Predictors of mucosal healing during induction therapy in patients with acute moderate-to-severe ulcerative colitis.

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.

• Authors: Maiko Motobayashi, Katsuyoshi Matsuoka, Kento Takenaka, Toshimitsu Fujii, Masakazu Nagahori, Kazuo Ohtsuka, Fumihiko Iwamoto, Kiichiro Tsuchiya, Mariko Negi, Yoshinobu Eishi, Mamoru Watanabe
• Journal: Journal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 34 Issue 6 Pg. 1004-1010 (Jun 2019) ISSN: 1440-1746 [Electronic] Australia
• PMID: 30551266 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Chemical References

• Biomarkers
• Cholesterol

Topics

• Acute Disease
• Adult
• Biomarkers (blood)
• Cholesterol (blood)
• Colitis, Ulcerative (diagnosis, drug therapy, pathology, physiopathology)
• Disease Progression
• Endoscopy, Gastrointestinal
• Female
• Humans
• Induction Chemotherapy
• Intestinal Mucosa (physiopathology)
• Male
• Middle Aged
• Prospective Studies
• Severity of Illness Index
• Time Factors
• Wound Healing