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Histologic remission does not offer additional benefit for ulcerative colitis patients in endoscopic remission
Neeraj Narula1, Achuthan Aruljothy1, Abdul-Aziz Alshahrani1,2
1Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
Alimentary Pharmacology & Therapeutics
|November 1, 2020
Summary
Achieving histologic remission does not extend the time to relapse for ulcerative colitis patients already in endoscopic remission. Endoscopic remission alone appears sufficient for maintaining clinical stability in this patient group.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Inflammatory Bowel Disease Research
Background:
- Histologic remission may correlate with better outcomes in ulcerative colitis (UC).
- The added benefit of histologic remission in UC patients already achieving endoscopic remission remains unclear.
Purpose of the Study:
- To investigate the association between histologic activity and time to relapse in UC patients with established endoscopic remission.
Main Methods:
- Retrospective analysis of an observational database.
- Identified UC patients with endoscopic remission (Mayo endoscopic subscore 0).
- Assessed histologic activity (normal, inactive, active) and analyzed time to relapse using Cox proportional hazards models.
Main Results:
- No significant difference in time to relapse was observed between patients with and without histologic activity (P = 0.85).
- Histologic activity did not impact time to clinical relapse compared to inactive colitis (AHR 1.17, P = 0.67).
- Factors associated with reduced time to relapse included 5-aminosalicylate use, pancolitis, left-sided colitis, and older age.
Conclusions:
- Histologic remission does not provide additional benefit regarding time to relapse in UC patients who have achieved endoscopic remission.
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