Incidence of Clinical Flare-Up in Patients with Ulcerative Colitis who Achieved Deep Remission and its Association Factors

Takeuchi, Yoji; Tashiro, Tomoe; Arai, Kumiko; Yoshida, Hitoshi

doi:10.1016/s0016-5085(17)31462-2

Cited by 2 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In most studies, endoscopy was read locally; central reading was performed in only 5 studies. 20,25,26,30,41 For studies comparing risk of clinical relapse in patients with histologic remission to those with persistent histologic activity, the majority used the MES for assessing endoscopic healing/remission (14/20 studies), and 15/20 used standardized indices for assessing histologic activity (Geboes' score, 7 studies; 16,17,21,32,35,36,39 Matts classification, 3 studies; 22,34,41 Harpaz index, 2 studies; 27,31 Riley score, 2 studies; 13,20 Nancy index, 1 study). 42 Study-level risk of bias assessment is summarized in Supplementary Table 2.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

Incremental Benefit of Achieving Endoscopic and Histologic Remission in Patients With Ulcerative Colitis: A Systematic Review and Meta-Analysis

et al. 2020

View full text Add to dashboard Cite

Background & Aims: Clinical remission, defined by a composite of patient reported outcomes and Mayo endoscopy subscore (MES) 0 or 1 is a recommended treatment target in patients with ulcerative colitis (UC). We estimated whether incorporating more rigorous remission definitions, of endoscopic remission (MES 0) and histologic remission, affects risk of relapse.Methods: Through a systematic review, we identified cohort studies in adults with UC in clinical remission that reported a minimum 12-month risk of clinical relapse, based on MES (0 vs 1) and/or histologic disease activity, in patients with endoscopic remission. Using random effects meta-analysis, we calculated relative and absolute risk of clinical relapse in patients with UC achieving different treatment targets.Results: In a meta-analysis of 17 studies that included 2608 patients with UC in clinical remission, compared to patients achieving MES 1, patients achieving MES 0 had a 52% lower risk of clinical relapse (relative risk, 0.48; 95% CI, 0.37-0.62). The median 12-month risk of clinical relapse in patients with MES 1 was 28.7%; the estimated annual risk of clinical relapse in patients with MES 0 was 13.7% (95% CI, 10.6-17.9). In a meta-analysis of 10 studies in patients in endoscopic remission (MES 0), patients who achieved histologic remission had a 63% lower risk of clinical relapse vs patients with persistent histologic activity (relative risk, 0.37; 95% CI, 0.24-0.56). Estimated annual risk of clinical relapse in who achieved achieving histologic remission was 5.0% (95% CI, 3.3-7.7). Conclusions:In a systematic review and meta-analysis of patients with UC in clinical remission, we observed that patients achieving more rigorous treatment endpoints (endoscopic and histologic remission) have a substantially lower risk of clinical relapse compared with patients achieving clinical remission.

show abstract