title: Mucosal healing for predicting clinical outcome in patients with ulcerative colitis using thiopurines in monotherapy.
abstract: BACKGROUND
  Mucosal healing (MH) has emerged as a desirable treatment goal for patients with ulcerative colitis (UC). Currently little is known about the efficacy of using thiopurine immunosuppressants in monotherapy to achieve and maintain long-term MH in UC. This study analyzes the efficacy and the clinical impact of MH in patients with UC responded to thiopurine immunosuppressants in the long term.
  
  
  METHODS
  An open, observational, cohort study in 20 patients with UC had been in clinical remission in monotherapy with thiopurine immunosuppressants for at least 1 year. MH was assessed by endoscopy. The patients according to the Mayo Endoscopic Score (0 vs 1 and 2), were followed until the end of the study or patient relapse. (according to Truelove and Witts criteria).
  
  
  RESULTS
  Mean treatment time was 5.4 years. Twelve (60%) patients presented a Mayo Endoscopic Score of 0. A total of 18 patients were followed up for a median of 27.1 months. After endoscopy, 4 patients (22.2%) presented relapse, with a mean time of 27.5 months for a score ≥1 (95% CI; 18.2-36.8) versus 54.3 months for a score=0 (95% CI 47.2-61.3) (p=0.032).
  
  
  CONCLUSIONS
  This study shows the efficacy of thiopurine immunosuppressants in achieving mucosal healing in patients who respond to thiopurine immunosuppressants in the long term. We also observe the presence of endoscopy activity is not a rare event in this group of patients and is a predictor of early relapse.
authors.affiliation: Department of Gastroenterology, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain. Natalia.lopa@gmail.com
authors.forename: Natalia
authors.initials: N
authors.lastname: López-Palacios
authors.forename: Juan L
authors.initials: JL
authors.lastname: Mendoza
authors.forename: Carlos
authors.initials: C
authors.lastname: Taxonera
authors.forename: Raquel
authors.initials: R
authors.lastname: Lana
authors.forename: José Miguel Esteban
authors.initials: JM
authors.lastname: López-Jamar
authors.forename: Manuel
authors.initials: M
authors.lastname: Díaz-Rubio
mesh_terms: D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage*; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000473:pathology / Q000502:physiology; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D015122:Mercaptopurine; D001379:Azathioprine