State University of Medicine and Pharmacy, Chişinău, Moldova
Aim. To define the factors for frequently relapsed ulcerative colitis.
Methods. The clinical course of ulcerative colitis in 306 patients with the diagnosis of ulcerative colitis confirmed by endoscopy and histology was assessed in the 5-year prospective cohort study. A positive clinical course with long periods of remission and rare relapses (≤1 per year) was registered in 184 (60.1%) of patients, a progressive clinical course with frequent relapses (over 2 per year) was registered in 122 (39.9%) patients. A list of possible risk factors of unfavorable course were analyzed, univariate and multivariate stepwise discriminant comparative analysis was used for statistical processing.
Results. Age at onset younger than 30 years, non-smoking, high disease activity at the onset, complications and extraintestinal manifestations, disease duration over 6 months until the specific treatment start, inadequate treatment at disease onset, over 6 months required to achieve remission, and a short maintenance treatment period are the risk factors for frequent ulcerative colitis relapses. When combined, the relative risk for frequent ulcerative colitis relapses is 75.8%. No demographic, social, hygiene factors, family and medical history data, comorbidities were associated with certain clinical types of ulcerative colitis.
Conclusion. The most significant risk factors for frequently relapses ulcerative colitis - disease duration until the specific treatment start, treatment at disease onset, disease duration before remission is achieved — are modifiable factors, therefore, the adequate and timely treatment can improve the disease prognosis.
ulcerative colitis, the evolution of the disease, risk factors, prognosis