Treatment Targets in Ulcerative Colitis: Is It Time for All In, including Histology?

Journal of Clinical Medicine

Gustavo Drügg Hahn¹  Panu Wetwittayakhlang¹  Peter L. Lakatos¹  Petra A. Golovics¹  Talat Bessissow¹  Livia Lontai²  Lorant Gonczi² 

[1] Division of Gastroenterology, McGill University Health Center, Montreal, QC H3G 1A4, Canada;First Department of Medicine, Semmelweis University, H-1083 Budapest, Hungary;

关键词: treat to target;    treatment target;    ulcerative colitis;    mucosal healing;    inflammatory bowel diseases;    histological remission;   

DOI  :  10.3390/jcm10235551

来源: DOAJ

【 摘 要 】

The main therapeutic goal of ulcerative colitis (UC) is to induce and maintain remission to prevent long-term disease progression. Treat-to-target strategies, first introduced by the STRIDE consensus and updated in 2021, have shifted focus from symptomatic control toward more stringent objective endpoints. Today, patient monitoring should be based on a combination of biomarkers and clinical scores, while patient-reported outcomes could be used as short-term targets in monitoring disease activity and therapeutic response. In addition, endoscopic healing was the preferred long-term goal in UC. A Mayo endoscopic score (MES) ≤ 1 can be recommended as a minimum target. However, recent evidence suggests that more stringent endoscopic goals (MES of 0) are associated with superior outcomes. Recently, emerging data support that histological remission (HR) is a superior prognostic factor to endoscopic healing in predicting long-term remission. Despite not yet being recommended as a target, HR may become an important potential therapeutic goal in UC. However, it remains questionable if histological healing should be used as a routine assessment in addition to clinical, biomarker, and endoscopic targets in all patients. Therefore, in this review, our aim was to discuss the current evidence for the different treatment targets and their value in everyday clinical practice.

【 授权许可】

Unknown