Accuracy of PanMayo endoscopic score in predicting long-term disease outcomes in ulcerative colitis– a promising scoring system
Péter Bacsur (Szeged, Hungary), Panu Wetwittayakhlang (Montréal, Canada), Tamás Resál (Szeged, Hungary), Béla Vasas (Szeged, Hungary), Bernadett Farkas (Szeged, Hungary), Mariann Rutka (Szeged, Hungary), Talat Bessissow (Montréal, Canada), Waqqas Afif (Montréal, Canada), Anita Bálint (Szeged, Hungary), Anna Fábián (Szeged, Hungary), Renáta Bor (Szeged, Hungary), Zoltán Szepes (Szeged, Hungary), Klaudia Farkas (Szeged, Hungary), Peter L Lakatos (Montréal, Canada), Tamás Molnár (Szeged, Hungary)
Background

Colonoscopy plays a crucial role in management of ulcerative colitis (UC) that helps to assess mucosal healing. Different scoring systems are available to assess severity, however most of them do not correlate with disease extent. Our study aimed to assess the predictive value and accuracy of PanMayo score compared to MES, UCEIS and Dublin in mid- and long-term disease outcomes.

Method

This is a retrospective, two-center study. UC patients, who underwent colonoscopy due to any reason between 2016 and 2018, were consecutively enrolled. PanMayo, MES, UCEIS and Dublin scores were recorded with clinical and demographical data at baseline. Disease flare, need for change in therapy (incl. initiation of biologicals, need for systemic steroids), hospitalisations and colectomy were collected during an at least 3-years follow-. Patients were stratified by using baseline clinical activity (pMayo>1). Log-rank, logistic regression and Chi2 tests were used to analyze outcomes and Kaplan Meier curves were plotted.

Results

A total of 250 UC patients (Table 1.) were enrolled. 157 (male ratio 0.49; mean age 46 IQR 19.5 years) UC patients had clinical remission, while 93 had active disease at baseline (male ratio 0.43; mean age 42 IQR 25 years). PanMayo, MES, and Dublin scores were positively associated with risk of flare-up (p=0.002; p<0.01; p=0.003). Increasing MES score was coupled with risk of relapse. PanMayo score (above 12 points), but not MES or UCEIS, was associated with the need of new biological (p<0.001) and treatment escalation (p=0.018), similar trend was found for the Dublin score for need for new biologicals in the remission cohort. All scores were strongly associated with the need for systemic steroids in patients with baseline remission. In the cohort with active disease at baseline, PanMayo (p=0.016) and Dublin (p=0.009) scores were associated to colectomy risk.

Conclusion

Our study suggests that combined endoscopic assessment of the extent and severity may be more precise in predicting disease outcomes in UC. PanMayo score may be an alternative of the existing scoring systems and was associated more granularly with disease outcomes.

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