Predictive markers of endoscopic remission at 12 months of therapy in mild-to-moderate ulcerative colitis

AIM: to identify predictors of ER after 12 months of therapy in patients with mild-to-moderate UC based on clinical, laboratory, endoscopic, and histopathological parameters.

PATIENTS AND METHODS: this prospective study enrolled patients with mild-to-moderate UC after excluding intestinal infections. Clinical, laboratory, endoscopic, and histological parameters were assessed at baseline and during follow-up. Early predictors of ER within 12 months were identified, and a predictive regression model was developed.

RESULTS: longitudinal follow-up of 72 patients revealed that unfavorable predictors of ER at 12 months included: excess body weight - observed in 9.1% of patients who achieved ER versus 41.0% of non-responders (adjusted odds ratio (aOR) 0.026; 95% confidence interval (CI): 0.002-0.374; p=0.007), and pancolitis - 23.3% versus 45.2% (aOR 0.076; 95% CI: 0.013-0.445; p=0.004). The protective factor was absence of fever at baseline (43.1% in ER group vs 7.1% in non-ER group; aOR 17.49; 95% CI: 1.203-254.206; p=0.036). Moderate endoscopic activity at inclusion showed no significant association with outcomes (p=0.077). The developed model (p<0.001) demonstrated an AUC of 0.800±0.052 (95% CI: 0.699–0.901), with 90.9% sensitivity, 82.6% specificity, and 80.6% overall accuracy.

CONCLUSION: excess body weight and pancolitis at baseline were negative prognostic markers for achieving ER at 12 months, whereas the absence of fever at baseline increased the likelihood of this outcome. However, endoscopic activity did not show a statistically significant impact in the multivariate analysis. The model exhibits high sensitivity and moderate specificity, suggesting its potential utility as a supplementary predictive tool in clinical practice following validation.

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