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Original Article
- IBD
- Histologic healing and clinical outcomes in ulcerative colitis
- Raymond Fueng-Hin Liang, Huiyu Lin, Cora Yuk-Ping Chau, Wee Chian Lim
- Intest Res 2025;23(2):182-192. Published online September 19, 2024
- DOI: https://doi.org/10.5217/ir.2024.00058
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Abstract
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ePub - Background/Aims
Growing evidence suggests histologic healing (HH) improves clinical outcomes in ulcerative colitis (UC) patients beyond endoscopic healing (EH). We hypothesize that HH is associated with better clinical outcomes in Asian UC patients, for whom data is lacking.
Methods
We performed a retrospective study of UC patients in clinical remission (CR) with a follow-up colonoscopy and minimum 1-year follow-up post-colonoscopy. Primary outcome was clinical relapse (CRL), defined as either a Simple Clinical Colitis Activity Index score of > 2, medication escalation, hospitalization or colectomy. Predictors of CRL and HH were assessed.
Results
One hundred patients were included with a median follow-up of 22 months. At index colonoscopy, 80 patients were in EH. On follow-up, 41 patients experienced CRL. Of 80 patients in EH, 34 (42.5%) had persistent histologic activity (Nancy Index ≥ 2) and 29 (36.3%) relapsed during the follow-up period. Amongst patients in CR and EH, those with HH had lower CRL rate (26.1% vs. 50.0%, P= 0.028) and longer CRL-free survival (mean 46.1 months vs. 31.5 months, P= 0.015) than those with persistent histologic activity. On bivariable analysis of 100 patients in CR, HH, and Mayo endoscopic score (MES) of 0 were significantly associated with lower risk of CRL. On multivariable analysis, only MES 0 remained predictive of lower CRL risk.
Conclusions
Above and beyond CR and EH, achieving HH improves clinical outcomes in Asian UC patients. However, HH may not confer incremental benefit if MES 0 has been achieved. Further prospective studies evaluating the benefit of histologically guided therapeutic decisions are needed. -
Citations
Citations to this article as recorded by
- The therapeutic mechanism of bornyl acetate in alleviating ulcerative colitis by regulating the intestinal flora
Bingqing Shang, Minghui Yang, Liduan Yin, Suyuan Lv, Tong Wang, Qiu Wu, Yue Geng
Food & Function.2026; 17(3): 1500. CrossRef - KASID and Intestinal Research journal: a central academic hub for research of intestinal diseases in the Asia-Pacific region
Jae Hee Cheon, Hye Kyung Hyun, You Sun Kim, Dong Il Park, Tae Il Kim, Dong Soo Han
Intestinal Research.2026; 24(1): 6. CrossRef - Correlation between clinical and histopathological scoring systems in Egyptian patients with ulcerative colitis (single center study)
Randa Ahmed El Garhy, Faten Wagdi Ragheb, Nermine Mohamed Abd Raboh, Hagar Elessawy, Fatma S. Hafez
The Egyptian Journal of Internal Medicine.2025;[Epub] CrossRef
- The therapeutic mechanism of bornyl acetate in alleviating ulcerative colitis by regulating the intestinal flora
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