title: Effect of mucosal healing (Mayo 0) on clinical relapse in patients with ulcerative colitis in clinical remission.
abstract: OBJECTIVE
  The aim of this study was to identify the effect of mucosal healing (MH) on clinical relapse in patients with ulcerative colitis (UC) who are in clinical remission, with special reference to Mayo endoscopic subscore 0.
  
  
  METHODS
  Between November 2005 and December 2013, medical records from a total of 215 patients with UC who underwent colonoscopic examination at the time of clinical remission were retrospectively reviewed. Endoscopic MH was defined as a '0 point' of Mayo endoscopic subscore (Mayo 0). Patients were categorized into two groups according to Mayo endoscopic subscore and then analyzed.
  
  
  RESULTS
  The baseline characteristics of both groups (MH vs. no-MH), including age at diagnosis, gender, and initial clinical and colonoscopic findings, were not significantly different. The median follow-up duration was 80 (12-118) months. Factors predictive of longer clinical remission duration were age ≥30 years at diagnosis (≥30 years vs. <30 years; hazard ratio [HR] 3.16, 95% CI 1.88-5.30, p < 0.001), shorter interval between diagnosis and clinical remission (<15 months vs. ≥15 months; HR 1.93, 95% CI 1.13-3.28, p = 0.015), and presence of MH at clinical remission (HR 1.95, 95% CI 1.15-3.32, p = 0.014). With a Cox regression model, patients with MH at clinical remission were more likely to have longer duration of clinical remission than patients without MH.
  
  
  CONCLUSIONS
  The achievement of MH, Mayo 0 in particular, in patients with UC who are in clinical remission is important in predicting a favorable disease course prognosis.
authors.affiliation: a Department of Internal Medicine and Institute of Gastroenterology , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine and Institute of Gastroenterology , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Cheon
authors.affiliation: a Department of Internal Medicine and Institute of Gastroenterology , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Yehyun
authors.initials: Y
authors.lastname: Park
authors.affiliation: a Department of Internal Medicine and Institute of Gastroenterology , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: a Department of Internal Medicine and Institute of Gastroenterology , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Park
authors.affiliation: a Department of Internal Medicine and Institute of Gastroenterology , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Tae Il
authors.initials: TI
authors.lastname: Kim
authors.affiliation: a Department of Internal Medicine and Institute of Gastroenterology , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003113:Colonoscopy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects*; D053208:Kaplan-Meier Estimate; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014945:Wound Healing / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine; D001379:Azathioprine
keywords: Clinical relapse; clinical remission; mucosal healing; prognosis; ulcerative colitis