Endoscopic Mucosal Healing as a Treatment Target in Ulcerative Colitis: Does It Have the Same Role in Asian Patients?

摘要

We read with great interest the article by Shin et al. , 1 which compared the outcomes of 131 ulcerative colitis (UC) patients in clinical remission according to the endoscopic mucosal healing status and the distribution pattern of mucosal inflammation. The au- thors reported that poor outcome-free survival was significantly higher in patients with endoscopic remission or only nonrectal inflammation than in those with rectal inflam- mation (p=0.003). Poor outcome-free survival in patients with only nonrectal inflam- mation was comparable to that in patients with endoscopic remission (p=0.647). In multivariable Cox regression analysis, rectal inflammation (hazard ratio, 5.76; p=0.027) was the only predictor of poor outcome. Therefore, the authors suggested that treat- ment escalation may be selectively required in consideration of the distribution pattern of residual mucosal inflammation in UC patients in clinical remission.