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Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study

BACKGROUND: Tacrolimus (TAC) is a powerful remission-inducing drug for refractory ulcerative colitis (UC). However, it is unclear whether mucosal healing (MH) influences relapse after completion of TAC.We investigated whether MH is related to relapse after TAC. Patients: Among 109 patients treated w...

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Autores principales: Ito, Ayumi, Murasugi, Syun, Omori, Teppei, Nakamura, Shinichi, Tokushige, Katsutoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320561/
https://www.ncbi.nlm.nih.gov/pubmed/32590945
http://dx.doi.org/10.1186/s12876-020-01317-9
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author Ito, Ayumi
Murasugi, Syun
Omori, Teppei
Nakamura, Shinichi
Tokushige, Katsutoshi
author_facet Ito, Ayumi
Murasugi, Syun
Omori, Teppei
Nakamura, Shinichi
Tokushige, Katsutoshi
author_sort Ito, Ayumi
collection PubMed
description BACKGROUND: Tacrolimus (TAC) is a powerful remission-inducing drug for refractory ulcerative colitis (UC). However, it is unclear whether mucosal healing (MH) influences relapse after completion of TAC.We investigated whether MH is related to relapse after TAC. Patients: Among 109 patients treated with TAC, 86 patients achieved clinical remission and 55 of them underwent colonoscopy at the end of TAC. These 55 patients were investigated. METHODS: Patients with MH at the end of TAC were classified into the MH group (n = 41), while patients without MH were classified into the non-MH group (n = 14). These groups were compared with respect to 1) clinical characteristics before treatment, 2) clinical characteristics on completion of treatment, and 3) the relapse rate and adverse events rates. This is a retrospective study conducted at a single institution. RESULTS: 1) There was a significant difference in baseline age between the two groups before TAC therapy, but there were no significant differences in other clinical characteristics. The NMH group was younger (MH group: 48.1 (23–79) years, NMH group: 36.3 (18–58) years, P = 0.007). Endoscopic scores showed significant differences between the 2 groups at the end of TAC. There were also significant differences in the steroid-free rate after 24 weeks (MH group: 85.3%, NMH group 50%, P = 0.012). There was no significant difference in the relapse rate between the 2 groups at 100 days after remission, but a significant difference was noted at 300 days (17% vs. 43%), 500 days (17% vs. 75%), and 1000 days (17% vs. 81%) (all P < 0.05). CONCLUSIONS: TAC is effective for refractory ulcerative colitis. However, even if clinical remission is achieved, relapse is frequent when colonoscopy shows that MH has not been achieved. It is important to evaluate the mucosal response by colonoscopy on completion of TAC.
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spelling pubmed-73205612020-06-29 Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study Ito, Ayumi Murasugi, Syun Omori, Teppei Nakamura, Shinichi Tokushige, Katsutoshi BMC Gastroenterol Research Article BACKGROUND: Tacrolimus (TAC) is a powerful remission-inducing drug for refractory ulcerative colitis (UC). However, it is unclear whether mucosal healing (MH) influences relapse after completion of TAC.We investigated whether MH is related to relapse after TAC. Patients: Among 109 patients treated with TAC, 86 patients achieved clinical remission and 55 of them underwent colonoscopy at the end of TAC. These 55 patients were investigated. METHODS: Patients with MH at the end of TAC were classified into the MH group (n = 41), while patients without MH were classified into the non-MH group (n = 14). These groups were compared with respect to 1) clinical characteristics before treatment, 2) clinical characteristics on completion of treatment, and 3) the relapse rate and adverse events rates. This is a retrospective study conducted at a single institution. RESULTS: 1) There was a significant difference in baseline age between the two groups before TAC therapy, but there were no significant differences in other clinical characteristics. The NMH group was younger (MH group: 48.1 (23–79) years, NMH group: 36.3 (18–58) years, P = 0.007). Endoscopic scores showed significant differences between the 2 groups at the end of TAC. There were also significant differences in the steroid-free rate after 24 weeks (MH group: 85.3%, NMH group 50%, P = 0.012). There was no significant difference in the relapse rate between the 2 groups at 100 days after remission, but a significant difference was noted at 300 days (17% vs. 43%), 500 days (17% vs. 75%), and 1000 days (17% vs. 81%) (all P < 0.05). CONCLUSIONS: TAC is effective for refractory ulcerative colitis. However, even if clinical remission is achieved, relapse is frequent when colonoscopy shows that MH has not been achieved. It is important to evaluate the mucosal response by colonoscopy on completion of TAC. BioMed Central 2020-06-26 /pmc/articles/PMC7320561/ /pubmed/32590945 http://dx.doi.org/10.1186/s12876-020-01317-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Ito, Ayumi
Murasugi, Syun
Omori, Teppei
Nakamura, Shinichi
Tokushige, Katsutoshi
Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
title Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
title_full Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
title_fullStr Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
title_full_unstemmed Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
title_short Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
title_sort relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320561/
https://www.ncbi.nlm.nih.gov/pubmed/32590945
http://dx.doi.org/10.1186/s12876-020-01317-9
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