Histological Remission in Ulcerative Colitis: Under the Microscope Is the Cure

Thomas Chateau, Roger Feakins, Aude Marchal-Bressenot, Fernando Magro, Silvio Danese, Laurent Peyrin-Biroulet

Research output: Contribution to journalArticle

Abstract

In recent years, the therapeutic goals in ulcerative colitis (UC) have become increasingly stringent. Histological features seem to be a reliable predictor of disease outcomes after therapy, and histological remission (HR) is the new frontier in the treatment of UC. Here, we first provide a historical perspective before reviewing indexes in the era of biologics; histology as a treatment goal in UC trials; the poor correlation between symptoms, endoscopy, and histology; and the impact of histology on disease outcomes. HR seems to be a promising end point for the treatment of UC because it is typically associated with better outcomes. Two new validated indexes are available to assess histology more accurately in trials, and they may also be applicable to clinical practice. Additional interventional trials are now necessary to establish definitions of HR and its potential for disease modification.

Original languageEnglish
Pages (from-to)179-189
Number of pages11
JournalThe American journal of gastroenterology
Volume115
Issue number2
DOIs
Publication statusPublished - Feb 2020

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