Literature DB >> 20401498

Novel endoscopic activity index is useful for choosing treatment in severe active ulcerative colitis patients.

Makoto Naganuma1, Hitoshi Ichikawa, Nagamu Inoue, Taku Kobayashi, Susumu Okamoto, Tadakazu Hisamatsu, Takanori Kanai, Haruhiko Ogata, Yasushi Iwao, Toshifumi Hibi.   

Abstract

AIM: Clinical symptoms are the most important factors used by physicians to evaluate the severity and extent of ulcerative colitis (UC). In this context, colonoscopy is also a useful diagnostic tool. We have recently developed an endoscopic activity index (EAI) to assess the severity of UC. Here, we assess the correlations among the EAI, other endoscopic indices, and clinical scores. The usefulness of the EAI for choosing treatment options, such as intravenous corticosteroid or cyclosporine A (CsA), in severe UC patients was also evaluated.
METHODS: Clinical symptoms and endoscopic finding were evaluated in 396 patients with UC (454 colonoscopies). The EAI was scored using the following six items: ulcer size, ulcer depth, redness, bleeding, edema, and mucus exudates. The patients were also scored using Matts' grade, Rachmilewitz's endoscopic index, and the Lichtiger index.
RESULTS: Our results showed that (1) the EAI scores were closely correlated with those of the Lichtiger index, Matts' grade, and Rachmilewitz's endoscopic index; (2) the EAI scores significantly decreased in patients who responded to treatment, while Matts' grade did not change in some responders treated with intravenous CsA and steroid; (3) patients with a higher EAI (14-16) tended to be refractory to corticosteroid therapy (responders 19%) compared to CsA (77%), while steroid treatment was effective in 58% of patients with EAI scores of 11-13.
CONCLUSIONS: The EAI is equivalent to other endoscopic indices and relatively more useful in choosing a treatment for patients with severe UC.

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Year:  2010        PMID: 20401498     DOI: 10.1007/s00535-010-0244-2

Source DB:  PubMed          Journal:  J Gastroenterol        ISSN: 0944-1174            Impact factor:   7.527


  16 in total

1.  Out-patient treatment of ulcerative colitis. Comparison between three doses of oral prednisone.

Authors:  J H BARON; A M CONNELL; T G KANAGHINIS; J E LENNARD-JONES; A F JONES
Journal:  Br Med J       Date:  1962-08-18

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Authors:  S C TRUELOVE; L J WITTS
Journal:  Br Med J       Date:  1955-10-29

Review 3.  A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis.

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Journal:  Gastroenterology       Date:  2006-12-20       Impact factor: 22.682

4.  The value of rectal biopsy in the diagnosis of ulcerative colitis.

Authors:  S G MATTS
Journal:  Q J Med       Date:  1961-10

5.  Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study.

Authors:  K W Schroeder; W J Tremaine; D M Ilstrup
Journal:  N Engl J Med       Date:  1987-12-24       Impact factor: 91.245

6.  Coated mesalazine (5-aminosalicylic acid) versus sulphasalazine in the treatment of active ulcerative colitis: a randomised trial.

Authors:  D Rachmilewitz
Journal:  BMJ       Date:  1989-01-14

7.  Randomized, double-blind comparison of 4 mg/kg versus 2 mg/kg intravenous cyclosporine in severe ulcerative colitis.

Authors:  Gert Van Assche; Geert D'Haens; Maja Noman; Séverine Vermeire; Martin Hiele; Katrien Asnong; Joris Arts; Andre D'Hoore; Freddy Penninckx; Paul Rutgeerts
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Authors:  L R Sutherland; F Martin; S Greer; M Robinson; N Greenberger; F Saibil; T Martin; J Sparr; E Prokipchuk; L Borgen
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4.  Rapid endoscopic improvement is important for 1-year avoidance of colectomy but not for the long-term prognosis in cyclosporine A treatment for ulcerative colitis.

Authors:  Taku Kobayashi; Makoto Naganuma; Susumu Okamoto; Tadakazu Hisamatsu; Nagamu Inoue; Hitoshi Ichikawa; Tetsuro Takayama; Riko Saito; Tomohisa Sujino; Haruhiko Ogata; Yasushi Iwao; Toshifumi Hibi
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6.  The Ulcerative Colitis Endoscopic Index of Severity More Accurately Reflects Clinical Outcomes and Long-term Prognosis than the Mayo Endoscopic Score.

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10.  Reclassifying Pseudopolyps in Inflammatory Bowel Disease: Histologic and Endoscopic Description in the New Era of Mucosal Healing.

Authors:  Mona Rezapour; Maria Alejandra Quintero; Nidah S Khakoo; Daniel A Sussman; Jodie A Barkin; Jennifer Clarke; Tanya Varma; Amar R Deshpande; David H Kerman; Oriana Damas; Maria T Abreu
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