Histology Grade Is Independently Associated With Relapse Risk in Patients With Ulcerative Colitis in Clinical Remission: A Prospective Study

Abstract

Histology grade has the strongest association with the risk of clinical relapse in patients with UC who are in clinical remission. Consideration should be given to including this end point in evaluating therapy for UC.

Leucine-rich Alpha-2 Glycoprotein is a Serum Biomarker of Mucosal Healing in Ulcerative Colitis

“…Histological analysis was performed for biopsy samples where Matts’ grading was determined, and the pathologist, EM, performed central analysis using Geboes grade 22 ; the grade of < 3.1 was defined as histological healing. 23 …”

Accuracy of Faecal Calprotectin and Neutrophil Gelatinase B-associated Lipocalin in Evaluating Subclinical Inflammation in UlceRaTIVE Colitis—the ACERTIVE study

“…Histological remission is a clinically relevant end-point that must be taken into consideration, as histological inflammation may be a better predictor of clinical relapses than endoscopic lesions in UC 5 . Moreover, and in the particular case of patients in clinical remission, the histology grade has the strongest association with the risk of clinical relapse 31 .…”

“…However, these studies have not included the histological assessment of the patients. Given the importance of the histological remission as a primary end-point in UC, particularly in the case of patients considered to be in clinical remission 5,31 , we believe that our study offers a more inclusive approach of the FC usefulness in asymptomatic patients.…”

Endoscopic evaluation in diagnosis and management of inflammatory bowel disease

“…Histological remission is not yet a routinely sought objective in the management of IBD[77], however histological remission better predicts need for hospitisation and corticosteroid use in patients with UC compared to endoscopic remission[78]. A recent prospective study of 179 patients with UC in clinical remission, revealed an association between baseline histology grade and risk of clinical relapse[79]. Patients with an elevated histological grade (Geboes[80] grade ≥ 3.1) at baseline had a relative risk of clinical relapse, over 12 mo follow-up, of 3.5 (95%CI: 1.9-6.4, P < 0.0001)[79].…”

“…A recent prospective study of 179 patients with UC in clinical remission, revealed an association between baseline histology grade and risk of clinical relapse[79]. Patients with an elevated histological grade (Geboes[80] grade ≥ 3.1) at baseline had a relative risk of clinical relapse, over 12 mo follow-up, of 3.5 (95%CI: 1.9-6.4, P < 0.0001)[79]. To aid assessment of histological disease activity in patients with IBD, there needs to be close co-operation between endoscopists and histopathologists[81].…”