Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis

Background & Aims: Ulcerative colitis (UC) is a chronic relapsing inflammat ory bowel disease. We aimed to assess whether clinical, biological, and his tologic parameters in quiescent UC predict time to clinical relapse. Method s: Seventy-four patients with clinically and endoscopically determined inac tive UC were followed up for 1 year or for a shorter period if they had a r elapse. Serum erythrocyte sedimentation rate; C-reactive protein, interleuk in (IL)-1 beta, IL-6, and IL-15 values; anti-neutrophil cytoplasmic antibod y titers; and rectal biopsy specimens were obtained at baseline, at 6 and 1 2 months, and/or at relapse, Multivariate survival analysis was performed t o determine independent predictors of clinical relapse. Results: Twenty-sev en patients relapsed (19/42 women; 8/32 men). Multivariate Cox regression a nalysis retained younger age (P = 0.003; hazard ratio, 0.4 per decade), gre ater number of prior relapses in women (P < 0.001; hazard ratio, 1.6 per pr ior relapse), and basal plasmacytosis (P = 0.003; hazard ratio, 4.5) on rec tal biopsy specimens as predictors of shorter time to clinical relapse. Kap lan-Meier survival curves showed the 20-30-year-old age group and women wit h more than 5 prior relapses to be groups with shorter times to relapse. Co nclusions: Younger age, multiple previous relapses (for women), and basal p lasmacytosis on rectal biopsy specimens were independent predictors of earl ier relapse. These findings may help identify patients with inactive UC who will require optimal maintenance medical therapy.