The Ulcerative Colitis Endoscopic Index of Severity (UCEIS) is useful to evaluate endoscopic activity of ulcerative colitis patients treated with tacrolimus

Background: Various scoring systems have been used to assess mucosal healing in ulcerative colitis (UC). The UC Endoscopic Index of Severity (UCIES) is a newly developed scoring system. The score of UCEIS consists of vascular pattern, bleeding, and erosions and ulcers and ranges from 3 (remission) to 11 (severe). Aim: To evaluate usefulness of the UCEIS in UC patients treated with tacrolimus. Methods: We used the UCEIS to evaluate endoscopic activity of UC patients treated with tacrolimus. Results: The average UCEIS score was 8.6 (range: 5-11) before treatment. At 3-6 months after initiating tacrolimus, the UCEIS scores were 3-4 in 20 patients (38.5%), 5-6 in 7 patients (13.5%), 7-8 in 19 patients (36.5%), and >=9 in 6 patients (11.5%). Importantly, patients with UCEIS scores of 3-4 had a significantly higher rate of medium-term event-free survival, defined as no requirement of either colectomy or other induction therapy, compared with those with UCEIS scores >= 5. Conclusions: The UCEIS is useful to evaluate endoscopic improvement in UC patients treated with tacrolimus. The UCEIS score of 3 or 4 after treatment is associated with a favorable medium-term outcome. Thus, the UCEIS is a useful instrument to evaluate UC patients on tacrolimus.