Patient-Reported Outcome and Clinical Scores Are Equally Accurate in Predicting Mucosal Healing in Ulcerative...

Area of Science:

• Gastroenterology and Hepatology
• Inflammatory Bowel Disease Research
• Clinical Trial Methodology

Background:

• Accurate assessment of ulcerative colitis (UC) disease activity is crucial for optimal patient management.
• Current assessment methods include patient-reported outcomes, clinical scores, endoscopy, and biomarkers.
• The correlation between these different assessment modalities requires further elucidation.

Purpose of the Study:

• To evaluate the correlation between patient-reported outcomes (PROs), clinical scores, and symptoms with endoscopic findings and biomarkers in UC patients.
• To determine the accuracy of various assessment tools in predicting endoscopic healing and remission.

Main Methods:

• Prospective study of 171 consecutive UC patients undergoing endoscopy.
• Collected data included PRO2, partial Mayo score, Simple Clinical Colitis Activity Index (SCCAI), Mayo endoscopic subscore (MES), Baron score, Ulcerative Colitis Endoscopic Index of Severity (UCEIS), C-reactive protein (CRP), and fecal calprotectin (FCAL).
• Statistical analysis, including ROC analysis and kappa agreement, was used to assess correlations and identify optimal cutoffs.

Main Results:

• Patient-reported outcomes (PRO2), partial Mayo, and SCCAI scores showed moderate-to-strong agreement with endoscopic healing (MES, Baron, UCEIS).
• An Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score of ≤3 was the optimal cutoff for predicting clinical and endoscopic remission.
• Fecal calprotectin (FCAL) demonstrated moderate-to-strong agreement with clinical and endoscopic outcomes, whereas C-reactive protein (CRP) showed poor agreement.

Conclusions:

• Patient-reported outcomes and clinical scores are reliable predictors of endoscopic healing in ulcerative colitis.
• Fecal calprotectin (FCAL) is a valuable biomarker for assessing clinical and endoscopic remission in UC, unlike C-reactive protein (CRP).
• The findings support the use of a combination of clinical assessment, patient-reported outcomes, and FCAL for monitoring UC disease activity.