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Determining the usefulness of Capsule Scoring of Ulcerative Colitis in predicting relapse of inactive ulcerative colitis
Author(s) -
Matsubayashi Mao,
Kobayashi Taku,
Okabayashi Shinji,
Nakano Masaru,
Sagami Shintaro,
Ozaki Ryo,
Kiyohara Hiroki,
Morikubo Hiromu,
Asonuma Kunio,
Miyatani Yusuke,
Maeda Shin,
Hibi Toshifumi
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15220
Subject(s) - medicine , ulcerative colitis , gastroenterology , calprotectin , white blood cell , capsule endoscopy , feces , area under the curve , receiver operating characteristic , lactoferrin , colitis , c reactive protein , erythrocyte sedimentation rate , univariate analysis , inflammatory bowel disease , multivariate analysis , inflammation , disease , biology , paleontology , genetics
Background and Aim The usefulness of second‐generation colon capsule endoscopy (CCE2) in ulcerative colitis (UC), especially in clinically inactive patients, has been reported. Capsule Scoring of Ulcerative Colitis (CSUC) was developed as a severity index for UC. We aimed to determine whether CSUC is useful for predicting relapse during clinical remission. Methods Forty‐one UC patients in clinical remission who underwent CCE2 were prospectively registered from April 2016 to August 2019. Patients' CSUC score was obtained; those with subsequent relapse were followed up retrospectively. The correlation of CSUC with white blood cell count, platelet count, albumin, C‐reactive protein, fecal calprotectin and fecal lactoferrin levels, and fecal immunochemical test results was evaluated; their predictive values for future relapse were compared. Results The correlations of CSUC with white blood cell, platelet, albumin, C‐reactive protein, fecal calprotectin, fecal immunochemical test, and fecal lactoferrin values were r s = 0.13, 0.27, −0.25, 0.15, 0.50, 0.43, and 0.50, respectively. CSUC was higher in 12 patients who relapsed within 1 year than in 29 patients who remained in clinical remission (2.83 ± 1.95 vs 0.72 ± 1.00, P < 0.01). Receiver operator characteristic curve analysis showed that CSUC ≥ 1 was a predictor of relapse (area under the curve of 0.82, sensitivity of 83.3%, specificity of 58.6%) and maybe superior to fecal biomarkers. In the univariate analysis, patients with CSUC of 0 had a lower relapse rate than those with CSUC of ≧ 1 ( P = 0.03, log–rank test). After analyzing patients who underwent CCE2 within 6 months after the successful induction treatment, results showed that those with CSUC of ≤ 1 remained in clinical remission for a year. Conclusion CSUC predicts relapse within 1 year in UC patients in clinical remission, especially when used 6 months after induction treatment.