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"Mucosal healing" in ulcerative colitis: Between clinical evidence and market suggestion
Cristiano Pagnini1, Francesca Menasci1, Stefano Festa1
1Cristiano Pagnini, Francesca Menasci, Stefano Festa, Gianenrico Rizzatti, Gianfranco Delle Fave, "Sapienza" University of Rome, Faculty of Medicine and Psychology, S. Andrea Hospital, 00189 Rome, Italy.
Abstract:
In recent decades, the prominent role of endoscopy in the management of ulcerative colitis (UC) has been translated into the concept of mucosal healing (MH) as a fundamental therapeutic end-point. This is partially the consequence of growing evidence of a positive prognostic role of MH on the disease course and partially due to market cues indicating a higher rate of MH in patients treated by novel potent biologic agents. The aim of the present review is to clarify the current knowledge of MH in UC, analyzing the definition, the putative prognostic role and the association of MH with the current drugs used to treat UC patients. Because solid data about the management of UC patients based solely on the healing of the mucosa are not yet available, a tailored approach for individual patients thatconsiders the natural history of UC and the presence of prognostic indicators of aggressive disease is desirable. Consequently, unnecessary examinations and treatment would be avoided and restricted to UC patients who require the maximum amount of effort to affect the disease course in the short and long term.
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