title: Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis.
abstract: OBJECTIVE
  Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease. We aimed to assess whether clinical, biological, and histologic parameters in quiescent UC predict time to clinical relapse.
  
  
  METHODS
  Seventy-four patients with clinically and endoscopically determined inactive UC were followed up for 1 year or for a shorter period if they had a relapse. Serum erythrocyte sedimentation rate; C-reactive protein, interleukin (IL)-1beta, IL-6, and IL-15 values; anti-neutrophil cytoplasmic antibody titers; and rectal biopsy specimens were obtained at baseline, at 6 and 12 months, and/or at relapse. Multivariate survival analysis was performed to determine independent predictors of clinical relapse.
  
  
  RESULTS
  Twenty-seven patients relapsed (19/42 women; 8/32 men). Multivariate Cox regression analysis retained younger age (P = 0.003; hazard ratio, 0.4 per decade), greater number of prior relapses in women (P < 0.001; hazard ratio, 1.6 per prior relapse), and basal plasmacytosis (P = 0.003; hazard ratio, 4.5) on rectal biopsy specimens as predictors of shorter time to clinical relapse. Kaplan-Meier survival curves showed the 20-30-year-old age group and women with more than 5 prior relapses to be groups with shorter times to relapse.
  
  
  CONCLUSIONS
  Younger age, multiple previous relapses (for women), and basal plasmacytosis on rectal biopsy specimens were independent predictors of earlier relapse. These findings may help identify patients with inactive UC who will require optimal maintenance medical therapy.
authors.affiliation: Gastroenterology Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. alain.bitton@muhc.mcgill.ca
authors.forename: A
authors.initials: A
authors.lastname: Bitton
authors.forename: M A
authors.initials: MA
authors.lastname: Peppercorn
authors.forename: D A
authors.initials: DA
authors.lastname: Antonioli
authors.forename: J L
authors.initials: JL
authors.lastname: Niles
authors.forename: S
authors.initials: S
authors.lastname: Shah
authors.forename: A
authors.initials: A
authors.lastname: Bousvaros
authors.forename: B
authors.initials: B
authors.lastname: Ransil
authors.forename: G
authors.initials: G
authors.lastname: Wild
authors.forename: A
authors.initials: A
authors.lastname: Cohen
authors.forename: M D
authors.initials: MD
authors.lastname: Edwardes
authors.forename: A C
authors.initials: AC
authors.lastname: Stevens
mesh_terms: D000328:Adult; D015415:Biomarkers; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D019409:Interleukin-15 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007378:Interleukins / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012737:Sex Factors; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D007375:Interleukin-1; D019409:Interleukin-15; D015850:Interleukin-6; D007378:Interleukins; D002097:C-Reactive Protein