Evaluation of disease activity in patients with moderately active ulcerative colitis: comparisons between a new activity index and Truelove and Witts' classification.

OBJECTIVES

We have recently proposed a new activity index (AI) for ulcerative colitis. The aim of this study was to examine how AI would reflect the effect of medical therapy in comparison with Truelove and Witts' criteria.

METHODS

In this trial, we studied 35 patients with extensive colitis who persisted with moderate disease for 2 wk. They showed no change in disease activity according to Truelove and Witts' classification despite 2 wk of corticosteroid therapy. Nine of the 35 patients underwent surgery (operated group), and 26 responded to the medical therapy and went into remission (nonoperated group).

RESULTS

In the nonoperated group, AI values significantly decreased at 1 and 2 wk after treatment compared with pretreatment values, whereas there was no significant change in AI in the operated group during the clinical course. Remission occurred in all patients indicating below 180 of AI values 2 wk after therapy, whereas approximately 65% of patients indicating above 180 of AI values subsequently needed colectomy.

CONCLUSIONS

This study suggests that AI will be useful in evaluation of response to medical therapy and prediction of remission and colectomy in patients with moderately active ulcerative colitis.