Acute histological inflammatory activity is associated with clinical relapse in patients with ulcerative colitis in clinical and endoscopic remission

Calafat, Margalida; Hernández-Gallego, Alba; Mañosa, Míriam; Torres, Paola; Cañete, Fiorella; Cabré, Eduard; Ojanguren, Isabel; Domènech, Eugeni

doi:10.1016/j.dld.2017.08.041

Cited by 40 publications

(26 citation statements)

References 29 publications

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“…Calafat et al 31 conducted a cohort study of 113 patients in clinical remission with an MES 1. Histologic activity, as defined by acute (neutrophilic) inflammation, was associated with clinical relapse on univariate analysis.…”

Section: Histology As a Predictor Of Clinical Outcomesmentioning

confidence: 99%

The emerging role of histologic disease activity assessment in ulcerative colitis

Pai

Jairath

Casteele

et al. 2018

Gastrointestinal Endoscopy

116

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Section: Histology As a Predictor Of Clinical Outcomesmentioning

confidence: 99%

The emerging role of histologic disease activity assessment in ulcerative colitis

Pai

Jairath

Casteele

et al. 2018

Gastrointestinal Endoscopy

116

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“…22 Several studies have demonstrated that HH is associated with improved clinical outcomes, beyond EH, and is a negative predictor of relapse and of colorectal neoplasia risk. 7,12,13,[16][17][18][19][20][21][22][23]25,48,49 In a study of 646 patients with UC, histologic normalization of colonic mucosa was associated with an increased odds of relapse-free survival compared with EH or histologic quiescence. 49 While studies of HH have largely focused on UC, in the aforementioned study of 101 patients with ileal CD in clinical remission followed for a median of 21 months, HH but not EH was associated with a decreased risk of clinical relapse, escalation of medical therapy, and corticosteroid use.…”

Section: Measures Of Inflammation and Ibd-related Hospitalizationmentioning

confidence: 99%

<p>A Novel Method for Quantifying Intestinal Inflammatory Burden in Inflammatory Bowel Disease Using Register Data</p>

Axelrad¹,

Sachs²,

Ludvigsson³

et al. 2020

CLEP

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Background: The Swedish Quality Register for Inflammatory Bowel Disease (SWIBREG) contains clinical data for the study of inflammatory bowel disease (IBD). The Epidemiology Strengthened by histoPathology Reports in Sweden (ESPRESSO) cohort was recently established for the study of gastrointestinal histopathology. We aimed to develop and validate a histology score from ESPRESSO using clinical information from SWIBREG, and secondarily, to evaluate the association of the score on IBD-related hospitalization. Methods: In a nationwide, population-based cohort study of patients with IBD during 1969-2017, we linked endoscopic inflammation in SWIBREG with histologic inflammation in ESPRESSO. We established a clinically interpretable model for predicting the endoscopic score from histology using scalable Bayesian rule lists to define a SNOMED-based histology score applicable to the ESPRESSO cohort. We also assessed the impact of baseline endoscopic and histology scores on time to IBD-related hospitalization. Results: We identified 5225 individuals with IBD comprising 11,051 endoscopic assessments in SWIBREG linked to a histopathology record in ESPRESSO. We created predictive models to calculate a SNOMED-based histology score which predicted the endoscopic score. Split-sample validated areas under the ROC curves for the score predicting a non-zero endoscopic score were 0.80 (0.78-0.81) in UC, 0.70 (0.68-0.72) in CD, and 0.76 (0.73-0.78) in IBD-U. In a subset of 2741 individuals with an initial IBD diagnosis and a corresponding record in ESPRESSO with an endoscopic assessment in SWIBREG, the baseline endoscopic and histology scores were associated with time to IBD-related hospitalization (endoscopy log-rank UC p<0.001, CD p=0.020, IBD-U p<0.001; histology log-rank UC p=0.018, CD p=0.960, IBD-U p=0.034). Conclusion: Histopathology data in ESPRESSO accurately predict endoscopic scores in SWIBREG. Baseline endoscopic and histologic scores were associated with time to IBDrelated hospitalization, particularly in UC. The SNOMED-based histology score can be used as a measure of disease activity in future register-based IBD studies.

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“…According to Calafat and colleagues, the presence of neutrophils in the epithelium was considered as a risk factor for clinical relapse in 113 asymptomatic patients affected by UC with both clinically and endoscopic remission. 43…”

Section: Definitions Of Endoscopic Transmural and Histological Healingmentioning

confidence: 99%

Can advanced endoscopic techniques for assessment of mucosal inflammation and healing approximate histology in inflammatory bowel disease?

Nardone

Cannatelli

Zardo

et al. 2019

Therap Adv Gastroenterol

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The targets of therapy in inflammatory bowel disease have transformed in the last few years. The standard definition of mucosal healing assessed using white light standard definition endoscopy is being challenged because even when endoscopy suggests mucosal healing, the presence of histological activity can often still be observed. Of note, microscopic signs of inflammation correlate with clinical outcomes such as risk of relapse, hospitalization and colorectal cancer. Therefore, histological healing has increasingly become an important target to achieve. Advanced endoscopic technologies have been developed and many are starting to be adopted in daily clinical practice. They can provide a more detailed view of the mucosal and vascular architecture almost at the histology level, including crypt, vessel architecture and cellular infiltration. So, these can provide a more accurate definition of mucosal and histological healing. In this review we focus on new advanced endoscopic techniques, and how these have the potential to reduce the gap between histological and mucosal healing.

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Acute histological inflammatory activity is associated with clinical relapse in patients with ulcerative colitis in clinical and endoscopic remission

Cited by 40 publications

References 29 publications

The emerging role of histologic disease activity assessment in ulcerative colitis

The emerging role of histologic disease activity assessment in ulcerative colitis

<p>A Novel Method for Quantifying Intestinal Inflammatory Burden in Inflammatory Bowel Disease Using Register Data</p>

Can advanced endoscopic techniques for assessment of mucosal inflammation and healing approximate histology in inflammatory bowel disease?

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