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Peer-reviewedCC BY-NCJournal of Gastroenterology and Hepatology

Five‐Year Outcomes and Disease Trajectories in Moderate‐to‐Severe Ulcerative Colitis: A Korean Multicenter Inception Cohort

  • Byong Duk Ye1
  • Hyo Jong Kim2
  • Dongil Park3
  • Young Sook Park4
  • K M Lee5
  • Jong Pil Im6
  • Sung‐Ae Jung7
  • Yoon Tae Jeen8
  • Jae Myung Cha9
  • Jae Hee Cheon10
  • Sung Noh Hong11
  • Youngdoe Kim12
3 more authors
  • J Choi Choi12
  • Y Lee12
  • Chang Kyun Lee2
12 affiliations
  1. 1Department of Gastroenterology and Inflammatory Bowel Disease Center Asan Medical Center, University of Ulsan College of Medicine Seoul South Korea
  2. 2Department of Gastroenterology, Center for Crohn's and Colitis Kyung Hee University Hospital, Kyung Hee University College of Medicine Seoul South Korea
  3. 3Department of Internal Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul South Korea
  4. 4Department of Internal Medicine Nowon Eulji Hospital, Eulji University School of Medicine Seoul South Korea
  5. 5Department of Internal Medicine St. Vincent's Hospital, The Catholic University of Korea College of Medicine Suwon South Korea
  6. 6Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Seoul South Korea
  7. 7Department of Internal Medicine Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine Seoul South Korea
  8. 8Department of Internal Medicine Korea University, Anam Hospital, Korea University College of Medicine Seoul South Korea
  9. 9Department of Internal Medicine Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine Seoul South Korea
  10. 10Department of Internal Medicine Severance Hospital, Yonsei University College of Medicine Seoul South Korea
  11. 11Department of Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul South Korea
  12. 12Medical Affairs, Johnson & Johnson Seoul South Korea
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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.

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Cite

BibTeXRIS
BibTeX
@article{ye2026fiveyear,
  title = {{Five‐Year Outcomes and Disease Trajectories in Moderate‐to‐Severe Ulcerative Colitis: A Korean Multicenter Inception Cohort}},
  author = {Byong Duk Ye and Hyo Jong Kim and Dongil Park and Young Sook Park and K M Lee and Jong Pil Im and Sung‐Ae Jung and Yoon Tae Jeen and Jae Myung Cha and Jae Hee Cheon and Sung Noh Hong and Youngdoe Kim and J Choi Choi and Y Lee and Chang Kyun Lee},
  journal = {Journal of Gastroenterology and Hepatology},
  year = {2026},
  month = jun,
  doi = {10.1111/jgh.70508},
  url = {https://doi.org/10.1111/jgh.70508},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Five‐Year Outcomes and Disease Trajectories in Moderate‐to‐Severe Ulcerative Colitis: A Korean Multicenter Inception Cohort
AU  - Byong Duk Ye
AU  - Hyo Jong Kim
AU  - Dongil Park
AU  - Young Sook Park
AU  - K M Lee
AU  - Jong Pil Im
AU  - Sung‐Ae Jung
AU  - Yoon Tae Jeen
AU  - Jae Myung Cha
AU  - Jae Hee Cheon
AU  - Sung Noh Hong
AU  - Youngdoe Kim
AU  - J Choi Choi
AU  - Y Lee
AU  - Chang Kyun Lee
PY  - 2026
DA  - 2026/06/29
JO  - Journal of Gastroenterology and Hepatology
DO  - 10.1111/jgh.70508
UR  - https://doi.org/10.1111/jgh.70508
AB  - 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.
SN  - 0815-9319
SN  - 1440-1746
ER  -