Prognostic significance of endoscopic remission in patients with active ulcerative colitis treated with oral and topical mesalazine : a prospective, multicenter study

Copyright © 2011 Crohn's & Colitis Foundation of America, Inc..

BACKGROUND: It has been recommended that the treatment of active ulcerative colitis (UC) should be continued until complete healing of endoscopic lesions. However, the evidence supporting this recommendation is scanty. Aims of the present study were to assess the rate of patients with active UC who achieve clinical but not endoscopic remission after treatment with oral plus topical mesalazine and to compare the rate of relapse in patients with clinical/endoscopic remission and those with only clinical remission.

METHODS: Patients with active mild or moderate UC were eligible. All patients received mesalazine, 4 g/day orally and 2 g/day per rectum for 6 weeks. Those achieving clinical remission underwent colonoscopy: afterwards, all received maintenance treatment with oral mesalazine, 2 g/day orally for 1 year. Clinical remission was defined as normal frequency of bowel movements with formed stools, no abdominal pain, and no blood in the stools. Endoscopic remission was defined as normal-appearing mucosa or only mild redness and/or friability, without either ulcers or erosions.

RESULTS: In all, 81 patients were enrolled. Sixty-one (75%) achieved clinical remission. Endoscopic activity was still present in five (8%). The cumulative rate of relapse at 1 year was 23% in patients with clinical and endoscopic remission and 80% in patients with only clinical remission (P < 0.0001).

CONCLUSIONS: Persistence of endoscopic activity is quite infrequent in patients with active UC achieving clinical remission after a 6-week treatment with oral plus topical mesalazine, but is a very strong predictor of early relapse.

Media Type:

Electronic Article

Year of Publication:

2012

Contained In:

Inflammatory bowel diseases - Vol. 18, No. 6 (2012), p. 1006-10

Language:

English

Contributors:

Meucci, Gianmichele
Fasoli, Renato
Saibeni, Simone
Valpiani, Daniela
Gullotta, Renzo
Colombo, Enrico
D'Incà, Renata
Terpin, Maddalena
Lombardi, Giovanni
IG-IBD

Urls:

Volltext

Keywords:

4Q81I59GXC
Administration, Oral
Administration, Topical
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal
Colitis, Ulcerative
Colonoscopy
Comparative Study
Endoscopy
Female
Humans
Journal Article
Male
Mesalamine
Middle Aged
Multicenter Study
Prognosis
Prospective Studies
Recurrence
Remission Induction
Risk Factors
Young Adult

Notes:

Date Completed 25.10.2012

Date Revised 13.09.2018

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1002/ibd.21838

PMID:

21830282

PPN (Catalogue-ID):

NLM210646624