Ulcerative colitis endoscopic index of severity is associated with long-term prognosis in ulcerative colitis patients treated with infliximab

Background and Aims

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that is characterized by periods of remission and episodes of relapse. Mucosal healing is an emerging therapeutic target in UC and various scoring systems have been used. The UC Endoscopic Index of Severity (UCEIS) is the only validated endoscopic index at present, with minimum inter-observer variation. The correlation of UCEIS scores after treatment and clinical outcomes of UC has not been examined. In this study, we aimed to evaluate usefulness of the UCEIS after treatment with infliximab.

Methods

The medical records of 82 UC patients, treated with infliximab at Keio University Hospital between October 2010 and July 2013, were reviewed retrospectively. Endoscopic findings were evaluated based on the UCEIS.

Results

The mean pre-therapeutic UCEIS score was 5.1. Pre-therapeutic UCEIS scores were not associated with short-term outcomes. Forty-five patients underwent colonoscopy at 3–12 months after starting treatment; the mean post-therapeutic UCEIS score was 2.4, with a score of 0–1 in 16 (35.6%) patients, 2–4 in 19 (42.2%) patients, and 5–8 in 10 (22.2%) patients. Importantly, a post-therapeutic UCEIS score of 0 or 1 after treatment was associated with a favorable long-term outcome.

Conclusions

UCEIS score is a useful instrument for evaluating endoscopic improvement in UC patients treated with infliximab, and mucosal healing may be defined with a UCEIS score of 0 or 1.

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