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Published on: August 26, 2014
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Long-Term Clinical Outcomes of Ulcerative Colitis with Concurrent Endoscopic and Histologic Remission
Ji Min Lee1, Kang-Moon Lee1, Dae Bum Kim1
1Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea.
Medicina (Kaunas, Lithuania)
|November 27, 2025
Summary
Nearly a quarter of ulcerative colitis patients achieving endoscopic and histologic remission relapsed within four years. This suggests dual remission alone may not predict long-term outcomes, necessitating further prognostic factors for ulcerative colitis management.
Area of Science:
- Gastroenterology and Hepatology
- Inflammatory Bowel Disease Research
- Clinical Outcomes and Prognostics
Background:
- Therapeutic goals for ulcerative colitis (UC) now include mucosal and histological healing, extending beyond symptom control.
- The long-term prognostic significance of achieving both endoscopic and histological remission in UC is not well-established, especially in Asian populations.
Purpose of the Study:
- To assess long-term outcomes in ulcerative colitis (UC) patients who achieved both endoscopic and histological remission.
- To identify predictors of relapse in UC patients who attained dual remission.
Main Methods:
- Prospective observational study of 41 adult UC patients achieving endoscopic (Mayo score 0) and histological (Nancy index ≤1) remission.
- Data collected included demographics, clinical factors, and fecal calprotectin.
- Patients were followed for a median of 55 months; relapse defined by Mayo score increase or new systemic therapy initiation. Relapse risk analyzed using Kaplan-Meier and Cox regression.
Main Results:
- 24.4% of patients relapsed within 4 years, with cumulative relapse rates reaching 24.1% at 48 months.
- Higher relapse rates were observed in patients with non-E1 disease extent (E2+E3), and prior use of immunomodulators or biologics.
- Immunomodulator and biologic use were significant predictors of relapse (HR 4.7-4.9); baseline fecal calprotectin was not statistically significant.
Conclusions:
- Dual endoscopic and histological remission in UC does not guarantee long-term stability, with approximately one-quarter relapsing within four years.
- Current dual remission targets may be insufficient as sole endpoints, highlighting the need for additional prognostic indicators.
- Patients with extensive disease or prior advanced therapy exposure represent high-risk subgroups requiring closer monitoring and personalized management strategies.
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