our study group consists of 64 male (44.4%) and 80 female (55.6%) UC patients with mean age at the time of the diagnosis 38.4 and 38.7 and age at the time of the evaluation 43.8 respectively 44.1. The duration of UC was 66.4 months for the male and 62.8 for the female patients. Of all 144 patients, 64 showed severity S0 (remission) (44.4%): E1 25%, E2 37.5%, E3 37.5%. Twenty-six patients (40%) did not present morphological remission. Pseudopolyps were observed in 28 patients (43.8%), fibrosis in 28 (43.8%). The endoscopic evaluation found Bs 0 in 22 (34%), Ms 0 in 20 (31.3%) and UCEIS 0 in 20 (31.3) patients. Only eighteen (28.13%) S0 patients were with Bs 0, Ms 0 and UCEIS 0. Sixteen of them (25%) were with complete endoscopic and morphological remission. The treatment of UC patients who achieved S0 was in 25% 5-ASA with Azathioprine and 4.6% was with anti TNF therapy. We observed a significant difference between the level of C-reactive protein F = 8.67 (p <0.001) according to the severity of the disease.

Conclusion

Mucosal healing was achieved in 18 patients (28.13%). Despite the MH at the endoscopy only 16 (25%) obtained complete remission without any morphological evidence of activity. We need a further evaluation about the prognosis and the evolution of the patients with mucosal healing with or without morphological remission.