P716 Clinical significance of residual non-rectal inflammation in ulcerative colitis patients with clinical remission
J. Shin, G. Seong, J.H. Song, S.M. Kong, T.J. Kim, E.R. Kim, S.N. Hong, D.K. Chang, Y.H. Kim
Samsung Medical Center, Internal Medicine Gastroenterology and Hepatology, Seoul, Republic of Korea
Background
The advancement of therapeutic agents has made it possible to achieve endoscopic remission in inflammatory bowel disease. Consequently, the treatment goal of ulcerative colitis (UC) also has been changed to achieve endoscopic remission (ER). However, there was insufficient clinical evidence of whether a step-up treatment should be performed to achieve ER in clinical remission (CR) without ER. And there is inadequate data on the need to consider the distribution and severity of residual inflammation in UC. This retrospective study aimed to evaluate the prognostic significance (such as step-up therapy, hospitalisation, and colectomy) of the distribution and severity of residual inflammation in UC patients with CR.
Methods
A total of 134 UC patients who underwent endoscopic evaluation in CR and underwent colonoscopy more than 3 times between January 2000 and December 2018 were retrospectively reviewed. Patients were allocated by endoscopic healing state and distribution of inflammation to an ER (
Results
In UC patient with CR, the PFS was significantly better in ER and NRI (
| Variables | Univariate analysis | Multivariate analysis | ||
| Distribution of residual inflammation | HR (95%CI) | | HR (95%CI) | |
| ER | 1 | 1 | ||
| NRI | 0.63 (0.60–6.51) | 0.694 | 0.53 (0.05–6.30) | 0.615 |
| RI | 6.15 (1.74–21.82) | 0.005 | 5.16 (1.13–23.61) | 0.034 |
Conclusion
There was no statistically significant difference in the PFS between ER and NRI in the CR state of UC patients. Therefore, we propose selective escalation of treatment modality in CR patients, even if they do not reach ER.