Validity of activity indices in ulcerative colitis: comparison of clinical and endoscopic indices.
OBJECTIVE
Various different clinical indices (CI) and endoscopic indices (El) have been used to evaluate the clinical disease activity of ulcerative colitis (UC). However, no standardized CI or El of UC has been established. The aim of the present study was to determine whether or not any of the CI and/or EI for assessing the disease activity of UC could be established as a standard.


METHODS
The most frequently used CI and EI were identified from 100 published clinical trials dealing with UC, and representative CI and El were selected. Seventy-four patients were enrolled in this study and their CI and El were assessed prior to treatment and at 2, 4 and 8 weeks after treatment. Furthermore, changes over time and relationships among the indices were analyzed. In this study, the clinical activity index (CAI), the disease activity index (DAI), the Lichtiger index (LI) and the Seo index were selected as the representative CI, and the Baron score and the Rachmilewitz endoscopic index (REI) were selected as the representative EI.


RESULTS
A significant decrease in all the CI and El was observed after treatment, as compared with the baseline values. Moreover, there were positive relationships among the CI and between the CI and El.


CONCLUSIONS
Our results demonstrated that all the CI and El examined were almost equally useful for evaluating disease activity in UC patients. Further studies may help to determine which of the indices is the most suitable for use in UC clinical trials.
Hirai
Fumihito
F
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan. fuhirai@cis.fukuoka-u.ac.jp
Matsui
Toshiyuki
T
Aoyagi
Kunihiko
K
Inoue
Nagamu
N
Hibi
Toshifumi
T
Oshitani
Nobuhide
N
Fujii
Hisao
H
Kobayashi
Kiyonori
K
Suzuki
Yasuo
Y
Tanaka
Shinji
S
D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index