Mucosal healing predicts the long-term prognosis of intestinal Behçet's disease

Mucosal healing (MH) has emerged as a therapeutic goal in the treatment of inflammatory bowel disease; however, little is known about the impact of MH on the prognosis of intestinal Behçet's disease (BD).

We investigated whether MH could predict the prognosis of intestinal BD.

We retrospectively reviewed the medical records of 80 patients with intestinal BD who underwent colonoscopy within 3 months after clinical remission. The clinical recurrence rate according to the presence or absence of MH was evaluated using the Kaplan-Meier method and the log-rank test. In order to evaluate MH as an independent prognostic factor, a multivariate analysis using Cox proportional hazards regression model was performed including other potential factors for the relapse of intestinal BD.

The number of patients with active ulcers at the time of clinical remission was 57 (71.3%), while 23 patients (28.7%) were experiencing MH. In the active ulcer group, 39 patients (68.4%) experienced recurrence during the follow-up period, whereas 7 patients (30.4%) recurred in the MH group. The cumulative recurrence rate was significantly higher in the active ulcer group than in the MH group (P < 0.001). A multivariate analysis identified active ulcers at the time of clinical remission as an independent predictive factor for relapse.

Our study demonstrates that MH is an independent factor predictive of long-term prognosis of intestinal BD. MH might be the ultimate therapeutic goal in the treatment of intestinal BD.