Comparison of PUCAI Score in Mesalazine-Treated Children with Ulcerative Colitis

Authors

  • Nadia Chairunnisa Department of Pediatrics, Gastroenterohepatology Division, Medical University of Diponegoro, Semarang, Indonesia
  • Juwita Pratiwi Department of Pediatrics, Gastroenterohepatology Division, Medical University of Diponegoro, Semarang, Indonesia
  • Ninung Rose Diana Kusumawati Department of Pediatrics, Gastroenterohepatology Division, Medical University of Diponegoro, Semarang, Indonesia

DOI:

https://doi.org/10.58427/apghn.2.2.2023.18-24

Keywords:

mesalazine, PUCAI score, ulcerative colitis

Abstract

Background: Ulcerative colitis is a chronic idiopathic inflammatory bowel disease (IBD) characterized by intestinal inflammation confined to the superficial mucosal layer. Mesalazine, a 5-aminosalicylic acid (5-aminosalicylic, or 5-ASA) compound, is most often used as first-line therapy for mild to moderate ulcerative colitis. The Pediatric Ulcerative Colitis Activity Index (PUCAI) is a non-invasive multi-item measure that has been shown to be valid, reliable, and responsive to short-term changes in several clinical trials and cohort studies. Therefore, this study aims to compare the PUCAI scores in children with ulcerative colitis who received mesalazine therapy to those who did not.

Methods: We performed a retrospective database analysis of 12 patients, who were diagnosed with ulcerative colitis at Dr. Kariadi General Hospital, Semarang, Indonesia in a span of 1 year. We included all cases of pediatric patients with ulcerative colitis, then we divided them into 2 groups, the group receiving mesalazine therapy and the group who did not. We monitored the development of PUCAI scores before and after treatment.

Results: The number of samples in this study was 12 samples. All sample data were taken based on data from pediatric gastroenterohepatology patients diagnosed with colitis ulcerative based on pathology anatomy results, who were treated in the pediatric ward of RSUP Dr. Kariadi Semarang. From the result of the paired t-test, there was a significant decrease in PUCAI score in patients who received Mesalazine, (p = 0.007), while those who did not receive mesalazine, did not show any significant decrease in PUCAI score.

Conclusion: Ulcerative colitis (UC) is a chronic relapsing inflammatory condition. UC is often treated with mesalazine as the first-line treatment. The use of the PUCAI score is an appropriate tool to determine the progression of this disease. Based on the data obtained, the administration of mesalazine therapy in children with ulcerative colitis can improve PUCAI scores compared to children who do not receive mesalazine therapy.

References

Benchimol EI, Kaplan GG, Otley AR, Nguyen GC, Underwood FE, Guttmann A, et al. Rural and Urban Residence During Early Life is Associated with Risk of Inflammatory Bowel Disease: A Population-Based Inception and Birth Cohort Study. Am J Gastroenterol. 2017;112(9):1412-22.https://doi.org/10.1038/ajg.2017.208

Kaplan GG, Ng SC. Understanding and Preventing the Global Increase of Inflammatory Bowel Disease. Gastroenterology. 2017;152(2):313-21.e2.https://doi.org/10.1053/j.gastro.2016.10.020

Fumery M, Singh S, Dulai PS, Gower-Rousseau C, Peyrin-Biroulet L, Sandborn WJ. Natural History of Adult Ulcerative Colitis in Population-based Cohorts: A Systematic Review. Clin Gastroenterol Hepatol. 2018;16(3):343-56.e3.https://doi.org/10.1016/j.cgh.2017.06.016

Gundersen MD, Goll R, Fenton CG, Anderssen E, Sørbye SW, Florholmen JR, et al. Fibrosis Mediators in the Colonic Mucosa of Acute and Healed Ulcerative Colitis. Clin Transl Gastroenterol. 2019;10(10):e00082.https://doi.org/10.14309/ctg.0000000000000082

Gordon IO, Agrawal N, Willis E, Goldblum JR, Lopez R, Allende D, et al. Fibrosis in ulcerative colitis is directly linked to severity and chronicity of mucosal inflammation. Aliment Pharmacol Ther. 2018;47(7):922-39.https://doi.org/10.1111/apt.14526

Le Berre C, Ananthakrishnan AN, Danese S, Singh S, Peyrin-Biroulet L. Ulcerative Colitis and Crohn's Disease Have Similar Burden and Goals for Treatment. Clin Gastroenterol Hepatol. 2020;18(1):14-23.https://doi.org/10.1016/j.cgh.2019.07.005

Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD. ACG Clinical Guideline: Ulcerative Colitis in Adults. Am J Gastroenterol. 2019;114(3):384-413.https://doi.org/10.14309/ajg.0000000000000152

Turner D, Ruemmele FM, Orlanski-Meyer E, Griffiths AM, de Carpi JM, Bronsky J, et al. Management of Paediatric Ulcerative Colitis, Part 2: Acute Severe Colitis-An Evidence-based Consensus Guideline From the European Crohn's and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2018;67(2):292-310.https://doi.org/10.1097/mpg.0000000000002036

Christensen B, Hanauer SB, Erlich J, Kassim O, Gibson PR, Turner JR, et al. Histologic Normalization Occurs in Ulcerative Colitis and Is Associated With Improved Clinical Outcomes. Clin Gastroenterol Hepatol. 2017;15(10):1557-64.e1.https://doi.org/10.1016/j.cgh.2017.02.016

Santha SL, Shankar PR, Pan A, Schoen B, Kugathasan S, Sauer CG. Mucosal Healing in Clinical Practice: A Single-Center Pediatric IBD Experience. Inflamm Bowel Dis. 2017;23(8):1447-53.https://doi.org/10.1097/mib.0000000000001176

Published

2023-05-31

How to Cite

1.
Comparison of PUCAI Score in Mesalazine-Treated Children with Ulcerative Colitis. Arch Pediatr Gastr Hepatol Nutr [Internet]. 2023 May 31 [cited 2024 Dec. 3];2(2):18-24. Available from: https://apghn.com/index.php/journal/article/view/39