TY - JOUR
T1 - Histological, But Neither Clinical Nor Endoscopic Activity Predicts the Risk of Colectomy in Patients With Ulcerative Colitis Treated With Biologics
AU - Zhao, Mirabella
AU - Riis, Lene Buhl
AU - Lo, Bobby
AU - Attauabi, Mohamed
AU - Ovesen, Pernille Dige
AU - Wewer, Mads Damsgaard
AU - Larsen, Lone
AU - Dige, Anders
AU - Hvas, Christian Lodberg
AU - Poulsen, Anja
AU - Christiansen, Dagmar
AU - Nagras, Zainab Gassem
AU - Dahlin, Pernille
AU - Petersen, Andreas Munk
AU - Bendtsen, Flemming
AU - Seidelin, Jakob
AU - Burisch, Johan
N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2025
Y1 - 2025
N2 - BACKGROUND: Biological treatment failure is common in patients with ulcerative colitis (UC), but the predictive value of baseline histological activity is unknown.AIMS: We aimed to investigate the associations between baseline histological activity and outcomes after biological treatment in patients with UC.METHODS: Adult biological-naïve patients with UC (n = 150) were followed prospectively during biological treatment. Histological activity was assessed using the Nancy Index and Geboes score. Endoscopic activity was assessed using the Mayo Endoscopic Subscore (MES). Associations with outcomes were assessed in multivariable models. Associations between histological, endoscopic, and biochemical activity were assessed using Spearman's correlation.RESULTS: In biological-treated patients with UC, severe histological activity at baseline was independently associated with colectomy risk during the induction period (Nancy 2 vs 4: odds ratio [OR] 0.18, 95% CI 0.01-0.61, P = 0.024; Nancy 3 vs 4: OR 0.12, 95% CI 0.02-0.63, P = .019; Geboes 3 vs 5: OR 0.06, 95% CI 0.00-0.57, P = .033; Geboes 4 vs 5: OR 0.13, 95% CI 0.01-0.69, P = 0.032) and total follow-up (Nancy 2 vs 4: HR 0.23, 95% CI 0.06-0.98, P = 0.046; Nancy 3 vs 4: HR 0.13, 95% CI 0.04-0.47, P = 0.002; Geboes 4 vs 5: HR 0.28, 95% CI 0.08-0.93, P = 0.038). Meanwhile, baseline MES was not independently associated with colectomy risk. Histological activity was correlated with MES and the levels of C-reactive protein, hemoglobin, and albumin, but not calprotectin.CONCLUSIONS: Severe histological activity at baseline as characterized by a higher Nancy Index or Geboes score independently predicted colectomy risk in biological-treated UC patients, whereas MES did not. Thus, histological assessment should be encouraged before initiating biological treatment.
AB - BACKGROUND: Biological treatment failure is common in patients with ulcerative colitis (UC), but the predictive value of baseline histological activity is unknown.AIMS: We aimed to investigate the associations between baseline histological activity and outcomes after biological treatment in patients with UC.METHODS: Adult biological-naïve patients with UC (n = 150) were followed prospectively during biological treatment. Histological activity was assessed using the Nancy Index and Geboes score. Endoscopic activity was assessed using the Mayo Endoscopic Subscore (MES). Associations with outcomes were assessed in multivariable models. Associations between histological, endoscopic, and biochemical activity were assessed using Spearman's correlation.RESULTS: In biological-treated patients with UC, severe histological activity at baseline was independently associated with colectomy risk during the induction period (Nancy 2 vs 4: odds ratio [OR] 0.18, 95% CI 0.01-0.61, P = 0.024; Nancy 3 vs 4: OR 0.12, 95% CI 0.02-0.63, P = .019; Geboes 3 vs 5: OR 0.06, 95% CI 0.00-0.57, P = .033; Geboes 4 vs 5: OR 0.13, 95% CI 0.01-0.69, P = 0.032) and total follow-up (Nancy 2 vs 4: HR 0.23, 95% CI 0.06-0.98, P = 0.046; Nancy 3 vs 4: HR 0.13, 95% CI 0.04-0.47, P = 0.002; Geboes 4 vs 5: HR 0.28, 95% CI 0.08-0.93, P = 0.038). Meanwhile, baseline MES was not independently associated with colectomy risk. Histological activity was correlated with MES and the levels of C-reactive protein, hemoglobin, and albumin, but not calprotectin.CONCLUSIONS: Severe histological activity at baseline as characterized by a higher Nancy Index or Geboes score independently predicted colectomy risk in biological-treated UC patients, whereas MES did not. Thus, histological assessment should be encouraged before initiating biological treatment.
U2 - 10.1093/ibd/izae287
DO - 10.1093/ibd/izae287
M3 - Journal article
C2 - 39657037
SN - 1078-0998
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
ER -