Histological Remission in Ulcerative Colitis: Under the Microscope Is the Cure
Thomas Chateau1,2, Roger Feakins3, Aude Marchal-Bressenot4
1Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, Grenoble, France.
The American Journal of Gastroenterology
|December 7, 2019
Summary
Histological remission (HR) is a new frontier in ulcerative colitis (UC) treatment, showing promise for better patient outcomes. New validated indexes aid accurate histological assessment, but further trials are needed to define HR and its disease-modifying potential.
Area of Science:
- Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Trial Design
Background:
- Therapeutic goals in ulcerative colitis (UC) are becoming more stringent.
- Histological features are reliable predictors of post-therapy disease outcomes.
- Histological remission (HR) is emerging as a critical treatment target in UC.
Purpose of the Study:
- To review the role of histology as a treatment goal in UC trials.
- To explore the correlation between symptoms, endoscopy, and histology.
- To assess the impact of HR on UC disease outcomes.
Main Methods:
- Historical perspective on UC treatment goals.
- Review of validated histological assessment indexes in the era of biologics.
- Analysis of UC trial data focusing on histological outcomes.
Main Results:
- Histological remission (HR) is associated with improved UC outcomes.
- A poor correlation exists between clinical symptoms, endoscopic findings, and histological status.
- Two new validated indexes can accurately assess histology in UC trials and practice.
Conclusions:
- Histological remission (HR) is a promising endpoint for UC treatment, linked to better disease outcomes.
- New validated indexes offer improved histological assessment accuracy.
- Further interventional trials are required to establish definitive HR definitions and disease modification potential.
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