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Early course of newly diagnosed moderate‐to‐severe ulcerative colitis in Korea: Results from a hospital‐based inception cohort study (MOSAIK)
Author(s) -
Yoon Jin Young,
Cha Jae Myung,
Lee Chang Kyun,
Park Young Sook,
Huh Kyu Chan,
Shin Jeong Eun,
Kim You Sun,
Eun Chang Soo,
Yoon Soon Man,
Cheon Jae Hee,
Park Young Soo,
Ye Byong Duk,
Lee YoungJa,
Kim Youngdoe,
Kim Hyo Jong
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.15435
Subject(s) - medicine , ulcerative colitis , thiopurine methyltransferase , colectomy , cohort , cohort study , prospective cohort study , corticosteroid , inflammatory bowel disease , disease , population , surgery , environmental health
Background and Aim No inception cohort study has ever evaluated the early course of moderate‐to‐severe ulcerative colitis (UC) within 1 year of diagnosis in the non‐Caucasian population. We aimed to investigate the early clinical course of moderate‐to‐severe UC patients in terms of remission, relapse, UC‐related hospitalizations, colectomy, mortality, and overall use of medications. Methods In the MOSAIK inception cohort, which is an ongoing multicenter, prospective, hospital‐based, observational cohort, 354 patients with moderate‐to‐severe UC were followed up for 1 year. Main outcomes of UC and predictive factors for medication use over the course of 1 year were evaluated. Result Among 354 patients, 276 (78.0%) patients were followed up for 1 year. The rates of remission, relapse, UC‐related hospitalizations, and proximal disease extension were 95.3%, 39.6%, 15.2%, and 12.3%, respectively. Systemic corticosteroids, thiopurines, and biologics were administered to 61.2%, 30.4%, and 10.5% of patients, respectively, throughout 1 year. One year after, 58.2% patients experienced remission or mild endoscopic activity. Overall disease courses did not show much difference according to moderate or severe disease activity at baseline. In addition, no colectomy and mortality were observed for 1 year. Predictive factors for medication use included disease severity, disease extent, endoscopic severity, and presence of periappendiceal inflammation at baseline for corticosteroid, disease extent and initial corticosteroid use for thiopurine, and only initial corticosteroid use for biologics. Conclusion Korean patients with moderate‐to‐severe UC may have more favorable early outcomes than Western patients. However, outcomes of them need to be further looked into for a longer time.