TY - JOUR
T1 - Histologic assessments in ulcerative colitis
T2 - the evidence behind a new endpoint in clinical trials
AU - Pai, Rish K.
AU - D’Haens, Geert
AU - Kobayashi, Taku
AU - Sands, Bruce E.
AU - Travis, Simon
AU - Jairath, Vipul
AU - De Hertogh, Gert
AU - Park, Bomina
AU - McGinnis, Kim
AU - Redondo, Isabel
AU - Lipitz, Nicole G.
AU - Gibble, Theresa Hunter
AU - Magro, Fernando
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2024
Y1 - 2024
N2 - Introduction: Treatment goals for ulcerative colitis (UC) are evolving from the achievement of clinical remission to more rigorous goals defined by endoscopic and histologic healing. Achievement of deeper remission targets aims to reduce the risk of colectomy, hospitalizations, and colorectal cancer. Areas covered: This review covers histologic assessments, histologic remission as a clinical trial endpoint, and the association between histologic disease activity and clinical outcomes. Future directions are also discussed, including the use of advanced imaging and artificial intelligence technologies, as well as potential future treatment targets beyond histologic remission. Expert opinion: Histologic assessments are used for their sensitivity in measuring mucosal inflammatory changes in UC. Due to correlation with disease activity, histologic assessments may support clinical decision-making regarding treatment decisions as such assessments can be associated with rates of clinical relapse, hospitalization, colectomy, and neoplasia. While histologic remission is limited by varying definitions and multiple histologic indices, work is ongoing to create a consensus on the use of histologic assessments in clinical trials. As research advances, aspirational targets beyond histologic remission, such as molecular healing and disease clearance, are being explored.
AB - Introduction: Treatment goals for ulcerative colitis (UC) are evolving from the achievement of clinical remission to more rigorous goals defined by endoscopic and histologic healing. Achievement of deeper remission targets aims to reduce the risk of colectomy, hospitalizations, and colorectal cancer. Areas covered: This review covers histologic assessments, histologic remission as a clinical trial endpoint, and the association between histologic disease activity and clinical outcomes. Future directions are also discussed, including the use of advanced imaging and artificial intelligence technologies, as well as potential future treatment targets beyond histologic remission. Expert opinion: Histologic assessments are used for their sensitivity in measuring mucosal inflammatory changes in UC. Due to correlation with disease activity, histologic assessments may support clinical decision-making regarding treatment decisions as such assessments can be associated with rates of clinical relapse, hospitalization, colectomy, and neoplasia. While histologic remission is limited by varying definitions and multiple histologic indices, work is ongoing to create a consensus on the use of histologic assessments in clinical trials. As research advances, aspirational targets beyond histologic remission, such as molecular healing and disease clearance, are being explored.
KW - Ulcerative colitis
KW - clinical trial endpoints
KW - endoscopic remission
KW - histologic healing
KW - histologic remission
KW - inflammatory bowel diseases
KW - mucosal healing
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U2 - 10.1080/17474124.2024.2326838
DO - 10.1080/17474124.2024.2326838
M3 - Review article
C2 - 38509826
AN - SCOPUS:85188468304
SN - 1747-4124
VL - 18
SP - 73
EP - 87
JO - Expert Review of Gastroenterology and Hepatology
JF - Expert Review of Gastroenterology and Hepatology
IS - 1-3
ER -