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P158 Comparison of three endoscopic scores for prediction of relapse risk in ulcerative colitis

N. Horita*1, E. Saito1, M. Motobayashi1, K. Suzuki1, K. Takenaka1, H. Shimizu1, T. Fujii1, M. Nagahori1, K. Ohtsuka1, M. Watanabe1

1Tokyo Medical and Dental University, Gastroenterology and Hepatology, Tokyo, Japan

Background

Mucosal healing (MH) is a target for induction therapy in the management of ulcerative colitis (UC). MH is defined by several endoscopic examinations and correlated with long-term clinical remission. However, the relationship between endoscopic examination and prediction of relapse rate in UC management has not been fully evaluated. We compared three endoscopic scores for the usefulness of relapse prediction after 12 months of endoscopic examination in the MH and non-mucosal healing (non-MH) group in UC.

Methods

We selected 51 cases of UC who underwent endoscopy at the Tokyo Medical and Dental University hospital from September 2014 to March 2017. Clinical remission was defined as partial Mayo score (pMayo) 2 or less and all other sub-scores were 1 or less. Clinical relapse was defined as introduction of new remission induction therapy. We compared three different endoscopic scores for prediction of relapse risk in UC. MH was defined in each endoscopic scores as Mayo Endoscopy sub-score (MES) 1 or less, Rachmilewitz endoscopic index (EI) 2 or less, and ulcerative colitis Endoscopic Index of Severity (UCEIS) 2 or less, with investigation for cumulative non-relapse rate.

Results

Patient background was as follows; average age was 42.9 ± 13.2 years old, 31 males and 20 females, 31 total colitis cases, 15 left-sided colitis cases, and 5 proctitis type cases, 34 clinical remission and 17 clinical non-remission, duration of disease was 9.3 ± 6.8 years. The cumulative non-relapse rate after 12 months of endoscopic examination was not significantly different in between MH group by MES at 75%, and non-MH group by MES at 52.2% (p = 0.071). Similarly, EI showed no significant difference in between MH group 76% and non-MH group 53.8% (p = 0.32). However, UCEIS showed significant difference between MH group 81.8%, and non-MH group 33.3% (p = 0.001).

Conclusion

It was suggested that diagnosis of MH by UCEIS might be useful for prediction of cumulative non-relapse rate after 12 months of endoscopic examination.