Abstract Background A recent meta-analysis demonstrated a significantly lower risk of clinical relapse in patients with UC who achieved endoscopic remission, corresponding to a Mayo score of 0, compared to a Mayo score of 1, with a follow-up of 12 months or longer. Objective: To determine the relationship between colonic mucosal healing, as measured by the endoscopic ulcerative colitis activity index (Mayo score), and ulcerative colitis outcomes. Methods The Department of IBD analyzed ulcerative colitis (UC) outcomes in 235 patients receiving infliximab (IFX). Colonic mucosal healing, as measured by a Mayo score of 0. The following outcomes were assessed: hospitalization for exacerbation, UC exacerbations accompanied by venous thromboembolic complications (VTE), intestinal complications (bleeding, toxic dilation), steroid-free remission for 12 months, and colectomy. Results In the group of patients receiving infliximab (n = 235) patients Mucosal healing (Mayo score 0 points) - 148 (63.0%) and 87 (37.0%) Mayo score ≥1 point. Hospitalization for exacerbation within 12 months was 58 (24.7%) in both groups. In the group Mayo 0 points - 9 patients (6.1%) and 49 (56.3%) Mayo score ≥1 point (OR-0.044; 95% CI 0.020-0.099; x2 71.720; p 0.001). UC exacerbations accompanied by TEE occurred in 6 (2.5%) patients in both groups. In the group Mayo 0 points - 1 patients (0.7%) and group Mayo ≥1 point 5 (5.7%) (OR-1.104; 95% CI 0.013-0.971; x2 3.809; p = 0.05). The incidence of intestinal complications (bleeding, toxic dilation) over 12 months among patients in both groups was 12 (5.1%). In the group Mayo 0 points - 1 patients (0.7%) and 11 (12.6%) group Mayo score ≥1 (OR - 0.047; 95% CI 0.006-0.371; x2 - 13.820; p 0.001). The need for steroids within 12 months among both groups was 43 (18.3%). In the group Mayo 0 - 12 patients (8.1%) and 31 (35.6%) group Mayo ≥1 point. (OR - 0.159; 95% CI 0.076-0.333; x2 - 25.955; p 0.001). Colectomy was 2 (0.85%) in both groups. In the group Mayo 0 points - 0 patients (0.0%) and 2 (2.3%) group Mayo ≥1 point (x2 - 1.248; p = 0.264). Conclusion Achieving endoscopic remission of a Mayo score of 0 should be considered the optimal therapeutic goal, as this indicator predicts the best course and most favorable outcomes in patients with UC. Reference: Viscido A, Valvano M, Stefanelli G, Capannolo A, Castellini C, Onori E, Ciccone A, Vernia F, Latella G. Systematic review and meta-analysis: the advantage of endoscopic Mayo score 0 over 1 in patients with ulcerative colitis. BMC Gastroenterol. 2022 Mar 3;22(1):92. doi: 10.1186/s12876-022-02157-5. PMID: 35240984; PMCID: PMC8895505. Conflict of interest: Prof. Knyazev, Oleg: No conflict of interest Kagramanova, Anna Valeryevna: No conflict of interest Timanovskaya, Mariya: No conflict of interest Lishchinskaia, Albina: No conflict of interest Sabelnikova, Elena: Li, Irina: No conflict of interest Fadeeva, Nina: No conflict of interest
Knyazev et al. (Thu,) studied this question.