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Histology Grade Is Independently Associated With Relapse Risk in Patients With Ulcerative Colitis in Clinical
Talia Zenlea1, Eric U Yee2, Laura Rosenberg1
1Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, Massachusetts, USA.
The American Journal of Gastroenterology
|March 16, 2016
Summary
Histologic grade, not endoscopic score, strongly predicts ulcerative colitis relapse in patients in remission. This finding suggests histology is crucial for assessing future clinical relapse risk and guiding UC therapy.
Area of Science:
- Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Trial Analysis
Background:
- Inflammation is linked to ulcerative colitis (UC) relapse risk in patients achieving clinical remission.
- Predicting relapse is crucial for managing UC and preventing complications.
Purpose of the Study:
- To compare the predictive power of endoscopic and histologic grades for clinical relapse in UC patients in remission.
Main Methods:
- Prospective observational cohort study of 179 UC patients in clinical remission.
- Collected baseline Mayo endoscopic scores, Geboes histology grades, and blood markers.
- Followed patients for 12 months, assessing relapse using clinical indices.
Main Results:
- Clinical relapse occurred in 23% of patients over 12 months.
- Geboes histology grade (P=0.006) was a significant predictor of relapse in multivariate analysis, unlike the Mayo score.
- Patients with a baseline Geboes grade ≥3.1 had a 3.5-fold increased risk of relapse (P<0.0001).
Conclusions:
- Histologic grade is the strongest predictor of clinical relapse in UC patients in remission.
- Histology should be considered as an endpoint for evaluating UC therapies.
- Patients achieving clinical, endoscopic, and histological remission had a low relapse rate (7%).
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