{ "abstract": "BACKGROUND AND AIM: The incidence of ulcerative colitis (UC) has been increasing in Asia. Comprehensive data on the long-term course of moderate-to-severe UC remain scarce. This study investigated the clinical outcomes and factors associated with a disabling disease course in Korean patients with moderate-to-severe UC. METHODS: The moderate-to-severe ulcerative colitis in Korea study was a prospective, multicenter, hospital-based inception cohort study that enrolled patients with newly diagnosed moderate-to-severe UC between August 2014 and February 2017. Clinical outcomes and factors associated with a disabling disease course were evaluated over 5 years. RESULTS: Among 353 patients included, the median follow-up duration was 4.9 (interquartile range, 2.1-5.0) years, and 214 patients (60.6%) completed the 5-year follow-up. At 5 years, the cumulative rates of outcomes were clinical relapses, 62.9%; proximal disease extension, 29.5%; and UC-related hospitalization, 22.4%. Colectomy was required in two patients (0.6%), without mortality. A disabling disease course occurred in 171 patients (48.4%), with cumulative probabilities of 41.0%, 51.1%, and 53.9% at 12, 36, and 60 months, respectively. Elevated baseline white blood cell count was independently associated with a disabling disease course (adjusted hazard ratio: 1.06; 95% confidence interval: 1.00-1.12; p = 0.035). Five distinct partial Mayo score-based disease trajectory clusters were identified, demonstrating clear prognostic separation. CONCLUSIONS: While Korean patients with moderate-to-severe UC showed a benign structural disease course with minimal colectomy rates, approximately half experienced a disabling disease course. The identified disease trajectories provide a novel framework for risk stratification and personalized management.", "abstract_shown": true, "affiliations": [ "Department of Gastroenterology and Inflammatory Bowel Disease Center Asan Medical Center, University of Ulsan College of Medicine Seoul South Korea", "Department of Gastroenterology, Center for Crohn's and Colitis Kyung Hee University Hospital, Kyung Hee University College of Medicine Seoul South Korea", "Department of Internal Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul South Korea", "Department of Internal Medicine Nowon Eulji Hospital, Eulji University School of Medicine Seoul South Korea", "Department of Internal Medicine St. Vincent's Hospital, The Catholic University of Korea College of Medicine Suwon South Korea", "Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Seoul South Korea", "Department of Internal Medicine Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine Seoul South Korea", "Department of Internal Medicine Korea University, Anam Hospital, Korea University College of Medicine Seoul South Korea", "Department of Internal Medicine Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine Seoul South Korea", "Department of Internal Medicine Severance Hospital, Yonsei University College of Medicine Seoul South Korea", "Department of Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul South Korea", "Medical Affairs, Johnson & Johnson Seoul South Korea" ], "article_type": null, "arxiv": null, "author_total": 15, "authors": [ { "affs": [ 0 ], "name": "Byong Duk Ye", "orcid": "0000-0001-6647-6325" }, { "affs": [ 1 ], "name": "Hyo Jong Kim", "orcid": "0000-0002-8761-5571" }, { "affs": [ 2 ], "name": "Dongil Park", "orcid": "0000-0001-7329-1724" }, { "affs": [ 3 ], "name": "Young Sook Park" }, { "affs": [ 4 ], "name": "K M Lee" }, { "affs": [ 5 ], "name": "Jong Pil Im", "orcid": "0000-0003-1584-0160" }, { "affs": [ 6 ], "name": "Sung‐Ae Jung" }, { "affs": [ 7 ], "name": "Yoon Tae Jeen", "orcid": "0000-0003-0220-3816" }, { "affs": [ 8 ], "name": "Jae Myung Cha", "orcid": "0000-0001-9403-230X" }, { "affs": [ 9 ], "name": "Jae Hee Cheon", "orcid": "0000-0002-2282-8904" }, { "affs": [ 10 ], "name": "Sung Noh Hong", "orcid": "0000-0002-4140-3717" }, { "affs": [ 11 ], "name": "Youngdoe Kim", "orcid": "0000-0002-0772-6360" }, { "affs": [ 11 ], "name": "J Choi Choi" }, { "affs": [ 11 ], "name": "Y Lee" }, { "affs": [ 1 ], "name": "Chang Kyun Lee", "orcid": "0000-0002-4279-3825" } ], "bibtex": "https://research.draconitic.com/paper/8rpqbtf0fxxqt.bib", "cited_by": 10, "doi": "10.1111/jgh.70508", "fulltext_url": null, "id": "8rpqbtf0fxxqt", "issns": [ "0815-9319", "1440-1746" ], "landing_url": "https://doi.org/10.1111/jgh.70508", "language": "en", "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "1311|Inflammatory Bowel Disease" ] ], "openalex": "W7166537806", "pdf_url": null, "pmcid": "PMC13431926", "pmid": "42373568", "published": "2026-06-29", "publisher": "Wiley", "ris": "https://research.draconitic.com/paper/8rpqbtf0fxxqt.ris", "sources": [ { "first_seen": "2026-10-30T13:26:46Z", "native_id": "W7166537806", "source": "openalex", "url": "https://doi.org/10.1111/jgh.70508" } ], "subjects": [ { "field": "biology", "origin": "openalex:1311|Inflammatory Bowel Disease", "subfield": "genetics-genomics" } ], "title": "Five‐Year Outcomes and Disease Trajectories in Moderate‐to‐Severe Ulcerative Colitis: A Korean Multicenter Inception Cohort", "title_text": "Five‐Year Outcomes and Disease Trajectories in Moderate‐to‐Severe Ulcerative Colitis: A Korean Multicenter Inception Cohort", "type": "peer-reviewed", "updated_at": "2026-11-06T13:20:30Z", "url": "https://research.draconitic.com/paper/8rpqbtf0fxxqt", "venue": "Journal of Gastroenterology and Hepatology", "versions": [] }