Accuracy of the Pancolonic Modified Mayo Score in predicting the long-term outcomes of ulcerative colitis: a promising scoring system

Péter Bacsur; Panu Wetwittayakhlang; Tamás Resál; Emese Földi; Béla Vasas; Bernadett Farkas; Mariann Rutka; Talat Bessissow; Waqqas Afif; Anita Bálint; Anna Fábián; Renáta Bor; Zoltán Szepes; Klaudia Farkas; Peter L Lakatos; Tamás Molnár

doi:10.1177/17562848241239606

Accuracy of the Pancolonic Modified Mayo Score in predicting the long-term outcomes of ulcerative colitis: a promising scoring system

Therap Adv Gastroenterol. 2024 Mar 21:17:17562848241239606. doi: 10.1177/17562848241239606. eCollection 2024.

Authors

Péter Bacsur¹, Panu Wetwittayakhlang^{2

3}, Tamás Resál¹, Emese Földi¹, Béla Vasas⁴, Bernadett Farkas¹, Mariann Rutka¹, Talat Bessissow², Waqqas Afif², Anita Bálint¹, Anna Fábián¹, Renáta Bor¹, Zoltán Szepes¹, Klaudia Farkas¹, Peter L Lakatos^{5

6}, Tamás Molnár⁷

Affiliations

¹ Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
² Division of Gastroenterology, McGill University Health Centre, Montreal, QC, Canada.
³ Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
⁴ Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
⁵ Division of Gastroenterology, McGill University Health Centre, Montreal General Hospital, 1650 Avenue Cedar, D7-201, Montreal, QC, Canada H3G 1A4.
⁶ Department of Oncology and Medicine, Semmelweis University, Üllői st. 26, Budapest H-1085, Hungary.
⁷ Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Kálvária Avenue 57, Szeged H-6725, Hungary.

Abstract

Background: Different endoscopic scoring systems for assessing ulcerative colitis (UC) severity are available. However, most of them are not correlated with disease extent.

Objectives: Our study aimed to compare the predictive value of the PanMay score versus the endoscopic Mayo (MES), Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and Dublin score in predicting long-term outcomes of UC.

Design: This retrospective study enrolled consecutive UC patients who underwent colonoscopy before at least a 3-year follow-up.

Methods: The PanMayo, MES, UCEIS, and Dublin scores and the baseline clinical and demographic characteristics of the participants were assessed. Endpoints were disease flare that required novel biological therapy, colectomy, and hospitalization. Patients were stratified using baseline clinical activity.

Results: Approximately 62.8% of the 250 enrolled patients were in clinical remission. In these patients, the PanMayo, MES, and Dublin scores were positively associated with the risk of clinical flare. The MES score increased with clinical flare. The PanMayo score (>12 points), but not the MES score, was associated with the need for novel biological initiation and biological escalation. Furthermore, the Dublin and UCEIS scores of patients in remission who need novel biological treatment had a similar trend. Colectomy risk was associated with PanMayo and Dublin scores.

Conclusion: The combined endoscopic assessment of disease extent and severity can be more accurate in predicting outcomes among patients with UC. PanMayo score can be utilized in addition to the existing scoring systems, thereby leading to a more accurate examination.

Summary: UC endoscopic scores do not assess extension. Our study aimed to analyze the predictive value of the PanMayo score. Based on 250 patients, results showed that the long-term disease outcomes of UC could be predicted with the PanMayo score more accurately.

Keywords: PanMayo; endoscopy; extension; ulcerative colitis.