Mucosal healing as a treatment target for ulcerative colitis is of growing interest because it is associated with improved clinical outcomes.
However, the feasibility and probability of reaching mucosal healing in clinical practice is unknown.
Dr Guillaume Bouguen and colleagues therefore evaluated the feasibility of "treating to target" according to endoscopic findings to reach mucosal healing.
All endoscopic outcomes of patients with ulcerative colitis followed in a single inflammatory bowel disease unit from 2011 to 2012 were reviewed and subsequent therapeutic management.
Cumulative incidence of mucosal healing and histologic healing were estimated using a Kaplan-Meier method.
|The probability of mucosal healing was 70% at 76 weeks|
|Inflammatory Bowel Diseases|
A total of 60 patients underwent at least 2 consecutive endoscopic assessments, of whom 45 and 48 patients had endoscopic and histologic evidence of active disease, respectively.
After a median follow-up of 76 weeks, 60% of patients with endoscopic disease activity at baseline achieved mucosal healing, and 50% of patients with histologic disease activity at baseline had histologic healing.
The team found that the cumulative probabilities of mucosal healing were 26%, 52%, and 70% at 26, 52, and 76 weeks, respectively.
The cumulative probabilities of histologic healing at weeks 26, 52, and 76 from the time of initial procedure were 19%, 41%, and 57%, respectively.
Any adjustment in medical therapy in case of persistent endoscopic activity was associated with both mucosal healing and histologic healing.
Dr Bouguen's team concludes, "Repeated assessment of endoscopic disease activity with adjustment of medical therapy to the target of mucosal healing is feasible in clinical practice in patients with ulcerative colitis, and seems to be of benefit."