Histological remission predicts relapse-free survival in ulcerative colitis

Histological grade is an important prognostic marker in ulcerative colitis patients in clinical and endoscopic remission. Histological remission independently predicts significantly longer relapse-free survival and, thus, may be a superior therapeutic target compared with endoscopic remission.

These were the main conclusions drawn from a single-centre study that aimed to assess histological activity using the validated Nancy histological activity score as a predictor of future relapse [1]. Enrolled were 74 ulcerative colitis patients in both clinical and endoscopic remission attending a tertiary centre in Canberra, Australia, between 2015 and 2018. Clinical remission was defined as partial Mayo score (MSp) <2, and endoscopic remission was defined as Mayo Endoscopic Subscore (MES) ≤1. Median follow-up was 42 months, the median relapse free period 30 months.

Patients with MES 0 (P=0.02) and histological remission (P≤0.0001) had a significantly longer relapse free survival. Multivariate analysis showed that histological activity was the only independent risk factor of future clinical relapse (HR 4.36, 95% CI 1.68-11.27; P=0.002). The authors added that long-term prospective studies will need to determine whether histological remission improves clinical and patient-reported outcomes.

1. Wang H, et al. ECCO 2019, DOP68.

Posted on 9 May, 20199 April, 2024